Page 138 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第43卷第5期
·720 · Journal of Nanjing Medical University（Natural Sciences） 2023年5月

·临床研究·

妊娠期糖尿病足月胎膜早破引产时机的探讨及其对母儿结局

的影响

王姗姗，石中华 *

南京医科大学生殖医学国家重点实验室，南京医科大学附属妇产医院（南京市妇幼保健院），江苏 南京 211166

［摘 要］ 目的：探讨妊娠期糖尿病（gestational diabetes mellitus，GDM）足月胎膜早破（premature rupture of membrane，PROM）
孕妇不同引产时机对母儿结局的影响。方法：回顾性分析南京市妇幼保健院2017年6月—2021年7月，除GDM以外无其他合
并症及并发症的足月胎膜早破催产素引产的孕妇585例，根据PROM距离启动催产素（oxytocin）引产的时间间隔（P⁃O）分为3
组：A组（2~6 h），B组（6~9 h）和C组（9~12 h）。对3组病例的一般临床资料、母儿主要结局进行统计学分析。结果：①PROM距
离分娩（delivery）的时间（P⁃D）随着引产启动时间（P⁃O）的延迟而增加（P 趋势＜0.05），其中A组的P⁃D时间最短（P＜0.05）；②剖
宫产、产间发热、绒毛膜羊膜炎、胎儿宫内窘迫的发生率会随着 P⁃O 的延长而升高（P 趋势＜0.05），其中 A 组发生率最低（P＜
0.05）；3组子宫收缩乏力、产后出血、产褥病率等发生率未见统计学差异；③3组产妇因子宫收缩乏力而剖宫产的发生率随着P⁃O
的延迟而增加（P 趋势＜0.05）；④A组新生儿败血症的发病率、新生儿颅内出血的发生率显著低于C组（P＜0.05）。结论：妊娠期
糖尿病足月胎膜早破孕妇在无其他并发症且排除阴道分娩禁忌症情况下，选择2~6 h内催产素引产，既可以减少临床抗菌素
的使用，也可以显著降低母儿不良结局的发生率。
［关键词］ 妊娠期糖尿病；足月胎膜早破；引产时机；母儿妊娠结局
［中图分类号］ R714.256 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）05⁃720⁃04
doi：10.7655/NYDXBNS20230519

Study on the precise timing of oxytocin labor induction in GDM women with term
premature rupture of membranes and its influence on pregnancy outcomes

WANG Shanshan，SHI Zhonghua *
State Key Laboratory of Reproductive Medicine，Nanjing Medical University，Women’s Hospital of Nanjing Medical
University（Nanjing Maternity and Child Health Care Hospital），Nanjing 210004，China

［Abstract］ Objective：To study the precise timing of labor induction in GDM women with term premature rupture of membranes and
its infuence on maternal and neonatal outcomes. Methods：A retrospective analysis was performed on 585 pregnant women with
premature rupture of membranes at term without other comorbidities and complications except GDM in Nanjing Maternal and Child
Health Hospital between June 2017 and July 2021，which were divided into three groups according to the interval time（P⁃O）between
preterm rupture of membranes and initiation of oxytocin induction：group A（2~6 h），group B（6~9 h），group C（9~12 h）. The general
clinical data，maternal and neonatal outcomes of the cases in the three groups were statistically analyzed. Results：①The time from
premature rupture of membranes to delivery（P⁃D）increased with the delay of induction of labor initiation（P⁃O）（Ptrend < 0.05），with the
shortest P⁃D time in group A（P < 0.05）. ②The incidence of cesarean delivery，interpartum fever，chorioamnionitis，and intrauterine
distress increased with the prolongation of P⁃O（Ptrend < 0.05），of which the incidence was the lowest in group A（P < 0.05）；no statistical
difference was found in the incidence of uterine contraction weakness，postpartum hemorrhage，and puerperal disease in the three
groups. ③The incidence of cesarean delivery due to uterine atony increased with the delay of P⁃O in the three groups（Ptrend < 0.05）. ④
The incidence of neonatal sepsis and neonatal intracranial hemorrhage in group A was significantly lower than that in group C（P trend<

［基金项目］ 国家自然科学基金面上项目（81971410）；国家重点研发计划（2022YFC2703503）；江苏省重大疾病生物资源样本
库出生队列子库开放课题（TC2021B024）
∗
通信作者（Corresponding author），E⁃mail：jesse_1982@163.com