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目的监测妊娠期糖尿病及妊娠期糖耐量异常孕妇的胎儿宫内情况,预测胎儿宫内窘迫。方法利用超声多普勒对胎儿脐动脉血流频谱S/D比值,联合应用10min生物物理评分,对妊娠期糖尿病、妊娠期糖耐量异常的孕妇与正常孕妇的胎儿宫内情况对比分析,预测胎儿是否宫内缺氧,提示胎儿宫内窘迫情况。结果17例妊娠期糖尿病胎儿脐动脉血流频谱均正常,10min生物物理评分5~6分4例,5例出现胎儿宫内窘迫;28例妊娠期糖耐量异常胎儿脐动脉血流频谱异常2例,10min生物物理评分5~6分1例,评分≤4分1例,3例出现胎儿宫内窘迫;77例正常妊娠胎儿脐动脉血流频谱异常5例,10min生物物理评分5~6分10例,评分≤4分6例,14例出现胎儿宫内窘迫。结论用胎儿脐动脉血流频谱的S/D比值预测胎儿宫内窘迫敏感性差;10min生物物理评分在4分以下,可预测胎儿宫内窘迫;10min生物物理评分在5~6分间,如合并妊娠期糖尿病、妊娠期糖耐量异常,则要高度警惕胎儿宫内缺氧可能;联合应用两种方法预测胎儿是否宫内窘迫,只要有一种检测异常,则要引起临床医生的警惕。
Objective To monitor the intrauterine situation of pregnant women with gestational diabetes mellitus and gestational abnormal glucose tolerance and to predict the fetal distress. Methods Using ultrasound Doppler to compare the S / D ratio of umbilical artery blood flow spectrum of fetus with the 10min biophysical score, to compare and analyze the intrauterine situation of gestational diabetes mellitus and gestational abnormal glucose tolerance pregnant women and normal pregnant women, Whether intrauterine hypoxia, suggesting fetal distress situation. Results Fetal umbilical artery blood flow spectrum was normal in 17 fetuses with gestational diabetes mellitus, 4 in 5 to 6 in 10 min, and 5 in fetus. There were 2 cases of umbilical arterial blood flow abnormalities in 28 fetuses with gestational diabetes mellitus , 10min biophysical score of 5 to 6 in 1 case, score ≤ 4 points in 1 case, 3 cases of fetal distress; 77 cases of normal fetal umbilical artery blood flow abnormalities in 5 cases, 10min biophysical score of 5 to 6 points 10 Cases, score ≤ 4 points in 6 cases, 14 cases of fetal distress. Conclusion The S / D ratio of fetal umbilical artery blood flow spectrum predicts poor sensitivity of fetal distress. The biophysical score of 10 min is below 4, predicting intrauterine distress. The biophysical score of 10 min is between 5 and 6, Gestational diabetes mellitus, gestational impaired glucose tolerance, it is necessary to be highly vigilant fetal hypoxia may be; combined application of two methods to predict fetal intrauterine distress, as long as there is a detection abnormalities, it is necessary to arouse the vigilance of clinicians.