Pregnancy outcome of gestational diabetes
妊娠期合并糖尿病产妇实施妇产科护
DOI：10.16658/ki.1672-4062.2022.20.130妊娠期合并糖尿病产妇实施妇产科护理干预方法的效果探讨陈瑞兰，卓瑞英，杨丽新莆田市荔城区医院妇产科，福建莆田351100[摘要]目的对妊娠期合并糖尿病产妇中实施妇产科护理干预的临床疗效分析。
方法以2018年1月—2021年11月期间在莆田市荔城区医院分娩的妊娠期合并糖尿病产妇72例为研究对象，依据随机数表法分为两组，每组36例。
对照组接受常规护理干预，观察组接受妇产科护理干预。
对比两组产妇护理干预前后血糖控制情况，记录两组产妇不良反应发生情况以及围产儿结局情况，并统计两组产妇的护理满意度情况。
结果护理后，两组HbA1c、FPG、2 hPG均显著低于护理前，观察组较对照组更低，差异有统计学意义（P<0.05）；观察组产妇围产期并发症发生率较对照组更低，差异有统计学意义（P<0.05）；观察组新生儿不良结局发生率较对照组更低，差异有统计学意义（P<0.05）；观察组产妇护理满意度较对照组更高，差异有统计学意义（P< 0.05）。
结论妊娠期合并糖尿病产妇中实施妇产科护理干预后，其血糖水平得以有效调控，产妇围生期并发症发生率显著降低，围产儿结局得以改善，产妇对护理方案具有较高的满意度，临床应用价值显著。
[关键词] 妊娠期；糖尿病；妇产科护理干预；血糖水平[中图分类号] R473 [文献标识码] A [文章编号] 1672-4062（2022）10（b）-0130-04Exploring the Effect of Implementing Obstetrical and Gynecological Nurs⁃ing Intervention Methods for Women with Combined Diabetes in Preg⁃nancyCHEN Ruilan, ZHUO Ruiying, YANG LixinDepartment of Obstetrics and Gynecology, Putian City Licheng Hospital, Putian, Fujian Province, 351100 China[Abstract] Objective To analyze the clinical efficacy of implementing obstetrical and gynecological nursing interven⁃tions among women with combined diabetes during pregnancy. Methods 72 cases of women with combined diabetes in pregnancy who delivered in Putian City Licheng Hospital during January 2018-November 2021 were used as study subjects, and were divided into two groups based on the random number table method, with 36 cases in each group. The control group received conventional nursing intervention and the observation group received obstetrical and gyne⁃cological nursing intervention. The glycemic control of the two groups before and after the nursing intervention was compared, the occurrence of adverse reactions and perinatal outcomes of the two groups were recorded, and the satis⁃faction of the two groups with the nursing care was counted. Results After care, HbA1c, FPG, and 2 hPG in both groups were significantly lower than before care, and HbA1c, FPG, and 2 hPG in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). The incidence of maternal perinatal complications was lower in the observation group compared with the control group, and the difference was statistically significant (P<0.05). The incidence of adverse neonatal outcomes in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). Maternal care satisfaction in the ob⁃servation group was higher than that in the control group, and the difference was statistically significant (P<0.05).Conclusion After the implementation of obstetric and gynecological care interventions in women with combined diabe⁃tes in pregnancy, their blood glucose levels were effectively regulated, the incidence of maternal perinatal complica⁃[作者简介]陈瑞兰（1983-），女，大专，主管护师，研究方向为妇科护理。
孕前体质指数及妊娠期血糖水平与大于胎龄儿发生风险的相关性
临床医学研究与实践2021年6月第6卷第17期DOI :10.19347/ki.2096-1413.202117010基金项目：广州市番禺区科技计划项目（No.2019-Z04-41）。
作者简介：蔡文竹（1982-），女，汉族，湖北荆州人，主治医师，学士。
研究方向：产科疾病。
Relationship between pre-pregnancy body mass index and blood glucoselevels during pregnancy and the risk of large for gestational ageCAI Wenzhu,YANG Meiying,MO Xiaoyue(Obstetrics and Gynecology Department,Guangdong Clifford Hospital,Guangzhou 511495,China)ABSTRACT:Objective To explore the relationship between pre-pregnancy body mass index (BMI)and blood glucose levels during pregnancy and the risk of large for gestational age (LGA).Methods The clinical data of 2035pregnantwomen who underwent regular obstetric checkups,completed 75g oral glucose tolerance test (OGTT),and followed up todelivery in Guangdong clifford hospital were selected.Multivariate Logistic regression was used to analyze the relationship between pre-pregnancy BMI and blood glucose levels at different time points of OGTT and the risk of LGA.Results Thestatistical results were as follows:average pre-pregnancy BMI (20.2±2.5)kg/m 2;average OGTT fasting blood glucose (4.4±0.4)mmol/L,average OGTT 1h blood glucose (7.9±1.7)mmol/L,average OGTT 2h blood glucose (6.8±1.4)mmol/L;255cases (12.5%)of gestational diabetes mellitus (GDM);199cases (9.8%)of LGA.The multivariate Logistic regression analysis showed that for every 1unit increase in blood glucose level in OGTT 1hour,the risk of LGA increased by 1.17times (OR =1.17;95%CI:1.02-1.32);the risk of LGA in newborns of pregnant women with GDM was 2.38times of that of normal pregnant women (OR =2.38;95%CI:1.63-3.48);the risk of LGA in pregnant women with a BMI of >23.5kg/m 2beforepregnancy was significantly higher than that of pregnant women with a BMI of <18.5kg/m 2(OR =3.09;95%CI:1.05-9.07).Conclusion Pre-pregnancy BMI>23.5kg/m 2and hyperglycemia during pregnancy are independent risk factors for LGA.KEYWORDS:pre-pregnancy body mass index;gestational diabetes mellitus;large for gestational age孕前体质指数及妊娠期血糖水平与大于胎龄儿发生风险的相关性蔡文竹，杨美英，莫小跃（广东祈福医院妇产科，广东广州，511495）摘要：目的探讨孕前体质指数（BMI ）及妊娠期血糖水平与大于胎龄儿（LGA ）发生风险的相关性。
妊娠合并糖尿病
期标准者，应及时加用胰岛素治疗。
胰岛素治疗方案
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最符合生理要求的胰岛素治疗方案为： 基础胰岛素联合餐前超短效或短效胰岛素。基础胰岛素的 替代作用可持续12～24 h，而餐前胰岛素起效快，持续时 间短，有利于控制餐后血糖。 应根据血糖监测结果，选择个体化的胰岛素治疗方案。
胰岛素治疗方案
但用药后发生子痫前期和新生儿黄疸需光疗的风险升高，
少部分孕妇有恶心、头痛及低血糖反应。
二甲双胍
