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目的探讨妊娠期糖尿病的最佳终止妊娠时机,改善母儿结局,提高阴道分娩率。方法回顾性分析我院2012年符合中国卫生部颁布的妊娠期糖尿病诊断标准的孕妇286例,在孕期予饮食营养运动指导后血糖控制满意,空腹血糖(FPG)均在3.3~5.1mmol/L,餐后2h在6.7mmol/L以下排除各种妊娠合并症、并发症,在充分知情同意下,随机分组选择终止妊娠时间,观察组(孕39+1~40周)170例,对照组(孕38+1~39周)116例,行宫颈评分,予缩宫素、米索前列醇、普贝生三种引产方法引产,比较阴道分娩率、因胎儿窘迫、头盆因素、社会因素、引产失败而行手术的剖宫产率。结果观察组(孕39+1~40周)比对照组(孕38+1~39周)阴道分娩率有所提高,因引产失败、社会因素而剖宫产的比率有所下降,差异有统计学意义,在胎儿窘迫、头盆因素而剖宫产方面较无明显差异。结论对于在孕期予饮食营养运动指导后血糖控制满意,无妊娠合并症、并发症的无产兆孕妇,孕39+1~40周是妊娠期糖尿病的最佳终止妊娠时机,可提高阴道分娩率。
Objective To investigate the optimal timing of gestational diabetes termination of pregnancy, improve maternal and child outcomes, improve vaginal delivery rate. Methods A retrospective analysis of 286 pregnant women in our hospital in 2012 in line with the diagnostic criteria for gestational diabetes issued by the Chinese Ministry of Health was satisfactory in controlling blood glucose during pregnancy and diet. The fasting blood glucose (FPG) were in the range of 3.3-5.1 mmol / L, 2h postprandial 6.7mmol / L below the exclusion of a variety of pregnancy complications, complications, with full informed consent, randomized to terminate the pregnancy group, 170 cases of observation group (39 + 1 to 40 weeks), control group 38 + 1 ~ 39 weeks) 116 cases, cervical score, to oxytocin, misoprostol, Pu Beisheng three induction of labor induction of labor, vaginal delivery rate, due to fetal distress, head and neck, social factors, induction of labor Caesarean section rate of failed surgery. Results The rate of vaginal delivery in the observation group (39 + 1 to 40 weeks of gestation) was higher than that of the control group (38 to 39 weeks of gestation), and the rate of cesarean section declined due to the failure of induction of labor and social factors Significance of learning, fetal distress, the first cesarean factors and no significant difference. Conclusion Pregnant women with gestational diabetes mellitus who have no evidence of pregnancy and gestational complications who are pregnant with gestational complications and complications are the best mothers with gestational diabetes who have satisfactory control of blood glucose during pregnancy, and can improve vaginal delivery rate.