产时超声管理妊娠期糖尿病初产妇产程的临床研究

doi:10.20223/j.cnki.1000-8535.2025.10.015

广州医药 ›› 2025, Vol. 56 ›› Issue (10): 1423-1427.DOI: 10.20223/j.cnki.1000-8535.2025.10.015

产时超声管理妊娠期糖尿病初产妇产程的临床研究

黄婉珊¹, 秦炜¹, 陆燕运¹, 李碧琳¹, 林敏仪¹, 区惠仪², 黄晓娟¹

1 佛山市高明区人民医院妇产科（广东佛山 528500）
2 佛山市高明区人民医院超声医学科（广东佛山 528500）

收稿日期:2024-09-14 出版日期:2025-10-20 发布日期:2025-11-28
基金资助:
佛山市卫生健康局医学科研项目（20220105）

A clinical study of intrapartum ultrasound in the management of labor in primiparous women with gestational diabetes mellitus

HUANG Wanshan¹, QIN Wei¹, LU Yanyun¹, LI Bilin¹, LIN Minyi¹, OU Huiyi², HUANG Xiaojuan¹

1 Department of Obstetrics and Gynecology,Foshan Gaoming District People’s Hospital,Foshan 528500,China
2 Department of Ultrasound Medicine,Foshan Gaoming District People’s Hospital,Foshan 528500,China

Received:2024-09-14 Online:2025-10-20 Published:2025-11-28

摘要/Abstract

摘要： 目的探讨产时超声管理妊娠期糖尿病产妇产程的应用价值。方法选择2022年1月1日—2023年12月31日在佛山市高明区人民医院妇产科分娩的妊娠期糖尿病初产妇共100例。患者签署知情同意书后,按照1∶1比例采用随机数字表法分为对照组和研究组各50例。对照组采用阴道指诊检查判断产程和分娩方式。研究组采用经腹联合会阴超声测量检查判断产程及分娩方式。收集两组初产妇血糖、血常规、分娩方式、产后24 h出血量以及切口情况,新生儿Apgar评分。结果研究组阴道分娩率高于对照组（88.0% vs 72.0%,P<0.05）,而阴道检查次数（4.18±0.8 vs 6.82±0.8,P<0.05）少于对照组、不良事件发生率（4% vs 16%,P<0.05）低于对照组。相对于对照组,研究组血红蛋白水平较高（104.10±5.25 vs 100.30±4.78,P<0.05）、而白细胞计数（11.40±1.49 vs 12.04±1.66,P<0.05）以及中性粒细胞百分比较低（72.79±4.04 vs 75.01±5.53,P<0.05）。结论通过产时超声监测判断妊娠期糖尿病初产妇产程,能够降低阴道操作引起的感染等风险,提高阴道分娩率,有效降低产妇感染,提高产妇分娩满意度以及舒适度,改善母婴结局。

关键词: 产时超声, 妊娠期糖尿病, 初产妇, 阴道分娩, 妊娠结局

Abstract: Objective To explore the application value of intrapartum ultrasound for labor management of pregnant women with gestational diabetes mellitus．Methods A total of 100 primiparous women with gestational diabetes mellitus who gave birth in the Obstetrics and Gynecology Department of Foshan Gaoming District People’s Hospital from January 1,2022 to December 31,2023 were selected．After signing the informed consent form,the patients were randomly divided into a control group and a study group with 50 cases in each group according to a ratio of 1∶1,using a random number table method．The control group underwent vaginal digital examination to assess the labor process and delivery method．For the study group,the labor process and delivery mode were determined using transabdominal ultrasound measurement．Blood glucose level,routine blood test results,delivery methods,24-hour postpartum bleeding volume and incision conditions of two groups of primiparas,as well as the Apgar score of newborns were collected．Results The study group demonstrated a significantly higher vaginal delivery rate than the control group（88.0% vs 72.0%,P<0.05）,with fewer vaginal examinations（4.18±0.80 vs 6.82±0.80,P<0.05）and a lower incidence of adverse events（4% vs 16%,P<0.05）．Compared to the control group,the study group exhibited higher hemoglobin levels（[104.10±5.25]g/L vs [100.30±4.78] g/L,P<0.05）,but lower white blood cell counts（[11.40±1.49]×10⁹/Lvs [12.04±1.66]×10⁹/L,P<0.05）and reduced neutrophil percentages（[72.79±4.04]% vs [75.01±5.53]%,P<0.05）．Conclusions Intrapartum ultrasound monitoring for assessing labor progression in primiparas with gestational diabetes mellitus reduces infection risks associated with vaginal procedures,increases vaginal delivery rates,effectively decreases maternal infections,enhances maternal satisfaction and comfort during delivery,and improves maternal-neonatal outcomes．

Key words: intrapartum ultrasound, gestational diabetes mellitus, primiparous women, vaginal delivery, pregnancy outcome

黄婉珊, 秦炜, 陆燕运, 李碧琳, 林敏仪, 区惠仪, 黄晓娟. 产时超声管理妊娠期糖尿病初产妇产程的临床研究[J]. 广州医药, 2025, 56(10): 1423-1427.

