Haeusler M C, Konstantiniuk P, Dorfer M, Weiss P A
Department of Obstetrics and Gynecology, Karl-Franzens University of Graz, Austria.
Am J Obstet Gynecol. 1998 Oct;179(4):917-20. doi: 10.1016/s0002-9378(98)70221-2.
We analyzed the safety and patient acceptance of amniotic fluid insulin measurements by third-trimester amniocentesis in women with gestational diabetes mellitus.
We studied the rate of early uterine contractions, need for tocolysis, premature rupture of membranes, mode of delivery, length of gestation, and fetal weight and length at birth in 194 women with gestational diabetes mellitus who underwent third-trimester amniocentesis and 268 controls. Patient acceptance of amniocentesis was assessed prospectively with a visual rating scale and a semistructured interview comparing 50 women with gestational diabetes mellitus to 50 women undergoing second-trimester amniocentesis for fetal karyotyping.
Only the length of gestation differed significantly but without clinical relevance (39.5 +/- 1.9 vs 40.0 +/- 2.0, P = .006) between women with gestational diabetes mellitus who had amniocentesis and controls. Patient acceptance was equally high both for second-trimester and third-trimester amniocentesis.
Third-trimester amniocentesis for measuring amniotic fluid insulin is safe and well accepted by the patients. This is important information both for treating and counseling women with gestational diabetes mellitus.
我们分析了妊娠晚期羊膜腔穿刺术测量羊水胰岛素在妊娠期糖尿病女性中的安全性及患者接受度。
我们研究了194例接受妊娠晚期羊膜腔穿刺术的妊娠期糖尿病女性和268例对照者的早期子宫收缩率、使用宫缩抑制剂的必要性、胎膜早破情况、分娩方式、妊娠时长以及出生时胎儿体重和身长。采用视觉评分量表和半结构化访谈对50例妊娠期糖尿病女性和50例因胎儿染色体核型分析接受妊娠中期羊膜腔穿刺术的女性进行前瞻性评估，以了解患者对羊膜腔穿刺术的接受程度。
接受羊膜腔穿刺术的妊娠期糖尿病女性与对照者之间仅妊娠时长存在显著差异，但无临床意义（39.5±1.9 vs 40.0±2.0，P = 0.006）。妊娠中期和晚期羊膜腔穿刺术的患者接受度同样高。
妊娠晚期羊膜腔穿刺术测量羊水胰岛素是安全的，且患者接受度良好。这对于妊娠期糖尿病女性的治疗和咨询均是重要信息。