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可增加胰岛素的敏感性，目前的资料显示，妊娠早期应用 对胎儿无致畸性，在多囊卵巢综合征的治疗过程中对早期 妊娠的维持有重要作用。由于该药可以透过胎盘屏障，妊 娠中晚期应用对胎儿的远期安全性尚有待证实。
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妊娠前药物的合理应用
妊娠前药物的合理应用
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PGDM妇女妊娠前应停用妊娠期禁忌药物，如血管紧张素 转换酶抑制剂(angiotensin convertingenzvme inhibitor， ACEI)和血管紧张素Ⅱ受体拮抗剂等。如果妊娠前应用 ACEI治疗糖尿病肾病（DN），一旦发现妊娠，应立即停 用。产前咨询时应告知患者，妊娠前或妊娠期停用ACEI后
妊娠期胰岛素应用的注意事项
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(2)胰岛素治疗期间清晨或空腹高血糖的处理： 夜间胰岛素作用不足、黎明现象和Somogyi现象均可导致 高血糖的发生。前2种情况必须在睡前增加中效胰岛素用量， 而出现Somogyi现象时应减少睡前中效胰岛素的用量。
somogyi现象（低血糖后高血糖中文翻译为索马吉效应）：
胰岛素应用时机
LOGO
糖尿病孕妇经饮食治疗3-5d后，测定24 h的末梢血糖(血糖 轮廓试验)，包括夜间血糖、三餐前30min及三餐后2h血糖 及尿酮体。如果空腹或餐前血糖 ≥5.3mmol／L(95 mg／ dl)，或餐后2 h血糖 ≥6.7mmol／L(120 mg／dl)，或调整 饮食后出现饥饿性酮症，增加热量摄人后血糖又超过妊娠
妊娠期糖尿病的诊治进展
1
伴有典型高血糖或高血糖危象症状，任意血糖≥11.1mmol/L
3
2
糖化血红蛋白（GHbA1c）≥6.5%
空腹血糖（FPG）≥7.0mmol/L
糖尿病合并妊娠的诊断
GDM的诊断
GDM的诊断定义是达到或超过下列任何一项指标75gOGTT FPG 5.1mmol/L1H后血糖 10.0mmol/L2H后血糖 8.5mmol/L孕妇有高危因素，首次OGTT正常，建议孕晚期重复OGTT。
孕期的治疗
输入标题
制定每日总热量
输入标题
输入标题
输入标题
多种维生素，矿物质和高纤维素
2
营养素的热量分配
制定食谱，少量多餐
1
4
3
饮食调理
运动提高胰岛素的敏感性，减轻体重
01
餐后30分钟
02
时间30-60分钟
03
限于有氧运动：快走，慢跑，游泳等
04
运动治疗
妊娠期胰岛素的应用请内分泌科医生协助
01
胰岛素的用量取决于：孕周，体重，24H血糖水平
T级：肾移植史
H级：冠心病
R级：增设性视网膜病变或玻璃体积血
F级：糖尿病性肾病
C
B
A
D
GDM的分期
妊娠前咨询：全面检查，进行分级
大量循证医学资料表明：严密监测血糖的情况下，可以妊娠。
孕前评估
妊娠期血糖控制的标准：
FPG为
餐前30分钟为
餐后两小时为
夜间为
孕期的管理
01
02
03
04
05
五驾马车：
GDM
类似于II型糖尿病
遗传因素：胰岛素抵抗胰岛β细胞功能缺陷
妊娠期糖尿病
三、妊娠期营养管理与指导
【推荐及共识】
3-1 妊娠期高血糖孕妇应控制每日总能量摄入，妊娠早期不低于1600 kcal/d （1kcal=4.184 kJ），妊娠中晚期1 800~2 200 kcal/d 为宜；伴孕前肥胖者应 适当减少能量摄入，但妊娠早期不低于1 600 kcal/d，妊娠中晚孕期适当增加 （推荐等级：C 级）。
本指南将对妊娠期高血糖的分类以及不同类型糖代谢异常的 孕前、孕期及产后的监测和管理进行阐述，旨在进一步改善妊娠 期高血糖的母儿结局。
推荐等级：本指南对于有良好和一致的科学证据支持（有随机对照研 究支持）的证据推荐等级为A级，对于有限的或不一致的文献支持（缺乏 随机对照研究支持）的证据推荐等级为B级，主要根据专家观点的证据推 荐等级为C级。
GDM指妊娠期发生的糖代谢异常，不包含孕前已经存在的T1DM或T2DM。妊娠 期产前检查发现血糖升高的程度已经达到非孕期糖尿病的标准，应诊断为PGDM而非 GDM。
OGTT 检查的方法如下：准备进行OGTT 检查前禁食8~10h；检查前连续3d正常 饮食，即每日进食碳水化合物不少于150g。检查期间静坐、禁烟。检查时，5min 内 口服含75g 葡萄糖（无水葡萄糖粉）的液体300ml，分别抽取服糖前、服糖后1h、2h 的静脉血（从开始饮用葡萄糖水计算时间），放入含有氟化钠的试管中，采用葡萄糖 氧化酶法测定血浆葡萄糖水平。
1-2 有糖尿病高危因素的孕妇应加强健康宣教和生活方式的管理（推荐 等级：B 级）。
首次产前检查需要排查糖尿病的高危因素，包括肥胖（尤其是重度肥胖）、一级亲 属患有T2DM、冠心病史、慢性高血压、高密度脂蛋白<1 mmol/L和（或）三酰甘油 >2.8 mmol/L、GDM 史或巨大儿分娩史、多囊卵巢综合征史、早孕期空腹尿糖反复阳性、 年龄>45岁。
妊娠期糖尿病规范化治疗和个体营养干预的临床应用效果探讨
妊娠期糖尿病规范化治疗和个体营养干预的临床应用效果探讨和俊芳，黄志碧，蔡秀莺莆田市涵江医院妇产科，福建莆田351111[摘要]目的探究分析妊娠期糖尿病规范化治疗和个体营养干预的临床应用效果。
方法选取2020年1月—2021年12月莆田涵江医院收治的妊娠期糖尿病患者100例，根据其入院序列数用随机数表法分为对照组和观察组，各50例。
对照组采用常规治疗模式，观察组采用规范化治疗结合个体营养干预模式，对比分析两组的妊娠结局与并发症发生率、血糖指标以及新生儿结局与并发症发生率。
结果治疗后，观察组妊娠不良结局与并发症发生率、FPG、2h PG以及新生儿不良结局与并发症发生率明显均优于对照组，差异有统计学意义（P<0.05）。
结论对妊娠期糖尿病患者进行干预的过程中，采用规范化治疗和个体营养干预模式，能够有效改善患者的妊娠结局以及血糖指标，同时能够显著降低新生儿并发症发生率，具有优良效果。
[关键词] 妊娠期糖尿病；规范化治疗；个体营养干预；妊娠结局；血糖指标；新生儿并发症发生率[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2023）04（a）-0048-04 Discussion on Clinical Application Effect of Standardized Treatment of Gestational Diabetes Mellitus and Individual Nutrition InterventionHE Junfang, HUANG Zhibi, CAI XiuyingDepartment of Obstetrics and Gynecology, Putian Hanjiang Hospital, Putian, Fujian Province, 351111 China [Abstract] Objective To explore and analyze the clinical application effect of standardized treatment of gestational diabetes mellitus and individual nutrition intervention. Methods 100 patients with gestational diabetes admitted to Pu⁃tian Hanjiang Hospital from January 2020 to December 2021 were selected. According to their admission sequence, they were divided into control group and observation group by random number table, with 50 cases in each group. The control group was intervened by conventional treatment mode; the observation group was intervened by standardized treatment combined with individual nutrition intervention. The pregnancy outcome, blood glucose index and incidence of neonatal outcome and complications were compared and analyzed between the two groups. Results After treatment, Observation group adverse pregnancy outcomes and complications, FPG, 2 hPG, and adverse neonatal outcomes and incidence of complications in the observation group were significantly better than those in the control group, the differ⁃ence was statistically significant (P<0.05). Conclusion In the process of intervening in patients with gestational diabe⁃tes mellitus, standardized treatment and individual nutritional intervention can effectively improve the pregnancy out⁃comes and blood glucose indicators of patients, and can significantly reduce the incidence of neonatal complications. In the process of practical application, it has excellent effect.[Key words] Gestational diabetes mellitus; Standardized treatment; Individual nutrition intervention; Pregnancy out⁃come; Blood glucose index; Incidence of neonatal complications妊娠期糖尿病属于妊娠期女性中相对常见的疾病类型，其能够对孕妇以及胎儿造成不同程度的影响，在血糖控制较差时，孕妇的妊娠并发症和新生儿不良事件的发生率均明显上升，对母婴安全造DOI：10.16658/ki.1672-4062.2023.07.048[作者简介]和俊芳（1985-），女，普米族，本科，副主任医师，研究方向为妊娠期糖尿病。
围产期个体化饮食干预对妊娠期糖尿病患者妊娠结局的影响
围产期个体化饮食干预对妊娠期糖尿病患者妊娠结局的影响陆凤莹 贺青蓉 黄彩云 劳冬俏 叶焕巧广东省佛山市高明区人民医院妇产科，广东佛山 528500[摘要] 目的 探讨妊娠期糖尿病患者围产期接受个体化饮食干预对患者妊娠结局的影响。
方法 研究对象选取我院2015年7月～2017年7月产科诊治的100例妊娠期糖尿病产妇，将所有患者根据随机数字表法分为两组。
对照组50例患者围产期实施常规饮食干预，观察组50例患者围产期接受个体化饮食干预，干预4个月后对比两组患者饮食计划依从性、血糖控制效果及妊娠结局。
