Mashini I S, Fadel H E, Nelson G H, Hadi H A
Am J Obstet Gynecol. 1985 Dec 1;153(7):759-66. doi: 10.1016/0002-9378(85)90341-2.
The management of 430 diabetic pregnancies is presented. Our protocol emphasized "tight" metabolic control and assessment of fetal well-being by antepartum fetal heart rate testings and estriol levels. Spontaneous labor was allowed in uncomplicated Class A diabetic patients. Labor in complicated cases and insulin-dependent diabetic pregnancies was induced after establishing fetal lung maturity, except when a maternal or fetal complication dictated otherwise. A significant drop in estriol was observed in 4% of Class A diabetic patients and 10.2% of insulin-dependent diabetic patients. None developed a positive contraction stress test. Abnormal fetal well-being tests contributed minimally to the indications for induction of labor. The incidence of induced preterm delivery was 2.8% in Class A diabetic patients and 18.4% in insulin-dependent diabetic ones. The perinatal mortality was 5.6:1000 and 13:1000, respectively. The incidence of respiratory distress syndrome was very low, and none of the cases were associated with a "mature" amniotic fluid lecithin phosphorus measurement.
本文介绍了430例糖尿病孕妇的管理情况。我们的方案强调“严格”的代谢控制，并通过产前胎心监护和雌三醇水平评估胎儿健康状况。对于无并发症的A类糖尿病患者，允许自然分娩。对于复杂病例和胰岛素依赖型糖尿病孕妇，在确定胎儿肺成熟后引产，除非有母体或胎儿并发症另有规定。4%的A类糖尿病患者和10.2%的胰岛素依赖型糖尿病患者观察到雌三醇显著下降。无一例出现阳性宫缩应激试验。异常的胎儿健康状况检查对引产指征的影响极小。A类糖尿病患者引产早产的发生率为2.8%，胰岛素依赖型糖尿病患者为18.4%。围产儿死亡率分别为5.6:1000和13:1000。呼吸窘迫综合征的发生率非常低，且所有病例均与“成熟”羊水卵磷脂磷测量无关。
