双胎妊娠妊娠期糖尿病筛查葡萄糖激发试验佳截断值研究.pdfVIP

OBSTETRICS

Screeningapproachforgestationaldiaesin

twinpregnancies

AndreiRebarber,MD;CaraDolin,MD;JessicaC.Fields,BA;DanielH.Saltzman,MD;

ChadK.Klauser,MD;SimiGupta,MD;NathanS.Fox,MD

OBJECTIVE:TheobjectiveofthisstudywastoevaluatetheidealcutoffRESULTS:Inall,475patientswithtwinpregnanciesunderwentaGCT

fortheglucosechallengetest(GCT)intwinpregnanciesundergoingween24-28weeks.TheincidenceofGDMwas6.5%.Thepositive

screeningforgestationaldiaesmellitus(GDM).screenrateusingthe3selectedcutoffswere:130mg/dL,34.7%;

135mg/dL,28.6%;and140mg/dL,23.4%.AGCTcutoffof

STUDYDESIGN:Ahistoricalcohortofpatientswithtwinpregnancies135mg/dLmaintained100%sensitivity,withaspecificityof76.4%.

wereidentifiedfrom1maternal-fetalmedicinepracticefrom2005Usingthiscutoff,thepositivepredictivevaluewas22.8%andthe

through2013.Allpatientswereadministereda1-hour,50-gGCTneivepredictivevaluewas100%.Comparedtoacutoffof130

ween24-28weeks’gestation.AllpatientswithaGCTof130mg/dL,acutoffof135mg/dLresultedin6.1%spatientstesting

mg/dLunderwenta3-hour,100-goralglucosetolerancetest.Thepositivewhilemaintainingthesame100%sensitivity.

diagnosisofGDMwasmadeif2ofthe4valuesontheoralglucose

CONCLUSION:Intwinpregnancies,theoptimal1-hour,50-gGCT

tolerancetestwereabnormal(CarpenterandCoustan).Thetesting

scre