瘢痕子宫再次妊娠合并妊娠期糖尿病对母婴结局的影响

Impact of Combined Gestational Diabetes Mellitus in Second Pregnancy with Scarred Uterus on Maternal and Infant Outcomes

目的研究瘢痕子宫再次妊娠合并妊娠期糖尿病对母婴结局的影响。方法择取2020年1月—2021年12月在福建省厦门市妇幼保健院就诊的80例瘢痕子宫再次妊娠患者,按照是否合并妊娠期糖尿病进行分组,对照组为未合并妊娠期糖尿病患者40例,观察组则为合并妊娠期糖尿病的患者40例。对比两组的母婴结局。结果观察组的瘢痕厚度小于对照组,糖尿病家族史比例多于对照组,空腹血糖、餐后2 h血糖、糖化血红蛋白水平均高于对照组,差异有统计学意义(P<0.05);观察组分娩孕周短于对照组,剖宫产率、产褥感染发生率高于对照组,产程时间、出血量数据均多于对照组,差异有统计学意义(P<0.05)。相较于对照组,观察组胎儿窘迫、新生儿窒息、新生儿肺炎的发生率均更高,Apgar评分亦更低,新生儿体质量则更高,差异有统计学意义(P<0.05)。结论瘢痕子宫再次妊娠合并妊娠期糖尿病患者的母婴结局较差,因此在产前应重点监测血糖变化并实施针对性的干预,以获得良好的母婴结局。

Objective To study the effect of gestational diabetes on maternal and infant outcomes in the second pregnancy with scarred uterus.Methods A total of 80 patients with scarred uterus and gestational diabetes were admitted to Xiamen Maternal and Child Health Hospital between January 2020 and December 2021.The control group consisted of 40 patients without gestational diabetes mellitus and the observation group consisted of 40 patients with gestational diabetes mellitus.The maternal and infant outcomes of the two groups were compared.Results The scar thickness of observation group was lower than that of control group,the proportion of family history of diabetes was higher than that of control group,the levels of fasting blood glucose,2 h postmeal blood glucose and glycated hemoglobin were higher than those of control group,and the difference was statistically significant(P<0.05).The gestational week of delivery in observation group was shorter than that in control group,the cesarean section rate and incidence of puerperal infection were higher than those in control group,and the data of labor time and blood loss were higher than those in control group,the difference was statistically significant(P<0.05).In the observation group,the incidence of fetal distress,neonatal asphyxia,neonatal pneumonia were higher than the control group,Apgar score was lower than the control group,and neonatal weight was higher than the control group,the difference was statistically significant(P<0.05).Conclusion The maternal and infant outcomes in patients with scarred uterus with combined gestational diabetes mellitus are poor,so the focus should be on monitoring the glycemic changes and implementing targeted interventions before delivery to obtain good maternal and infant outcomes.