糖尿病孕妇择期分娩前行羊水泡沫试验的临床价值探讨

目的:探讨妊娠期糖尿病(GDM)孕妇择期终止妊娠前不做羊水泡沫试验测定胎肺成熟度是否会增加新生儿呼吸窘迫综合征(NRDS)的发生率。方法:对52例GDM孕妇于妊娠36~40周在终止妊娠前行羊膜腔穿刺术抽取羊水行羊水泡沫试验,确定胎肺成熟后终止妊娠。64例孕龄准确的孕足月(孕龄>37周)的GDM孕妇作为非穿刺组,在终止妊娠前不予测定胎肺成熟度,比较两组的妊娠结局和NRDS的发生率。结果:两组孕妇的孕周、体重指数(BM I)、剖宫产率及产后出血、羊水过多的发生率无明显差异;两组巨大胎儿、足月低体重儿、新生儿低血糖、新生儿窒息和NRDS的发生率差异无统计学意义。结论:孕龄准确的GDM孕妇妊娠足月后在择期终止妊娠前不需常规行羊膜腔穿刺术做胎肺成熟度的测定。

Clinical value of foam test of amniotic fluid prior to elective delivery in women with diabetic pregnancies

Objective:To evaluate whether it increases the incidence of neonatal respiratory distress syndrome in infants of diabetic mother without amniotic fluid analysis for lung maturity prior to elective delivery.Methods:We performed a retrospective study in which 52 women with GDM were scheduled for amniocentesis to assess fetal lung maturity prior to elective delivery at 36～40 weeks,and in controls 64 women with GDM without amniocentesis prior to elective delivery at or beyond 37 weeks were evaluated.The pregnancy outcome were observed and compared between the two groups.Results:There were no significant differences in gestational age,BMI,the rate of cesarean section,polyhydramnios and postpartum hemorrhage between the two groups.And no significant differences about the incidence of fetal macrosomia,low birth weight infant,neonatal hypoglycemia,neonatal asphyxia and NRDS was found between the two groups.Conclusion:The confirmation of gestational age eliminates the need for amniotic fluid assessment of fetal lung maturity prior to elective delivery at or beyond 37 weeks in patients with GDM.