妊娠期糖尿病择期剖宫产前羊膜腔穿刺注射地塞米松对新生儿的影响

Effect of Amniocentesis Injection of Dexamethasone on Newborns before Elective Cesarean Section

目的研究分析妊娠期糖尿病择期剖宫产前羊膜腔穿刺注射地塞米松对新生儿的影响。方法选取2018年12月—2019年12月期间于该院收治的90例剖宫产分娩的妊娠期糖尿病产妇为研究对象,并按照双色球分组法将产妇分为观察组与常规组,每组45例。常规组辅助产妇产前进行常规检查、常规干预,观察组在产前给予小剂量地塞米松羊膜腔穿刺注射,在两组分娩后,采用统计学方法比较两组产妇与新生儿的情况。结果两组产妇用药前的空腹血糖以及餐后血糖浓度比较,差异无统计学意义(P>0.05);观察组产妇用药后的空腹血糖与常规组比较差异无统计学意义(P>0.05),但餐后血糖水平明显升高,高于常规组,差异有统计学意义(P<0.05)。两组新生儿并发症发生率(胎儿窘迫、新生儿呼吸窘迫综合征、高胆红素血症、新生儿感染、低血糖)比较,差异无统计学意义(P>0.05)。结论妊娠期糖尿病择期剖宫产产妇产前应用小剂量地塞米松羊膜腔穿刺注射,对新生儿结局无明显影响,但对产妇血糖水平有轻微影响,所以对于这一类产妇是否需要给予地塞米松注射促进胎儿肺成熟,临床还需斟酌。

Objective To study and analyze the effect of dexamethasone injection on neonates by amniocentesis before elective cesarean section for gestational diabetes.Methods 90 cases of gestational diabetic women who were delivered by cesarean section in the hospital from December 2018 to December 2019 were selected as the research objects,and the women were divided into observation group and routine group according to the two-color ball grouping method.There were 45 parturients in each group.The routine group assisted the parturients to perform routine examinations and routine interventions before delivery.The observation group was given a small dose of dexamethasone amniocentesis injections before delivery.After the two-component delivery,statistical methods were used to compare the conditions of the mothers and newborns between the two groups.Results There was no statistically significant difference in fasting blood glucose before medication and postprandial blood glucose concentration between the two groups of parturients(P>0.05);there was not statistically significant difference in fasting blood glucose between the observation group and the routine group after medication(P>0.05),but the blood glucose level after meal was higher than the conventional group,the difference was statistically significant(P<0.05).There was not statistically significant difference in the incidence of neonatal complications(fetal distress,neonatal respiratory distress syndrome,hyperbilirubinemia,neonatal infection,hypoglycemia)between the two groups(P>0.05).Conclusion Prenatal application of low-dose dexamethasone amniocentesis in women with gestational diabetes during elective cesarean section has no significant effect on neonatal outcome,but has a slight effect on maternal blood glucose levels.Therefore,whether this type of parturient needs to be given dexamethasone injection to promote fetal lung maturity,clinically still needs to be considered.