Garabedian C, Deruelle P
Pôle d'obstétrique, Maternité Jeanne de Flandre, CHRU de Lille, 59037 Lille Cedex, France.
J Gynecol Obstet Biol Reprod (Paris). 2010 Dec;39(8 Suppl 2):S274-80. doi: 10.1016/S0368-2315(10)70053-3.
To provide management guidelines for labor and delivery in women with gestational diabetes.
A literature search was performed using the Pubmed and Cochrane database. Foreign societies guidelines were also consulted.
There is no additional information from recent studies that may suggest changing current French guidelines about timing of delivery in gestational diabetes. The incidence of shoulder dystocia is increased in women with gestational diabetes, especially when infants are weighing more than 4500 g. Elective cesarean section when the fetal weight was greater than or equal to 4250 to 4500 g may reduce the risk of shoulder dystocia. Meticulous attention to avoiding maternal hyperglycemia during labor can prevent neonatal hypoglycemia. There is no significant role for x-ray pelvimetry in the management of gestational diabetes.
Management of labor and delivery in women with gestational diabetes will mainly depend on estimated fetal weight, especially when macrosomia is present.
为妊娠期糖尿病女性的分娩管理提供指导方针。
使用PubMed和Cochrane数据库进行文献检索。同时参考了国外学会的指南。
近期研究未提供额外信息表明需改变当前法国关于妊娠期糖尿病分娩时机的指南。妊娠期糖尿病女性肩难产的发生率增加，尤其是当胎儿体重超过4500克时。当胎儿体重≥4250至4500克时，择期剖宫产可降低肩难产风险。分娩期间精心注意避免母体高血糖可预防新生儿低血糖。X线骨盆测量在妊娠期糖尿病管理中无显著作用。
妊娠期糖尿病女性的分娩管理主要取决于估计胎儿体重，尤其是存在巨大儿时。
