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中华产科急救电子杂志 ›› 2021, Vol. 10 ›› Issue (01) : 25 -30. doi: 10.3877/cma.j.issn.2095-3259.2021.01.006

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妊娠合并糖尿病患者胎儿宫内安全监测
周翠香1, 郭晓辉1,()   
  1. 1. 518020 深圳市人民医院产科
  • 收稿日期:2020-11-14 出版日期:2021-02-18
  • 通信作者: 郭晓辉

Intrauterine safety monitoring in gestational diabetes mellitus

Cuixiang Zhou1, Xiaohui Guo1()   

  • Received:2020-11-14 Published:2021-02-18
  • Corresponding author: Xiaohui Guo
引用本文:

周翠香, 郭晓辉. 妊娠合并糖尿病患者胎儿宫内安全监测[J]. 中华产科急救电子杂志, 2021, 10(01): 25-30.

Cuixiang Zhou, Xiaohui Guo. Intrauterine safety monitoring in gestational diabetes mellitus[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2021, 10(01): 25-30.

妊娠合并糖尿病增加了母儿疾病的发生风险,如妊娠期高血压疾病、羊水过多、巨大胎儿、肩难产、胎儿畸形、胎儿生长受限、胎儿窘迫和胎死宫内、新生儿低血糖、新生儿高胆红素血症以及新生儿远期并发症。对妊娠合并糖尿病患者规范化、专业化及多学科合作的血糖管理,有助于降低母婴并发症发生的风险,合理的宫内监测有助于及早发现胎儿的异常,进而采取适当的干预措施。

Gestational diabetes mellitus increased the risk of maternal and fetal diseases, such as hypertensive disorder complicating pregnancy, polyhydramnios, macrosomia, shoulder dystocia, fetal malformation, fetal growth restriction, fetal distress, intrauterine fetal death, neonatal hypoglycemia, neonatal hyperbilirubinemia and long-term neonatal complications. The standardized, professional and multidisciplinary management of blood glucose in gestational diabetes mellitus is helpful to reduce the risk of maternal and infant complications. Reasonable intrauterine monitoring is helpful for early detection of fetal abnormalities and appropriate intervention measures.

[1]
Mackin ST, Nelson SM, Kerssens JJ, et al. Diabetes and pregnancy: national trends over a 15 year period [J]. Diabetologia, 2018, 61(5): 1081-1088.
[2]
Berger H, Gagnon R, Sermer M. Diabetes in pregnancy [J]. J Obstet Gynaecol Can, 2016, 38(7): 667-679.
[3]
AlAgha R, Firth RG, Byrne M, et al. Outcome of pregnancy in type 1 diabetes mellitus (T1DMP): results from combined diabetesobstetrical clinics in Dublin in three university teaching hospitals (1995-2006) [J]. Ir J Med Sci, 2012, 181(1): 105-109.
[4]
1型糖尿病合并妊娠多学科综合管理专家组.1型糖尿病合并妊娠多学科综合管理专家共识 [J].中华糖尿病杂志,2020,12(8):576-584.
[5]
Hummel M, Marienfeld S, Huppmann M, et al. Fetal growth is increased by maternal type 1 diabetes and HLA DR4-related gene interactions [J]. Diabetology, 2007, 50(4): 850-858.
[6]
Jensen DM, Korsholm L, Ovesen P, et al. Peri-conceptional A1C and risk of serious adverse pregnancy outcome in 933 women with type 1 diabetes [J]. Diabetes Care, 2009, 32(6): 1046-1048.
[7]
Charron-Prochownik D, Sereika SM, Becker D, et al. Long-term effects of the booster-enhanced READY-Girls preconception counseling program on intentions and behaviors for family planning in teens with diabetes [J]. Diabetes Care, 2013, 36(12): 3870-3874.
[8]
Ogurtsova K, da Rocha Fernandes JD, Huang Y, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040 [J]. Diabetes Res Clin Pract, 2017, 128: 40-50.
[9]
Liu L, Yang D, Zhang Y, et al. Glycaemic control and its associated factors in Chinese adults with type 1 diabetes mellitus [J]. Diabetes Metab Res Rev, 2015, 31(8): 803-810.
[10]
Alexopoulos AS, Blair R, Peters AL. Management of preexisting diabetes in pregnancy: a review [J]. JAMA, 2019, 321(18): 1811-1819.
[11]
杨炜博,唐仕芳,马娟,等.美国妇产科医师协会"巨大儿指南(2020)"解读 [J].中国计划生育和妇产科, 2020,12(8):15-23.
[12]
Haeri S, Khoury J, Kovilam O, et al. The association of intrauterine growth abnormalities in women with type 1 diabetes mellitus complicated by vasculopathy [J]. Am J Obstet Gynecol, 2008, 199(3): 278.e1e5.
[13]
中华医学会围产医学分会胎儿医学学组,中华医学会妇产科学分会产科学组.胎儿生长受限专家共识(2019版) [J].中华围产医学杂志,2019,22(6):361-380.
[14]
余昕烊,漆洪波.加拿大妇产科学会妊娠合并糖尿病临床指南(2016)要点解读 [J].中国实用妇科与产科杂志,2017,33(4):377-382.
[15]
中华医学会妇产科学分会产科学组,中华医学会围产医学分会.妊娠合并糖尿病诊治指南(2014) [J].中华妇产科杂志,2014,49(8):561-569.
[16]
潘小辉,王育璠.2015年国际妇产科联盟(FIGO)妊娠期糖尿病诊疗指南解读 [J].中华内分泌代谢杂志,2016,32(11):895-899.
[17]
Lees CC, Stampalija T, Baschat A, et al. ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction [J]. Ultrasound Obstet Gynecol, 2020, 56(2): 298-312.
[18]
宋树良,郭晓辉.实用胎儿电子监护学[M].北京:人民卫生出版社,2016:17-110.
[19]
万杰,孙玉伟,王艺桦,等.彩色多普勒超声预测妊娠期糖代谢异常妊娠不良结局的应用价值及其影响因素分析 [J].临床超声医学杂志.2018,20(8): 535-539.
[20]
郭琳娜,张志坤.脑胎盘率诊断胎儿宫内缺氧的研究进展 [J].国际妇产科学杂志,2017,44(1):71-74.
[21]
桂永浩,韩玲,丁文虹.胎儿及新生儿心脏病学[M].北京:北京科学技术出版社.2014.
[22]
ACOG. ACOG Practice bulletin No. 145: antepartum fetal surveillance [J]. Obstet Gynecol, 2014, 124(1): 182-192.
[23]
中华医学会妇产科学分会产科学组.孕前和孕期保健指南(2018) [J].中华围产医学杂志.2018,21(3):145-152.
[24]
Queensland Health. Queensland Clinical Guideline: Intrapartum fetal surveillance(IFS)[R/OL]. (2019-11-30)[2020-11-16].

