论文部分内容阅读
目的探讨妊娠期糖代谢监测在妊娠相关并发症及胎儿窘迫等不良事件防预中的价值。方法回顾性分析2014年2月-2015年2月于松桃县人民医院建档行定期产前检查的124例孕周为24~28周的孕妇临床资料,根据其妊娠期葡萄糖筛查试验(GCT)、口服葡萄糖耐量试验(OGTT)检测结果分为妊娠期糖代谢异常组(研究组,n=48)和妊娠期糖代谢正常组(对照组,n=76)。观察对比两组孕妇妊娠结局(剖宫产率、早产率、产后出血率、羊水过多率、羊水过少率、子痫前期率、胎膜早破率、妊高症率)及胎儿结局(Apgar评分、巨大儿率、胎儿宫内窘迫率、新生儿窒息率、高胆红素血症率、低血糖率、湿肺率)差异。结果两组孕妇除羊水过多、羊水过少、子痫前期等发生率比较差异无统计学意义(P>0.05)外,研究组剖宫产、早产、产后出血、胎膜早破、妊高症等发生率明显高于对照组(41.7%、39.6%、35.4%、14.6%、18.8%vs.17.1%、11.8%、14.5%、3.9%、5.3%,均P<0.05)。研究组新生儿出生后第1 min和第5 min时Apgar评分均明显低于对照组[(8.6±0.2)分、(9.1±0.2)分vs.(9.6±0.3)分、(9.8±0.2)分,均P<0.05];两组胎儿除高胆红素血症、低血糖、新生儿窒息、湿肺等发生率比较差异无统计学意义(P>0.05)外,研究组巨大儿、胎儿宫内窘迫、早产儿等发生率明显高于对照组(18.8%、12.5%、39.6%vs.5.3%、2.6%、11.8%,均P<0.05)。结论妊娠期糖代谢异常可增加母婴不良结局风险,积极有效的早期糖代谢监测对调控母体孕期糖代谢状态、降低相关妊娠期并发症和胎儿不良结局发生率等有利。
Objective To investigate the value of monitoring glucose metabolism during pregnancy in prevention of adverse events such as pregnancy-related complications and fetal distress. Methods The clinical data of 124 pregnant women with gestational weeks of 24 to 28 weeks from 2014 to February 2015 in Songtong County People’s Hospital were retrospectively analyzed. According to their gestational glucose screening test ( GCT) and oral glucose tolerance test (OGTT) were divided into abnormal glucose metabolism group (study group, n = 48) and normal glucose metabolism group during pregnancy (control group, n = 76). The pregnancy outcomes (cesarean section rate, premature delivery rate, postpartum hemorrhage rate, polyhydramnios, oligohydramnios, preeclampsia, premature rupture of membranes and pregnancy induced hypertension) and fetal outcome Apgar score, macrosomia, fetal distress rate, neonatal asphyxia, hyperbilirubinemia, hypoglycemia, wet lung rate). Results Except for the presence of amniotic fluid, oligohydramnios and preeclampsia, there was no significant difference between the two groups (P> 0.05). In the study group, cesarean section, premature labor, postpartum hemorrhage, premature rupture of membranes, The incidence of disease was significantly higher than that of the control group (41.7%, 39.6%, 35.4%, 14.6%, 18.8% vs.17.1%, 11.8%, 14.5%, 3.9%, 5.3%, all P <0.05). The Apgar scores at the first minute and fifth minute after birth in the study group were significantly lower than those in the control group (8.6 ± 0.2), (9.1 ± 0.2) vs. (9.6 ± 0.3), (9.8 ± 0.2) Points, all P <0.05]. Except for the incidence of hyperbilirubinemia, hypoglycemia, neonatal asphyxia and wet lung in the two groups, there was no significant difference between the two groups (P> 0.05) The incidence of intrauterine distress, premature children was significantly higher than that of the control group (18.8%, 12.5%, 39.6% vs 5.3%, 2.6%, 11.8%, both P <0.05). Conclusions Abnormal glucose metabolism during pregnancy may increase the risk of maternal and infant adverse outcomes. The positive and effective monitoring of early glucose metabolism may be beneficial to the regulation of glycometabolism during maternal pregnancy, the reduction of complications related to pregnancy and the incidence of fetal adverse outcomes.