终止妊娠时机对妊娠期糖尿病妊娠结局的影响

摘要

目的：探讨终止妊娠时间对妊娠期糖尿病患者妊娠结局的影响，为临床治疗提供相应依据。方法回顾性分析我院2011年9月～2013年9月502例GDM患者，将患者按终止妊娠时间分为A、B、C组，A组125例患者37～38周；B组255例患者38～40周；C组122例患者40周以后。比较三组GDM患者并发症发生率以及围生儿结局。结果三组患者血糖控制良好，剖宫产率无明显差异（P＞0.05）。A、B组间妊娠期并发症比较无明显差异（P＞0.05），C组妊娠期高血压、羊水过多、胎儿窘迫发生率则显著性升高（P＜0.05）。C组巨大儿发生率显著升高（P＜0.05），三组患者FGR、NRDS、新生儿畸形、新生儿窒息、新生儿低血糖发生率方面无显著性差异。结论妊娠期严格控制血糖可以改善GDM患者的妊娠结局，血糖控制良好的GDM患者选择在38～40周终止妊娠可以降低母婴并发症。%Objective To explore the effect of termination of pregnancy in different periods on pregnancy outcomes in gestational diabetes,to provide corresponding basis for clinical treatment. Methods Clinical data of 502 cases with gestational diabetes between September 2011 and September 2013 were analyzed retrospectively, patients were divided into A,B,C groups according to the time of termination of pregnancy,A group of 125 patients,37 ~ 38 gestational weeks; Group B 255 cases,38-40 gestational weeks;C group of 122 patients,40 weeks after gestational weeks.The incidences of maternal complications in three groups were analyzed. Results Three groups of patients with good glycemic control, show no significant difference in the rate of cesarean section(P > 0.05).There are no significant difference in pregnancy complications between A and B group(P>0.05),but the incidence of gestational hypertension,polyhydramnios,fetal distress were significant lower than those in the C group(P < 0.05);The incidence of macrosomia in group C was significantly increased than the other groups (P < 0.05). The incidence of FGR,NRDS,neonatal malformations,neonatal asphyxia neonatal hypoglycemia of three groups had no significant difference. Conclusion Well -controlled serum glucose during pregnancy can improve pregnancy outcomes in patients with GDM,Termination of pregnancy in 38 ~ 40 gestational weeks can reduce the incidence of maternal complications in gestational diabetes with well-controlled serum glucose.