摘要
目的探讨脐动脉血流监测在妊娠期糖尿病孕妇中的临床意义。方法选择妊娠期糖尿病（GDM）患者102例，随机选择同期分娩的正常孕妇105名为对照组，常规进行脐动脉血流速率在收缩期末和舒张期末的比值（S／O）、搏动指数与阻力指数测定。比较两组脐动脉血流值，并随访两组分娩结局。结果（1）在GDM组中S／D值、搏动指数及阻力指数分别为2．55±0．52、1．03±0．23、0．59±0．68，对照组上述指标分别是2．11±0．22、0．81±0．13、0．52±0．47，两组比较差异均有统计学意义（均P〈0．01）。（2）在GDM组胎膜早破、产后出血、巨大儿、围产儿预后不良发生率分别为12．7％（13／102）、7．8％（8／102）及17．7％（17／102）、12．7％（13／102），对照组上述指标分别为1．9％（2／105）、1．9％（2／105）、6．7％（7／105）及1．9％（2／105），两组比较差异均有统计学意义（均P〈0．05）。（3）在GDM组S／Dt〉2．5孕妇（47例）中的早产、胎膜早破、胎盘异常、脐带异常、围产儿不良预后发生率分别为36．2％（17／47）、21．3％（10／47）、17．0％（8／47）、55．3％（26／47）及21．3％（10／47），S／D〈2．5组上述指标分别为12．7％（7／55）、3．6％（2／55）、1．8％（1／55）、7．3％（4／55）及3．6％（2／55），两者比较差异均有统计学意义（P〈0．05）。结论在GDM孕妇中进行脐动脉血流监测，是了解胎盘功能、预测围产儿预后一种敏感、有效的监护手段，当S／D≥2．5时，要警惕胎儿缺氧等不良围产儿结局的发生。
Objective To investigate the clinical significance of ultrasonic umbilical artery flow analysis in pregnancy with gestational diabetes mellitus （GDM）. Methods Ultrasonic Doppler umbilical artery blood flowmeter was used to detect the systolic/diastolic blood pressure （S/D） ratio, pulse index, and resistance index of umbilical artery in 102 GDM women, aged （ 29 ± 4 ）, and 105 aged-matched normal pregnant women. The delivering and perinatal outcomes were observed. Results The S/D ratio, pulse index, and resistance index of the GDM women were 2.55± 0. 52, 1.03 ± 0. 23, and 0.59± 0. 68 respectively, all significantly higher than those of the control group （2.11 ±0.22, 0.81 ±0.13, and 0.52 ±0. 47 respectively, all P 〈 0. 01. The rates of premature rupture of fetal membrane, postpartum hemorrhage, fetal macrosomia, and bad outcome of perinatal infant in the GDM group were 12.7%, 7.8%, 17.7%, and 12.7% respectively, all significantly higher than those in the control group （ 1.9%, 1.9%, 6.7%, and 1.9%, all P 〈 0.05 ）. The rates of premature labor, premature rupture of fetal membrane, postpartum hemorrhage, fetal macrosomia, and bad outcome of perinatal infant of the GDM women with the S/D. S/D≥2.5 （n =47） were 36.2%, 21. 3%, 17.0%, 55. 3%, and 21.3% respectively, all significantly higher than those of the GDM women with the S/D 〈 2.5 （ n = 55 ） 12.7%, 3.6%, 1.8%, 7.3% and 3.6%, （ all P 〈 0.05 ）. Conclusion Ultrasonic umbilical artery flow analysis in pregnancy with GDM is a good method to forecast the placenta function and perinatal outcomes. The poor perinatal outcome is associated with the S/D≥2.5 in GDM.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2008年第5期317-319,共3页
National Medical Journal of China
基金
浙江医学重点建设学科基金资助项目（产科学07-008）
关键词
妊娠
糖尿病
脐动脉
预后
Pregnancy
Gestational diabetes mellitus
Umbilical arteries
Perinatal