结果 干预后，观察组患者饮食计划依从性优于对照组，血糖控制效果较对照组好，各不良妊娠结局发生情况较对照组少，差异均有统计学意义（P＜0.05）。
结论 妊娠期糖尿病患者围产期接受个体化饮食干预效果较常规饮食干预好，患者饮食计划依从性明显提升，血糖控制效果理想，妊娠结局好。
[关键词] 妊娠期糖尿病；围产期；个体化饮食干预；妊娠结局[中图分类号] R473.71 [文献标识码] A [文章编号] 2095-0616（2018）06-118-04 Influence of of perinatal individualized dietary intervention on pregnancy outcome in gestational diabetes mellitus patientsLU Fengying HE Qingrong HUANG Caiyun LAO Dongqiao YE Huanqiao Department of Obstetrics and Gynecology,the People’s Hospital of Foshan,Foshan 528500,China[Abstract] Objective To investigate the influence of perinatal individualized dietary intervention on pregnancy outcome in gestational diabetes mellitus patients(GDM). Methods One hundred pregnant women with gestational diabetes mellitus were selected from July 2015 to July 2017.All the patients were divided into two groups according to the random number table method.The control group(50 cases) received routine dietary intervention during perinatal period,and the observation group(50 cases) received individualized dietary intervention during perinatal period.After 4 months of intervention,the compliance of diet plan,the effect of blood glucose control and the outcome of pregnancy were compared between the two groups. Results After intervention,the compliance of patients in the observation group was better than that in the control group,and the effect of blood glucose control was better than that in the control group.The incidence of adverse pregnancy outcomes was less than that in the control group, and the difference was statistically significant(P＜0.05). Conclusion Perinatal individual diet intervention is more effective than routine diet intervention for GDM patients,it can increase the diet plan compliance of patients,achieve satisfactory blood glucose control effect and good pregnancy outcome.[Key Words] Gestational diabetes mellitus;Perinatal period;Individualized dietary intervention;Pregnancy outcome妊娠期糖尿病是指产妇在妊娠期首次发现或首次检出糖代谢异常，随着我国经济水平的发展，居民不断改变的生活方式及饮食习惯，导致妊娠期糖尿病的检出率也随之上升，妊娠期糖尿病的发生与发展将对母婴的安全造成影响[1]。
未足月羊水过少孕妇行羊膜腔灌注对妊娠结局、新生儿出生质量的影响
•经验交流•未足月羊水过少孕妇行羊膜腔灌注对妊娠结局、新生儿出生质量的影响韩凤琼曾韵王莉刘桂芳【摘要】目的探究未足月羊水过少孕妇行羊膜腔灌注对妊娠结局、新生儿出生质量的影响。
方法选择2016年3月一2019年3月本院收治的未足月羊水过少孕妇60例作为研究对象，随机分成研究组和对照组两组,每组各30例。
对照组进行传统静脉补液治疗，研究组则利用羊膜腔灌注治疗。
观察两组患者的妊娠结局、羊水指数、孕周时长及新生儿出生质量等。
结果研究组的妊娠结局中死胎、早产等发生率低于对照组，差异有统计学意义(P<0.05),研究组中的活产儿、阴道顺产的发生率高于对照组，差异有统计学意义(P<0.05);研究组的羊水指数、分娩孕周均高于对照组，差异有统计学意义(P<0.05)；研究组的新生儿出生质量高于对照组，差异有统计学意义(P<0.05)。
结论利用羊膜腔灌注方法治疗未足月孕妇羊水过少症状，可以提高顺产数量，降低剖宫产的发生率，同时提高了羊水指数和延长了孕周时间，降低早产率，改善了新生儿的出生质量，值得推广。
【关键词】未足月；羊水过少孕妇；羊膜腔灌注；妊娠结局；新生儿出生质量［中图分类号］R717［文献标识码］A DOI：10.3969/j.issn.1002-1256.2020.15.006Effect of amniotic cavity perfusion on pregnancy outcome and neonatal birth quality in pregnant womenwith oligohydramnios before term朋N Feng-g,ong.Department of o6stetr/cs,SAun^e woman's and ch/dren's hosp/ta/of Guangdong med/ca/university(maternal and child health hosp/ta/of Shunde district,Foshan),Foshan,Guangdong,528300,China.［Abstract］Objective To investigate the effect of amniotic cavity perfusion on pregnancy outcome andnewborn quality in pregnant women with preterm oligohydramnios.Methods60cases of pregnant women withpreterm insufficient amniotic fluid those admitted to our hospital from March2016to March2019were randomlydivided into study group and control group，30cases in each group.The control group received traditionalintravenous fluid infusion for therapy，while the study group received amniotic cavity perfusion for therapy.Pregnancy outcome,amniotic fluid index,duration of gestational age and newborn quality of the two groups wereobserved.Results The incidence of stillbirth and premature birth in the study group was lower than that in thecontrol group,and the difference was statistically significant(P<0.05).The incidence of live births and vaginalbirth in the study group was higher than that in the control group，and the difference was statistically significant(P<0.05).The amniotic fluid index and gestational age were higher in the study group than in the control group，andthe differences were statistically significant(P<0.05).The quality of newborns in the study group was higher thanthat in the control group,and the difference was statistically significant(P<0.05).Conclusions Using amniotic-cavity perfusion to treat the symptoms of oligohydramnios in pre-term pregnant women could improve the numberof natural births，reduce the incidence of cesarean section，improve the amniotic fluid index and prolong thegestational week,reduce the rate of premature delivery,improve the quality of newborn,and is worthy of promotion.【Key words］Preterm;Pregnant women with oligohydramnios;Amniotic cavity perfusion;Pregnancy outcome;Neonatal quality羊水过少症状主要是孕妇在妊娠晚期的羊水量未达到300毫升产生的症状。
丙基硫氧嘧啶与甲巯咪唑治疗妊娠合并甲亢的效果及对母婴结局的影响
《中外医学研究》第17卷 第15期（总第419期）2019年5月 临床与实践 Linchuangyushijian①荆门市康复医院 湖北 荆门 448000通信作者：官葵花丙基硫氧嘧啶与甲巯咪唑治疗妊娠合并甲亢的效果及对母婴结局的影响张昌凤① 周雪梅① 官葵花①【摘要】 目的：研究丙基硫氧嘧啶(PTU)与甲巯咪唑(MMI)治疗妊娠合并甲亢的效果及对母婴结局的影响。
方法：选取2015年1月-2018年1月笔者所在医院收治的妊娠合并甲亢患者86例作为研究对象，运用随机数表法将所有研究对象随机分成A 组和B 组，每组43例。
A 组确诊后口服PTU 治疗，B 组确诊后服用MMI 治疗，观察两组病情变化，统计分析两组母婴结局。