HUANG Wanshan, QIN Wei, LU Yanyun, LI Bilin, LIN Minyi, OU Huiyi, HUANG Xiaojuan. A clinical study of intrapartum ultrasound in the management of labor in primiparous women with gestational diabetes mellitus[J]. Guangzhou Medical Journal, 2025, 56(10): 1423-1427.

参考文献

[1] MALVASI A,VIMERCATI A.Is it time for midwives to do intrapartum ultrasound in the delivery ward?[J].J Matern Fetal Neonatal Med,2022,35(25):9568-9569.
[2] KATZIR T,BREZINOV Y,KHAIRISH E,et al.Intrapartum ultrasound use in clinical practice as a predictor of delivery mode during prolonged second stage of labor[J].Arch Gynecol Obstet,2023,307(3):763-770.
[3] HINKSON L,HENRICH W,TUTSCHEK B.Intrapartum ultrasound during rotational forceps delivery:A novel tool for safety,quality control,and teaching[J].Am J Obstet Gynecol,2021,224(1):93.e1-93.e7.
[4] 刘洪莉,李俊男.《产时超声:世界围产医学会和围产医学基金会临床实践指南和推荐》解读[J].中国产前诊断杂志(电子版),2022,14(3):1-7.
[5] 章玉霞,张诗婕,廖瑞碧,等.产时超声临床应用的初步研究[J].中国超声医学杂志,2023,39(10):1153-1156.
[6] LI Y,WANG C,LU H,et al.Effects of perineal massage during childbirth on maternal and neonatal outcomes in primiparous women:A systematic review and meta-analysis[J].Int J Nurs Stud,2023(138):104390.
[7] HASSAN W A,EGGEBO T M,FERGUSON M,et al.Simple two-dimensional ultrasound technique to assess intrapartum cervical dilatation:A pilot study[J].Ultrasound Obstet Gynecol,2013,41(4):413-418.
[8] NASSR A A,BERGHELLA V,HESSAMI K,et al.Intrapartum ultrasound measurement of angle of progression at the onset of the second stage of labor for prediction of spontaneous vaginal delivery in term singleton pregnancies:A systematic review and meta-analysis[J].Am J Obstet Gynecol,2022,226(2):205-214.
[9] 刘洪莉,张兰,漆洪波.国际妇产科超声学会实践指南解读:产时超声[J].中国实用妇科与产科杂志,2019,35(2):206-209.
[10] USMAN S,BARTON H,WILHELM-BENARTZI C,et al.Ultrasound is better tolerated than vaginal examination in and before labour[J].Aust N Z J Obstet Gynaecol,2019,59(3):362-366.
[11] BIROL ILTER P,YASSA M,TIMUR H,et al.Intrapartum ultrasound for fetal head asynclitism:Is it possible to establish a degree of asynclitism to correlate to delivery outcome?[J].Int J Gynaecol Obstet,2023,163(1):271-276.
[12] CUERVA M J,RODRIGUEZ E,PEREZ DE AGUADO M,et al.Intrapartum ultrasound in maternal lateral versus semi-recumbent posture.A repeated measures study[J].Eur J Obstet Gynecol Reprod Biol,2023(285):46-49.
[13] di PASQUO E,RAMIREZ ZEGARRA R,KIENER A J O,et al.Usefulness of an intrapartum ultrasound simulator(IUSimTM)for midwife training: Results from an RCT[J].Fetal Diagn Ther,2021,48(2):120-127.
[14] 陈晓霞. 产时超声评估产程与分娩方式的临床研究[D].遵义:遵义医科大学,2020.
[15] 刘婷婷,杨杰,赵娜,等.产时超声在初产妇阴道试产产程中的临床应用价值研究[J].西藏医药,2024,45(3):32-34.
[16] 魏婧,董晓超,刘蓉,等.产时超声在第二产程延长中对分娩方式的指导及对母婴结局的影响[J].实用医学杂志,2022,38(14):1798-1803.

产时超声管理妊娠期糖尿病初产妇产程的临床研究

A clinical study of intrapartum ultrasound in the management of labor in primiparous women with gestational diabetes mellitus

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