Lurie S, Matzkel A, Weissman A, Gotlibe Z, Friedman A
Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel.
Am J Perinatol. 1992 Sep-Nov;9(5-6):484-8. doi: 10.1055/s-2007-999294.
The charts of all diabetic women and their infants delivered during the years 1983-1988 in our department were reviewed. The test group included consecutive gestational diabetic women class A1 (n = 65) and class A2 (n = 59), who delivered beyond 40 weeks of gestation. The mean gestational age at delivery was 40.90 weeks (range, 40.0 to 42.57) in class A1 and 40.49 weeks (range, 40.0 to 42.28) in class A2 patients. The first control group matched for age, parity, and presentation included 65 gestational diabetic patients class A1 and 59 A2 who delivered prior to 40 weeks' gestation. The second control group matched for age, parity, and presentation included 124 nondiabetic patients who delivered beyond 40 weeks of gestation (mean, 41.04 +/- 0.83 weeks). By allowing the pregnancies of gestational diabetic patients class A1 and class A2 to proceed beyond 40 weeks of gestation, we did not increase the incidence of perinatal mortality and morbidity rate. The cesarean section rate was low (10.76% in class A1 and 22.03% in class A2). We suggest that not only elective intervention prior to 40 weeks of gestation is to be avoided, but an attempt should be made to allow the gestational diabetics class A1 and class A2 to proceed to spontaneous labor.
我们回顾了1983年至1988年期间在我们科室分娩的所有糖尿病孕妇及其婴儿的病历。试验组包括连续的A1级（n = 65）和A2级（n = 59）妊娠期糖尿病妇女，她们的孕周超过40周。A1级患者分娩时的平均孕周为40.90周（范围为40.0至42.57周），A2级患者为40.49周（范围为40.0至42.28周）。第一对照组在年龄、产次和胎位方面相匹配，包括65例A1级和59例A2级妊娠期糖尿病患者，她们在40周前分娩。第二对照组在年龄、产次和胎位方面相匹配，包括124例孕周超过40周的非糖尿病患者（平均为41.04±0.83周）。通过让A1级和A2级妊娠期糖尿病患者的妊娠持续到40周以上，我们并没有增加围产期死亡率和发病率。剖宫产率较低（A1级为10.76%，A2级为22.03%）。我们建议，不仅应避免在妊娠40周前进行选择性干预，而且应尝试让A1级和A2级妊娠期糖尿病患者自然分娩。
