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目的分析国际妊娠期糖尿病专家组(IADPSG)标准诊断的妊娠期糖尿病(GDM)患者的妊娠结局,探讨该最新诊断标准在我国临床应用价值。方法选择2012.年4月~2013年4月于广州医科大学第五附属医院门诊定期产检、住院分娩妇女1874例为研究对象,按照最新诊断标准诊断GDM组196例,以同期分娩的糖代谢正常妇女用单纯随机抽样法抽取130例为对照组,对两组母儿妊娠结局进行比较。结果两组巨大儿、胎膜早破、早产、羊水污染显示差异无统计学意义(P>0.05);GDM组剖宫产率、产后出血量及新生儿转科率均高于对照组,差异有统计学意义(P<0.05);两组剖宫产手术指征构成比显示,GDM组第一位为社会因素、对照组为疤痕子宫。结论用最新诊断标准诊断GDM,患者及时得到监护和诊治,可以减少不良妊娠结局;严格掌握GDM剖宫产手术指征,尽量减少人为因素的剖宫产。
Objective To analyze the pregnancy outcome of gestational diabetes mellitus (GDM) diagnosed by the International Gestational Diabetes Group (IADPSG) and explore the clinical value of the latest diagnostic criteria in China. METHODS: From April 2012 to April 2013, 1874 women at regular outpatient clinics and hospital delivery in the Fifth Affiliated Hospital of Guangzhou Medical University from April 2012 to April 2013 were selected as the research objects. According to the latest diagnostic criteria, 196 cases of GDM group were diagnosed, with normal glucose metabolism Women used simple random sampling of 130 cases as a control group, the two groups of pregnant women compared pregnancy outcomes. Results There was no significant difference in macrosomia, premature rupture of membranes, premature labor and amniotic fluid contamination between two groups (P> 0.05). The rate of cesarean section, postpartum hemorrhage and neonatal morbidity in GDM group were higher than those in control group There was statistical significance (P <0.05). The constituent ratio of cesarean section indications in the two groups showed that the first factor in GDM group was social factor, while the control group was scar uterus. Conclusion Diagnosis of GDM with the latest diagnostic criteria, timely patient care and diagnosis and treatment, can reduce the adverse pregnancy outcomes; rigorous grasp of GDM cesarean section indications to minimize cesarean section of human factors.