结果：治疗后，两组患者甲状腺功能各项指标(TT 4、TT 3、FT 4、FT 3、TSH)对比差异无统计学意义(P >0.05)；治疗后，A 组孕产妇不良妊娠结局发生率(23.25%)明显高于B 组(6.98%)，差异有统计学意义(P <0.05)，A 组新生儿不良结局发生率(4.65%)明显低于B 组(18.60%)，差异有统计学意义(P <0.05)。
结论： PTU 和MMI 治疗妊娠合并甲亢均取得良好治疗效果，很大程度上优化了孕妇甲状腺功能，改善母婴结局。
但PTU 对孕产妇产生的不良影响更大，MMI 对胎儿发育影响较大，但两种药物大多数为轻微不良反应。
综合衡量，MMI 可作为优先治疗妊娠合并甲亢的药物，值得临床借鉴。
【关键词】 甲巯咪唑； 妊娠； 甲亢； 母婴结局 doi：10.14033/ki.cfmr.2019.15.018文献标识码 B文章编号 1674-6805(2019)15-0041-03 Efficacy of Propylthiouracil and Methimazole in the Treatment of Pregnancy with Hyperthyroidism and Its Effect on Maternal and Infant Outcomes/ZHANG Changfeng，ZHOU Xuemei，GUAN Kuihua.//Chinese and Foreign Medical Research，2019，17(15)：41-43 【Abstract】 Objective：To study the effect of Propylthiouracil(PTU) and Methimazole(MMI) on pregnant women with hyperthyroidism and their maternal and infant outcomes.Method：A total of 86 pregnancy complicated with hyperthyroidism were selected from January 2015 to January 2018.All the subjects were randomly divided into group A and group B with 43 cases in each group.The patients in group A were treated with PTU orally and the patients in group B were treated with MMI after diagnosis.The changes of the two groups were observed，and the outcomes of mothers and infants in two groups were analyzed statistically. Result：After treatment，there was no significant difference in thyroid function indexes(TT 4，TT 3，FT 4，FT 3，TSH) between the two groups(P >005).The incidence of adverse pregnancy outcome was 23.25%，significantly higher than 6.98% in group B (P <0.05).The incidence of adverse outcome in group A was 4.65%，significantly lower than 18.60% in group B(P <0.05).Conclusion：PTU and MMI in the treatment of pregnancy with hyperthyroidism achieved good results，greatly optimized the thyroid function of pregnant women，improve maternal and infant outcomes.But the negative impact of PTU on pregnant women is even greater，and the influence of the MMI on the development of the fetus is large，but the two drugs are mostly mild bad prehensive measurement，MMI can be used as a priority treatment of pregnancy with hyperthyroidism drugs，worthy of clinical reference. 【Key words】 Methimazole； Pregnancy； Hyperthyroidism； Maternal and infant outcome First-author ’s address：Jingmen Rehabilitation Hospital，Jingmen 448000，China 正常水平的甲状腺功能是胎儿神经、智力发育的重要条件，甲亢是指多种原因导致甲状腺激素分泌过多引起的甲状腺功能亢进[1]。
孕期营养与围产结局
目前，中国城市及农村居民营养失衡现象严重，相关疾病发病率不断攀升，孕期妇女也出现同样状况。
由于孕期活动量减少，同时不恰当的补充营养，饮食营养不均衡，大量高蛋白、高热量食物，导致妊娠期糖代谢、脂肪代谢异常。
而在本地因特殊的地理环境，孕妇多来自农村、牧区的少数民族人群(回族、维吾尔族、哈萨克族等)，饮食特点侧重于面食、肉食，喜欢喝奶茶，水果、蔬菜摄入相对较少，导致妊娠期各种高危因素出现，同时也导致胎儿的高风险。
资料与方法对2008年-2012年在医院分娩的16 715例孕产妇产前、产后相关记录及新生儿情况回顾分析。
方法：以入院时孕妇的临床诊断及新生儿出生40d相关实验室检查结果分析围产结局。
评估标准：①妊娠期高血压疾病：130/90mmHg、蛋白尿(+)～(+++)、浮肿(+)～(+++)；②妊娠期糖尿病：孕24～28周糖耐量；③妊娠期贫血：血红蛋白＜90g/L；④巨大儿：出生体重＞4000g；⑤低体重儿：出生体重＜2400g；⑥胎死宫内：经临床检查及B超确诊；⑦新生儿窒息：出生后1min评分；⑧胎儿畸形：经B超提示，包括孕中期终止妊娠；⑨婴儿贫血：出生后定点医院实验室检查。
结果5年统计：2008年-2012年分娩总人数16715例，其中妊娠期高血压疾病2447例，发病率14.6%；妊娠期糖尿病438例，发病率2.6%；妊娠期贫血795例，发病率4.7%，见表1。
5年统计：巨大儿出生752例(4.4%)；低体重儿235例(1.4%)；死胎死产70例(0.4%)；新生儿窒息581例(3.4%)；经B超孕中期筛查终止妊娠出生87例(0.5%)；婴儿出生后42d血常规检验，血红蛋白低于正常值495例(2.9%)，见表2。
孕期营养与围产结局童德梅高丽艳石杰831100新疆昌吉市妇幼保健院doi:10.3969/j.issn.1007-614x.2015.25.97摘要目的：分析孕产妇由于不均衡的膳食结构而引起的母儿高危因素。
个体化营养在妊娠期糖尿病患者治疗中的价值
DIABETES NEW WORLD糖尿病新世界[作者简介]高静静(1990-),女,本科,住院医师,研究方向为产科。
DOI:10.16658/ki.1672-4062.2021.23.035个体化营养在妊娠期糖尿病患者治疗中的价值高静静1,严曼琳21.福州市第二医院产科,福建福州350000;2.福州泰康体检中心妇科,福建福州350000[摘要]目的观察分析个性化营养应用于妊娠期糖尿病患者治疗时的价值。
方法选取该院2020年3月—2021年3月收治的80例患者等比例分为观察组、对照组,均接受基础治疗,观察组患者额外接受个体化营养治疗。
比对两组治疗前后3项血糖指标;比对两组患者妊娠结局;比对两组治疗前后4个维度自我管理行为能力评分结果。
结果治疗前,两组空腹血糖、餐后2h 血糖、糖化血红蛋白3项指标对比,差异无统计学意义(P>0.05);治疗后,两组3项指标均显著降低,但观察组降低幅度更大,差异有统计学意义(P<0.05)。
观察组患者不良妊娠结局发生率为27.50%,低于对照组的47.50%,差异有统计学意义(P<0.05)。
治疗前,两组饮食、运动、生活习惯、个人卫生4个维度的自我管理能力评分对比,差异无统计学意义(P>0.05);治疗后,两组4个维度指标评分均有所上升,但观察组各项上升幅度更大,差异有统计学意义(P<0.05)。
结论个体化营养应用于妊娠期糖尿病治疗时,能够有效控制患者血糖,明显降低不良妊娠结局发生率,显著提高糖尿病患者的自我管理能力。
[关键词]个体化营养;妊娠期糖尿病;不良妊娠结局;自我管理[中图分类号]R714[文献标识码]A[文章编号]1672-4062(2021)12(a)-0035-04The Value of Individualized Nutrition in the Treatment of Patients with Gestational Diabetes GAO Jingjing 1,YAN Manlin 21.Department of Obstetrics,Fuzhou Second Hospital,Fuzhou,Fujian Province,350000China;2.Department of Gynecology,Fuzhou Taikang Physical Examination Center,Fuzhou,Fujian Province,350000China[Abstract]Objective To observe and analyze the value of personalized nutrition in the treatment of patients with gestational diabetes.Methods 80patients admitted to the hospital from March 2020to March 2021were divided into observation group and control group,all received basic treatment,and observation group received additional individualized nutrition pared the three blood glucose indicators before and after treatment in the two groups;compared the pregnancy outcomes of the two groups;compared the four dimensions of self-management behavior ability score results before and after treatment between the two groups.Results Before treatment,there was no significant difference in fasting blood glucose,2h postprandial blood glucose,and glycosylated hemoglobin between the two groups,the difference was not statistically significant (P>0.05).After treatment,the three indicators of the two groups were significantly