Landon M B, Gabbe S G
Department of Obstetrics and Gynecology, Ohio State University College of Medicine, Columbus 43210.
Clin Obstet Gynecol. 1991 Sep;34(3):535-43.
During the last decade, outpatient protocols have been developed for antepartum fetal assessment in pregnancies complicated by diabetes mellitus. This approach has been associated with a markedly reduced cost of health care and emotional stress for patients and their families attributable to lengthy hospitalization. These programs have used primarily biophysical testing, with twice weekly NSTs followed by a CST or biophysical profile when necessary. Most recently, Doppler studies have been investigated as a method for identifying fetal compromise. Maternal assessment of fetal activity can be used as a screening test in most surveillance programs. Essential to the success of these protocols has been our ability to monitor maternal glycemia and to maintain glucose levels in the physiologic range through aggressive therapy with insulin and diet. Reassuring tests of fetal condition are present in most diabetic women and therefore permit fetal maturation to take place before delivery.
在过去十年中，已制定了门诊方案，用于对患有糖尿病的妊娠进行产前胎儿评估。这种方法显著降低了医疗保健成本，也减轻了患者及其家属因长期住院而产生的精神压力。这些方案主要采用生物物理检测，每周进行两次无应激试验（NST），必要时随后进行宫缩应激试验（CST）或生物物理评分。最近，已对多普勒研究作为识别胎儿窘迫的一种方法进行了调查。在大多数监测方案中，孕妇对胎动的自我评估可作为一种筛查试验。这些方案成功的关键在于我们有能力监测孕妇血糖，并通过积极的胰岛素治疗和饮食控制将血糖水平维持在生理范围内。大多数糖尿病女性的胎儿状况检查结果令人放心，因此可以让胎儿在分娩前成熟。
