不同时期终止妊娠对妊娠期糖尿病患者妊娠结局的影响

目的:探讨不同时期终止妊娠对妊娠期糖尿病妊娠结局的影响。方法:对215例住院分娩的妊娠期糖尿病患者的临床资料进行回顾性分析,根据不同分娩时期分成3组,Ⅰ组妊娠28～36周末,Ⅱ组妊娠37～39周末,Ⅲ组妊娠≥40周。对3组母婴并发症进行统计分析,包括围生儿病率、围生儿死亡率、巨大儿、妊娠高血压病、剖宫产率、产后出血发生情况。结果:妊娠37～39周末终止妊娠母婴并发症发生率较低(P<0.05);37周后终止妊娠,巨大儿发生率明显增加(P<0.05);40周以后终止妊娠妊娠高血压病发生率明显高于其他组;血糖控制满意孕妇(128例)与不满意孕妇(87例)比较,有较好的妊娠结局。结论:①对于妊娠期糖尿病患者,血糖控制水平是决定终止妊娠时期的关键因素,严格控制血糖可改善妊娠结局。②妊娠37～39周末终止妊娠可以降低母婴的并发症。

Effect of termination of pregnancy in different periods on pregnancy outcomes in gestational diabetes

Objective: To explore the effect of termination of pregnancy in different periods on pregnancy outcomes in gestational diabetes. Methods: Clinical data of 215 cases with gestational diabetes were analysed retrospectively, then the cases were divided into three groups according to termination opportunity of pregnancy: 28 ～ 36 gestational weeks (group Ⅰ), 37 ～ 39 gestational weeks (groupⅡ), 40 gestational weeks (group Ⅲ) . The incidences of maternal complications in three groups were analysed, including perinatal morbidity, prenatal mortality, macrosomia, hypertensive disorder complicating pregnancy, cesarean section, postpartum hemorrhage. Results: The incidence of maternal complications in group Ⅰ was lower than those in the other groups (P <0. 05) ; the incidence of macrosomia in group Ⅰ was lower than those in the other groups (P <0. 05) ; the incidence of hypertensive disorder complicating pregnancy in group Ⅲ was higher than those in the other groups; the pregnancy outcomes of women with well -controlled serum glucose were better. Conclusion: ①For the pregnant women with gestational diabetes, the level of serum glucose is a key factor of pregnancy outcomes, well -controlled serum glucose will improve pregnancy outcomes.②Terminstion of pregnancy in 37 ～ 39 gestational weeks can reduce the incidence of maternal complications.