reduced,but the observation group decreased even more,the difference was statistically significant(P <0.05).The incidence of adverse pregnancyoutcomes in the observation group was 27.50%,which was lower than 47.50%in the control group,the difference was statistically significant (P<0.05).Before treatment,there was no significant difference in the self-management ability scoresof the four dimensions of diet,exercise,living habits,and personal hygiene between the two groups(P>0.05).After treatment,the scores of the four dimensions of the two groups increased,but the increase in the observation group was even greater,the difference was statistically significant (P<0.05).Conclusion When individualized nutrition is applied to the treatment of gestational diabetes,it can effectively control the patient's blood glucose,significantly reduce the incidence of adverse pregnancy outcomes,and significantly improve the self-management ability of diabetic patients.[Key words]Individualized nutrition;Gestational diabetes;Adverse pregnancy outcome;Self-management35. All Rights Reserved.糖尿病新世界DIABETES NEW WORLD妊娠期糖尿病是糖尿病的一种常见类型,是指女性患者在妊娠前并未出现糖尿病相关症状,糖代谢处于正常状态(糖耐量同样正常);但在成功妊娠之后,首次发生糖耐量降低情况,且空腹血糖超过5.1mmol/L [1]。
降调节激素替代方案中雌激素启动时机对冻融胚胎移植妊娠结局的影响
DOI:10.12280/gjszjk.20200355邢雅纯，苏雁，赵纯，李欣，凌秀凤【摘要】目的：研究降调节激素替代方案中雌激素启动时机对冻融胚胎移植（frozen-thawed embryotransfer，FET）妊娠结局的影响。
方法：对采用降调节激素替代方案行FET的436个周期进行研究。
雌激素启动前持续监测血清雌二醇（estradiol，E2）水平，根据E2处于上升或下降趋势分为2组。
A组雌激素类药物使用前E2呈上升趋势，共262个周期；B组雌激素类药物使用前E2呈下降趋势，共174个周期。
比较2组患者的一般情况、降调节后的临床指标及妊娠结局。
结果：2组患者的年龄、体质量指数（BMI）、不孕年限、基础性激素水平等基本情况差异无统计学意义（均P＞0.05）。
A组使用雌激素时间及雌激素用量低于B组，差异有统计学意义（P＜0.05）。
A组早期流产率低于B组，差异有统计学意义（P＜0.05）。
结论：FET周期中，注射长效促性腺激素释放激素激动剂（gonadotropin-releasing hormone agonist，GnRHa）降调节后，待血清雌激素水平呈上升趋势时启动，可以缩短外源性雌激素用药时间，节省外源性雌激素用量，有利于降低早期流产率，改善妊娠结局。
【关键词】降调节；促性腺素释放激素；激素替代疗法；冻融胚胎移植；胚胎移植；子宫内膜准备方案；雌激素启动时机；早期流产Effect of Estrogen Starting Time on the Outcome of Frozen-Thawed Embryo Transfer in HormoneReplacement Treatment after GnRHa Down Regulation XING Ya-chun,SU Yan,ZHAO Chun,LI Xin,LING Xiu-feng.Reproductive Medicine Center of Women′s Hospital of Nanjing Medical University(NanjingMaternity and Child Health Care Hospital),Nanjing210004,ChinaCorresponding author:LING Xiu-feng,E-mail:************************【Abstract】Objective:To study the effect of estrogen starting time on the outcome of frozen-thawedembryo transfer(FET)in hormone replacement treatment(HRT)after GnRHa down regulation.Methods:The436cycles of FET with GnRHa down regulation+HRT protocol were studied retrospectively.According to the rising orfalling trend of serum estrogen level(E2)before the start of estrogen,these cycles were divided into two groups.Group A:E2showed an upward trend before estrogen starting,262cycles;Group B,E2showed a downward trendbefore estrogen starting,174cycles.The baseline characteristics,clinical indicators after down regulation andpregnancy outcome between the two groups were compared.Results:There were no statistically significantdifferences in baseline characteristics such as age,body mass index(BMI),years of infertility,and baseline ofserum hormone between the two groups(P＞0.05).The average days of estrogen use and the amount of estrogen inthe group A were significantly lower than those in the group B(both P＜0.05).The early miscarriage rate in thegroup A was lower than that in the group B(P＜0.05).Conclusions:During the GnRHa down regulation+HRTcycles,estrogen starting when the level of serum estrogen shows an upward trend can shorten the using days ofexogenous estrogen,save the amount of exogenous estrogen,decrease early miscarriage,and improve the pregnancyoutcome in the end.【Keywords】Down regulation;Gonadotropin-releasing hormone;Hormone replacement therapy;Frozen-thawedembryo transfer;Embryo transfer;Endometrial preparation protocol;Estrogen starting time;Early miscarriage（ＪＩｎｔＲｅｐｒｏｄＨｅａｌｔｈ蛐ＦａｍＰｌａｎ，2021，40：89-92）·论著·基金项目：南京市科技发展计划项目（201803016）作者单位：210004南京医科大学附属妇产医院（南京市妇幼保健院）生殖医学中心通信作者：凌秀凤，E-mail：************************近年来，冻融胚胎移植（frozen-thawed embryotransfer，FET）在人类辅助生殖技术（assistedreproductive technology，ART）领域的应用越来越广泛，已成为ART的重要组成部分之一。
妊娠期糖尿病患者母婴结局现状及影响因素
【摘要】 目的 调查妊娠期糖尿病患者母婴结局的现状并分析其影响因素，为促进母婴健康提供参考依据。
方法 以2020年1月—2021年12月在北京大学第一医院宁夏妇女儿童医院定期产检并分娩的752例妊娠期糖尿病患者为研究对象，收集患者的临床资料，采用单因素和多因素Logistic 回归分析影响妊娠期糖尿病患者母婴结局的因素。
结果 752例妊娠期糖尿病患者中，母婴不良结局的发生率为70.88%，多因素Logistic 回归分析结果显示，孕期体质量增长>14 kg、分娩时孕期<37周或>40周 、孕前BMI 增大（超重OR =2.466，95% CI :1.269~4.775、肥胖OR =26.968，95% CI :5.948~122.505）是妊娠期糖尿病患者母婴不良结局发生的独立危险因素（P <0.05）。
结论 银川市妊娠期糖尿病患者母婴不良结局总发生率较高，防治形式不容乐观；孕期体质量增长>14 kg、分娩时孕周不正常、孕前BMI 高是影响妊娠期糖尿病患者母婴不良结局的重要因素。