URL    
[25]
Visser GH, Ayres-De-Campos D. FIGO Intrapartum Fetal Monitoring Expert Consensus Panel. FIGO consensus guidelines on intrapartum fetal monitoring: Adjunctive technologies [J]. Int J Gynaecol Obstet, 2015, 131(1): 25-29.
[26]
Ruozi-Berretta A, Piazze JJ, Cosmi E, et al. Computerized cardiotocography parameters in pregnant women affected by pregestational diabetes mellitus [J]. J Perinat Med, 2004, 32(5): 426-429.
[27]
Robert Liston, Diane Sawchuck RN, David Young. No.197a-Fetal Health Surveillance: Antepartum Consensus Guideline [J]. J Obstet Gynaecol Can, 2018, 40(4): e251-271.
[28]
中华医学会围产医学分会.电子胎心监护应用专家共识 [J].中华围产医学杂志,2015,18(7):486-490.
[29]
Penny Simkin, Ruth Ancheta.助产手册: 早期预防和处理难产. 雷慧中, 涂新, 译.4版. 广州: 广东科技出版社.2018: 155.
[30]
Baergen, Rebecca N. Manual of Benirschke and Kaufmann′s Pathology of the Human Placenta [J]. Pathology, 2006, 38(2): 194.
[31]
Lausman A, Kingdom J, Gagnon R, et al.Intrauterine growth restriction: screening, diagnosis, and management [J]. J Obstet Gynaecol Can, 2013, 35(8): 741-748.
[32]
Lees CC, Stampalija T, Baschat A, et al. ISUOG Practice Guidelines: diagnosis and management of Small-for-gestational-age fetus and fetal growth restriction [J]. Ultrasound Obstet Gynecol, 2020, 56(2): 298-312.
[33]
Dervisoglu P, Kosecik M, Kumbasar S. Effects of gestational and pregestational diabetes mellitus on the foetal heart: a cross-sectional study [J]. J Obstet Gynaecol, 2018, 38(3): 408-412.
[34]
谢幸.妇产科学 [M]. 9版.北京:人民卫生出版社,2018:53.
[35]
Daly LM, Gardener G, Bowring V, et al. Care of pregnant women with decreased fetal movements: Update of a clinical practice guideline for Australia and New Zealand [J]. Aust N Z J Obstet Gynaecol, 2018, 58(4): 463-468.
[36]
National Institute for Health and Care Excellence. Diabetes in pregnancy: management of diabetes and its complications from preconception to the postnatal period [M/OL]. London: National Institute for Health and Care Excellence, 2020 [2020-11-06].
[37]
吕红娟,刘爱敏,薛萍萍.妊娠期糖尿病患者脐血促红细胞生成素含量及其与胎儿缺氧的相关性研究 [J].中国优生与遗传杂志,2012,20(5):82-83,79.
[38]
Hughes RC, Moore MP, Gullam JE, et al. An early pregnancy HbA1c≥5.9% (41 mmol/mol) is optimal for detecting diabetes and identifies women at increased risk of adverse pregnancy outcomes [J]. Diabetes Care, 2014, 37(11): 2953-2959.
[39]
Sweeting AN, Ross GP, Hyett J, et al. Baseline HbA1c to Identify High-Risk Gestational Diabetes: Utility in Early vs Standard Gestational Diabetes [J]. J Clin Endocrinol Metab, 2017, 102(1): 150-156.
[40]
孙立娣,张成帅.远程医疗在妊娠期糖尿病患者中应用的研究进展 [J].中国妇幼保健,2018,33(19):4556-4558.
[41]
Borowska-Matwiejczuk K, Lemancewicz A, Tarasów E, et al. Assessment of Fetal Distress Based on Magnetic Resonance Examinations: Preliminary Report [J]. Acad Radiol, 2003, 10(11): 1274-1282.
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