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目的对医源性早产因素构成及结局进行回顾性分析,旨在为医源性早产临床诊治提供流行病学资料。方法将2012年本院产科分娩的单胎早产儿作为研究对象,分为医源性早产组和自发性早产组。分析医源性早产因素构成,比较两组孕母情况、早产儿结局、疾病情况等。结果251例医源性早产儿中,晚期早产儿占79.7%,医源性早产因素前五位分别为胎儿宫内窘迫(23.1%)、母亲重度先兆子痫(20.7%)、前置胎盘(16.7%)、母亲妊娠期肝内胆汁淤积症(16.3%)和胎盘早剥(9.2%)。医源性早产组剖宫产率和母亲产后出血发生率均高于自发性早产组(94.4%比32.2%,6.0%比1.3%),早产儿出生体重低于自发性早产组[(2378±579)g比(2540±597)g],住院比例高于自发性早产组(51.4%比32.5%),差异有统计学意义(P<0.01)。两组早产儿住院患儿中,医源性早产儿组新生儿湿肺、新生儿呼吸窘迫综合征、电解质紊乱发生率高于自发性早产儿组,高胆红素血症发生率低于自发性早产儿组(P<0.01)。结论对于医源性早产,重视孕期保健及产前检查,选择合适的孕周及分娩方式对母婴安全十分重要。
Objective To retrospectively analyze the composition and outcome of idiopathic premature labor in order to provide epidemiological data for clinical diagnosis and treatment of idiopathic premature labor. Methods The singleton fetus with obstetric delivery in our hospital from 2012 to 2012 was divided into iatrogenic preterm group and spontaneous preterm group. Analysis of iatrogenic factors of preterm birth, comparison of the two groups of pregnant mothers, premature children outcome, disease conditions. Results Among the 251 cases of iatrogenic preterm infants, 79.7% of them were premature infants with preterm birth, and the top five iatrogenic preterm infants were fetal distress (23.1%), maternal preeclampsia (20.7%), placenta previa 16.7%), maternal pregnancy intrahepatic cholestasis (16.3%) and placental abruption (9.2%). The incidence of cesarean section and maternal postpartum hemorrhage in iatrogenic preterm group were higher than those in spontaneous preterm group (94.4% vs 32.2%, 6.0% vs 1.3%), and the birth weight in premature children was lower than that in spontaneous preterm group [(2378 ± 579), g (2540 ± 597) g, and hospitalization rate was higher than spontaneous preterm labor group (51.4% vs 32.5%, P <0.01). In the two groups of infants with preterm infants, the incidence of neonatal wet lungs, neonatal respiratory distress syndrome and electrolyte imbalance in iatrogenic preterm infants was higher than that in spontaneous preterm infants, and the incidence of hyperbilirubinemia was lower than spontaneous Sex premature children group (P <0.01). Conclusion For iatrogenic premature delivery, emphasis on prenatal care and prenatal care, it is very important for mothers and babies to choose appropriate gestational age and mode of delivery.