【关键词】 妊娠期糖尿病；母婴不良结局；影响因素；超重；肥胖中图分类号R473.71 文献标识码A DOI:10.3969/j.issn.1672-9676.2023.23.002妊娠期糖尿病患者母婴结局现状及影响因素基金项目：宁夏回族自治区科技惠民计划专项课题（编号:2022CMG03014）作者单位：750001 宁夏回族自治区银川市，宁夏回族自治区人民医院（马嫔，李海霞）；北京大学第一医院宁夏妇女儿童医院（张广意，于慧）；宁夏医科大学总医院（张燕，米光丽）；宁夏医科大学（吉双对，白雪，刘风景）通信作者：米光丽，主任护师，护理部副主任，宁夏医科大学护理研究所所长，硕士研究生导师马嫔 张广意 李海霞 张燕 于慧 吉双对 白雪 刘风景 米光丽Status quo of maternal and infant outcomes in gestational diabetes mellitus and the influencing factors MA Pin, ZHANG Guangyi, LI Haixia, ZHANG Yan, YU Hui, JI Shuangdui, BAI Xue, LIU Fengjing, MI Guangli (General Hospital of Ningxia Medical University, Yinchuan, 750001, China)【Abstract 】 Objective To investigate the current status of maternal and infant outcomes in patients with gestational diabetes mellitus and analyse the infl uencing factors, to provide a reference basis for the promotion of maternal and infant health. Methods 752 patients with gestational diabetes mellitus who underwent regular obstetric examination and delivered at Ningxia Women's and Children's Hospital of Peking University First Hospital from January 2020 to December 2021 were selected as the study subjects, and the clinical data of the patients were collected, and the factors affecting maternal and infant outcomes of patients with gestational diabetes mellitus were analysed by using univariate and multivariate logistic regression. Results The incidence of adverse maternal and infant outcomes was 70.88% in 752 patients with gestational diabetes mellitus, and the results of multifactorial Logistic regression showed that an increase in body mass of >14 kg during pregnancy, a delivery gestation of <37 or >40 weeks, and an increase in pre-pregnancy BMI (overweight OR=2.466, 95% CI : 1.269~4.775, obesity OR=26.968, 95% CI : 5.948~122.78, and obesity OR=5.948~123.968, 95% CI : 5.948~122.968, 95% CI : 5.948~122.505) were independent risk factors for the occurrence of adverse maternal and infant outcomes in patients with gestational diabetes mellitus (P <0.05). Conclusion The overall incidence of adverse maternal and infant outcomes in patients with gestational diabetes mellitus in Yinchuan was high, and the prevention and treatment are not optimistic; body mass increase of >14 kg during pregnancy, abnormal gestational week of delivery, and high pre-pregnancy BMI are important factors aff ecting adverse maternal and infant outcomes in patients with gestational diabetes mellitus.【Key words 】 Gestational diabetes mellitus; Maternal and infant adverse outcomes; Influencing factors; Overweight; Obesity 本文作者：马嫔妊娠期糖尿病（gestational diabetes mellitus，GDM）是妊娠期间的糖代谢异常性疾病，其发病率在全球范围内呈增长趋势[1]。
妊娠晚期B族链球菌感染患者敏感性抗生素预防性治疗时机对母婴结局的影响
- 23 -[18]刘荣华，屈洪波.低分子肝素对慢性肾小球肾炎患者血脂的影响效果观察[J/OL].中西医结合心血管病电子杂志，2016，4（22）：53.[19]何洋，赵小玉.低分子肝素联合强的松对小儿肾病综合征的治疗效果及对患儿肾功能、APTT、PT 水平的影响分析[J].川北医学院学报，2018，33（2）：268-270.[20]但刚，刘媛，江忠勇，等.低分子肝素治疗肾病综合征患者高凝状态的实验室观察[J].重庆医学，2015，44（14）：1916-1917.（收稿日期：2020-05-11） （本文编辑：刘蓉艳）*基金项目：东莞市社会科技发展一般项目（2019507150110493）①广东省东莞台心医院 广东 东莞 523128通信作者：舒艳子妊娠晚期B族链球菌感染患者敏感性抗生素预防性治疗时机对母婴结局的影响*舒艳子① 陈星① 张秀果①【摘要】 目的：探究妊娠晚期B 族链球菌感染（GBS）患者敏感性抗生素预防性治疗时机对母婴结局的影响。
方法：选取2019年4月1日-2020年3月31日在本院收住的GBS 感染者70例为研究对象，将其分为A、B 组，每组35例。
A 组于妊娠35~37周给予青霉素G 预防治疗，B 组于临产或胎膜早破后给予青霉素G 或氨苄青霉素治疗，并以2018年4月1日-2019年3月31日在本院行产检并确诊GBS 感染者但未进行抗生素治疗的孕妇35例为C 组，比较三组母婴不良结局发生率、自然分娩率、分娩时间及产后出血量，比较三组给药前后凝血功能[血清纤维蛋白原水平、凝血酶原时间（PT）]。
结果：A 组产妇及新生儿不良妊娠结局发生率低于C 组（P <0.05），B、C 组产妇及新生儿不良妊娠结局发生率对比差异无统计学意义（P >0.05）；A 组的自然分娩率高于C 组，分娩时间短于B 组、C 组，产后出血量少于B 组、C 组（P <0.05），B 组分娩时间短于C 组，产后出血量少于C 组（P <0.05）；分娩后，A 组血清纤维蛋白酶原含量低于B 组、C 组，PT 值小于B 组、C 组（P <0.05），分娩后，B 组PT 值小于C 组（P <0.05）。
妊娠期糖尿病孕妇行胰岛素治疗对妊娠结局的影响
•临床研究•糖尿病新世界2020年11月D0I：10.16658/ki.1672-4062.2020.22.048妊娠期糖尿病孕妇行胰岛素治疗对妊娠结局的影响郑杰辉福建省莆田市第一医院妇产科，福建莆田351100［摘要］目的分析妊娠期糖尿病孕妇行胰岛素治疗对妊娠结局影响。
方法回顾性分析该院2019年1月一2020年1月收治妊娠期糖尿病孕妇80例,分为两组，对照组40例经接受饮食控制与运动治疗,研究组40例在对照组基础上行胰岛素治疗，对两组血糖水平及妊娠结局进行比较。
结果研究组FPG、2hPG及HbA1c指标优于对照组，比较差异有统计学意义(P<0.05)；研究组胎膜早破、羊水过多、早产、新生儿窒息等发生率5.00%比对照组22.50%低，差异有统计学意义(P<0.05)o结论妊娠期糖尿病孕妇采用胰岛素治疗,可降低孕妇血糖水平，还能改善其妊娠结局。
［关键词］妊娠期糖尿病；胰岛素；妊娠结局；血糖；结局；分析［中图分类号］R59［文献标识码］A［文章编号］1672-4062(2020)11(b)-0048-03Effect of Tnsulin Therapy on Pregnancy Outcome in Pregnant Women with Gestational DiabetesZHENG Jie-huiDepartment of Obstetrics and Gynecology,First Hospital of Putian City,Putian,Fujian Province,351100China[Abstract]Objective To analyze the effect of insulin therapy on pregnancy outcome in pregnant women with gestational diabetes.Methods A retrospective analysis of80pregnant women with gestational diabetes in the hospital from January 2019to January2020were divided into two groups.40cases in the control group received diet control and exercise therapy,and40cases in the study group ascended insulin treatment on the basis of the control group,the blood glucose levels and pregnancy outcome of the two groups were compared.Results The indicators of FPG,2hPG and HbA1c in the study group were better than those in the control group,and the difference was statistically significant(P<0.05);the incidence of premature rupture of membranes,polyhydramnios,premature birth,and neonatal asphyxia in the study group5.00%compared with the control group22.50%was lower,and the difference was statistically significant(P<0.05).Conclusion The use of insulin therapy in pregnant women with gestational diabetes can lower the blood glucose level of the pregnant women and improve their pregnancy outcome.[Key words]Gestational diabetes;Insulin;Pregnancy outcome;Blood glucose;Outcome;Analysis妊娠合并糖尿病在妇产科是一种常见疾病，具有较高的发病率。
早期护理干预对妊娠期糖尿病妊娠结局的影响
护理实论Womens Health Research2018年1月第1期文章编号:WHR2017082073早期护理干预对妊娠期糖尿病妊娠结局的影响刘学凤山东省罗庄区册山中心卫生院，山东临沂276017【摘要】目的：研究分析早期护理干预对任娠期糖尿病任娠结局的影响。
方法：选取2010年1月至2017年1月本院接受治疗的 80例任娠期糖尿病患者作为研究对象。
以护理方式为依据，将患者分成对照组与观察组,每组各40例患者。
其中，对照组给予常规 护理，观察组给予早期护理干预。
结果：两组患者经相应护理后，观察组患者了0、扭)7\1£：、1^、21«5情况明显优于对照组;另外,观 察组患者不良任娠结局发生率为7.5%,明显低于对照组患者不良任娠结局发生率35.0%。
结论：将早期护理干预应用于任娠期糖 尿病护理中能够有效控制患者血糖，且不良任娠结局发生率更低。
【关键词】早期护理干预;任娠期糖尿病;任娠结局Effect of early nursing intervention on gestational diabetes mellitus pregnancy outcomeLiu XuefengLuozhuang mountain Central Hospital of Shandong District,Linyi,Shandong276017[Abstract] Objective：To study the effect of early nursing intervention on pregnancy outcome of gestational diabetes mellitus. Methods：80 cases of gestational diabetes mellitus treated in our hospital from January2010to January2017 were selected as the research object Based on the nursing method,the patients were divided into control group and observation group,each group of 40 patients.Among them,the control group was given routine care,the observation group to give early care intervention Results：After treatment,the TG,HbAlc,FBG and2hPG in the observation group were significantly better than those in the control group.In addition,the incidence of adverse pregnancy outcomes in the observation group was7.S%^which was significantly lower than that in the control group (35. 0%). Conclusion：Early care intervention can be used to control blood glucose in pregnant women with gestational diabetes mellitus,and the incidence of adverse pregnancy outcome is lower.[K ey words]Early care intervention；Gestational diabetes mellitus;Pregnancy outcome妊娠期糖尿病还会对妊娠结局有严重影响，主要包括: 胎儿的死亡率增高、巨大胎儿、胎儿畸形等等[1]。
剖宫产术后再次妊娠阴道试产的妊娠结局分析
孕妇选择剖宫产术的情况不断增多,随之增多的就是瘢痕子宫情况。
目前我国平均剖宫产率不断攀升,而且随着人口政策的改革,剖宫产后再次进行妊娠的女性增多,关于选择哪种分娩方式成为了临床比较关注的话题[1]。
因为接受剖宫产后再次妊娠选择阴道试产很可能会出现子宫破裂的情况,而且有些孕妇还是选择再次剖宫产,而不是进行阴道试产。
剖宫产会造成产妇大量出血、住院时间长、组织受损等问题。
所以,该文将会对接受剖宫产术后再次妊娠的孕妇选择阴道试产和剖宫的妊娠结局进行分析,随机选择2016年7月—DOI:10.16662/ki.1674-0742.2018.35.072剖宫产术后再次妊娠阴道试产的妊娠结局分析陈玲思福建医科大学附属福建省妇幼保健院妇产科,福建福州350001[摘要]目的分析剖宫术后在次妊娠阴道试产(VBAC)的妊娠结局。
方法分析随机在该院2016年7月—2017年6月收治的200例剖宫产再次妊娠阴道试产产妇,根据不同的生产方式进行分组,其中100例是剖宫组选择剖宫产术,另100例阴式组选择的阴道分娩的方式,之后对两组产妇的分娩结局进行对比。
结果阴式组产妇分娩结局情况:阴式组的产后出血量(168.41±11.3)mL、住院时间(3.5±1.6)d和总产程(10.4±1.9)h,剖宫组分别是(265.7±10.8)mL、(4.5±1.5)d、(11.6±2.1)h,差异有统计学意义(t=5.007、10.073、5.631;P<0.05)。
阴式组产后并发症发生率是7.0%,显著低于剖宫产组的28.0%,两组数据差异有统计学意义(χ2=15.6843;P<0.05)。
结论对剖宫产术后再次妊娠产妇给予阴道试产妊娠结局显著优于剖宫产,而且产妇分娩出血量较少,产后出现并发症的情况比较少,产妇住院时间比较短,临床安全性很高,值得推广。
[关键词]剖宫产术;阴道分娩;再次妊娠;妊娠结局[中图分类号]R71;R59[文献标识码]A[文章编号]1674-0742(2018)12(b)-0072-03 Analysis of Pregnancy Outcomes of Vaginal Trials after Re-pregnancy after Cesarean SectionCHEN Ling-siDepartment of Obstetrics and Gynecology,Fujian Maternal and Child Health Hospital,Fujian Medical University,Fuzhou, Fujian Province,350001China[Abstract]Objective To analyze the pregnancy outcome of vaginal trial production(VBAC)after cesarean section.Meth⁃ods200cases of cesarean section re-pregnancy vaginal trial delivery admitted to the hospital from July2016to June2017 were analyzed.According to different production methods,100cases were randomly selected for cesarean section.Another 100cases of vaginal delivery were selected as the vaginal group,and then the outcomes of the two groups of women were compared.Results The results of maternal delivery in the vaginal group:postpartum hemorrhage(168.4±11.3)mL,hospital⁃ization time(3.5±1.6)d and total labor(10.4±1.9)h in the vaginal group,and(265.7±10.8)mL,(4.5±1.5)d,(11.6±2.1)h in the cesarean section.There were significant differences(t=5.007,10.073,5.631;P<0.05).The incidence of postpartum compli⁃cations in the vaginal group was7.0%,which was significantly lower than that in the cesarean section(28.0%).The differ⁃ence between the two groups was significant(χ2=15.6843;P<0.05).Conclusion The pregnancy outcome of vaginal trial de⁃livery after cesarean section is significantly better than cesarean section,and the amount of bleeding in maternal delivery is less,the complications after birth were less,the maternal hospitalization time was shorter,with very high clinical safety, which is worth promoting.[Key words]Cesarean section;Vaginal delivery;Re-pregnancy;Pregnancy outcome[作者简介]陈玲思(1982-),女,福建南安人,本科,主治医师,研究方向:产科高危妊娠。
妊娠合并贫血患者应用生血宁片和琥珀酸亚铁片治疗的效果比较
·药物临床·妊娠合并贫血患者应用生血宁片和琥珀酸亚铁片治疗的效果比较贾爱英*王雪萍（河南省安阳县中医院妇产科河南安阳 455112）摘要目的：比较观察妊娠合并贫血患者应用生血宁片和琥珀酸亚铁片治疗的效果。
方法：将90例妊娠合并贫血患者随机分为A组（琥珀酸亚铁片治疗）和B组（生血宁片治疗）各45例。
治疗3月，比较两组贫血相关指标、不良反应、总有效率、妊娠结局情况。
结果：A组总有效率、血红蛋白和血清铁蛋白水平、红细胞计数均明显优于B组（P ＜0.05）；A组药物不良反应、不良妊娠结局均比B组高（P＜0.05）。
结论：对于妊娠合并贫血患者，琥珀酸亚铁片的疗效明显优于生血宁片，但是生血宁片安全性更高。
对于严重贫血患者，两种药物联合使用有互补作用，优化整体治疗效果。
关键词妊娠合并贫血琥珀酸亚铁片生血宁片 疗效中图分类号：R714.254; R286 文献标志码：B 文章编号：1006-1533(2019)09-0040-03Comparison of the effect of Shengxuening tablet and ferrous succinate tablet in the treatment of pregnancy complicated with anemiaJIA Aiying*, WANG Xueping(Department of Gynaecology and Obstetrics, Anyang Hospital of Traditional Chinese Medicine, He’nan Anyang 455112, China) ABSTRACT Objective: To compare the effect of Shengxuening tablet and ferrous succinate tablet in the treatment of pregnancy with anemia. Methods: Ninety pregnant women with anemia were randomly divided into group A (treated with ferrous succinate tablets) and group B (treated with Shengxuening tablets) with 45 cases each. Anemia-related indicators, adverse reactions, total effective rate and pregnancy outcomes were compared between the two groups at 3 months after treatment.Results: The total effective rate, the levels of hemoglobin and serum ferritin, the red blood cell count, and the incidence of adverse drug reactions and adverse pregnancy outcomes were significantly higher in group A than group B (P<0.05). Conclusion: For pregnant women with anemia, the efficacy of ferrous succinate tablets is better than Shengxuening tablets but the safety of Shengxuening tablets is higher. For patients with severe anemia, the combination of the two drugs can complement each other and optimize the overall treatment effect.KEY WORDS pregnancy with anemia; ferrous succinate tablets; Shengxuening tablet; curative effect妊娠合并贫血（iron deficiency anemia, IDA）是妊娠期晚期常见并发症，以缺铁性贫血为主，具有起病急、贫血程度较为严重的特点，我国孕妇IDA发病率19.1%左右[1]。
妊娠期间大剂量应用免疫球蛋白对复发性新生儿血色病的作用
妊娠期间大剂量应用免疫球蛋白对复发性新生儿血色病的作用Whitington P.F.;Hibbard J.U.;郝筱倩【期刊名称】《世界核心医学期刊文摘：胃肠病学分册》【年(卷),期】2005(000)004【摘要】Background Neonatal haemochromatosis is a rare disease of gestation that results in severe fetal liver injury. We hypothesised an alloimmune aetiology for the disorder on the basis of its high recurrence rate in sibships. In this study, we assessed the effectiveness in preventing or changing the severity of recurrent neonatal haemochromatosis of administering during pregnancy high-dose intraven ous immunoglobulin (IVIG) derived from pooled serum of multiple donors. Methods Women whose most recent pregnancy ended in documented neonatal haemochromatosis were treated with IVIG, 1 g/kg bodyweight, weekly from the 18th week until the end of gestation in their subsequent pregnancy. The outcomes of treated pregnancies were compared with those of randomly selected previous affected pregnancies for each woman, which were used as historical controls. Findings 15 women were treated through 16 pregnancies. All pregnancies progressed uneventfully and resulted in live babies with normal physical examinations and birthweights that were a ppropriate for gestational age. 12 babies had evidence of liver involvement with neonatal haemochromatosis: 11 had higher than normal concentrations of serum α-fetoprotein and ferritin or serum α-fetoproteinalone, including four with coagulopathy (international normalisedratio >1.5), and one had coagulopathy alone. All babies survived with medical or no treatment and were healthy at follow-up within the past 6 months. In analysis on a per-mother basis comparing outcomes of treated gestations with those of randomly selected previous affected gesta tions, gestational IVIG therapy was associated with better infant survival (15 good outcomesvs two in previous pregnancies; p=0.0009). Interpretation Treatment with high dose IVIG during gestation appears to have modified recurrent neonat al haemochromatosis so that it was not lethal to the fetus or neonate. These res ults further support an alloimmune mechanism for recurrent neonatal haemochromat osis.【总页数】1页(P10-10)【作者】Whitington P.F.;Hibbard J.U.;郝筱倩【作者单位】Department of Pediatrics;Feinberg Sch.of Med. of NW Univ.;Children’s Memorial Hospital;2300 Children’s Plaza Box57;Chicago;IL 60614;United States;Dr.【正文语种】中文【中图分类】R714.7【相关文献】1.大剂量静脉注射免疫球蛋白对新生儿肺炎患儿T,B细胞功能的抑制作用 [J], 赵晓东;罗洪琦2.大剂量静脉免疫球蛋白在儿科的临床应用及作用机制 [J], 杨跃煌3.分析大剂量静脉注射免疫球蛋白对新生儿肺炎T、B淋巴细胞功能的抑制作用[J], 南称赞4.大剂量免疫球蛋白对妊娠期复发性新生儿血色素沉着病的治疗 [J], Whitington P.F.;Hibbard J.U.;高雪莲5.大剂量静脉免疫球蛋白在新生儿ABO溶血病中的应用研究 [J], 袁惠华;张雪宇;黎小秀;何炯志因版权原因，仅展示原文概要，查看原文内容请购买。
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∙1Seethapathy Clinic and Hospital, Chennai, India.
∙2Madras Diabetes Research Foundation, Chennai, India.
∙3International Diabetes Federation, Brussels, Belgium.
Abstract
AIM:
To evaluate the impact of a structured model of care (MOC) prepared for
resource-constrained settings, on the pregnancy outcomes of Asian Indian women
with gestational diabetes mellitus (GDM).
METHODS:
Pregnant women were screened under the Women in India with GDM Strategy (WINGS) MOC for GDM using the International Association of Diabetes and Pregnancy Study
Groups criteria. Women with GDM went through a structured MOC that included medical nutrition therapy (MNT), regular physical activity (PA); and insulin when indicated. Fasting blood glucose and post-prandial blood sugar were monitored every 2 weeks. The
pregnancy outcomes of women with GDM who underwent the MOC were compared with those without GDM.
RESULTS:
Under the MOC, 212 women with GDM were followed through pregnancy, of whom 33
(15.6%) required insulin and 179 (84.4%) were managed with MNT and PA. The maternal
and neonatal outcomes of women with GDM were similar to the non-GDM women: there were no significant differences in pregnancy complications such as cesarean section, macrosomia, pre-eclampsia, oligo/polyhydramnios, preterm delivery, neonatal
death, fetal distress, hyperbilirubinemia and low birthweight.
CONCLUSION:
Implementation of a structured MOC for women with GDM helped achieve pregnancy outcomes similar to those without GDM.。