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目的回顾性分析巨大胎儿(巨大儿)的孕期及分娩期的临床特点,为孕期保健和临床管理提供依据。方法选取2014年6月至2015年5月在福建省妇幼保健院行中孕产前筛查的单胎病历6 893例,其中巨大儿(胎儿体重≥4 000g)471例;同期体重<4 000g的胎儿6 422例为对照,分析两组的孕期及分娩情况。结果巨大儿组妊娠期糖尿病、胎膜早破、羊水过多、产后出血发生率与剖宫产率均高于对照组,羊水过少发生率低于对照组;巨大儿组阴道分娩者产后出血和新生儿窒息发生率(2.8%、19.2%)高于剖宫产(0.4%、5.5%),而对照组两种分娩情况差异无统计学意义。结论应重视巨大儿的临床特点和诊断,加强对妊娠期糖尿病的筛查和管理,加强胎儿生长发育的宫内监测,及早诊断,选择合适的分娩方式,以减少母儿并发症。
Objective To retrospectively analyze the clinical features during pregnancy and childbirth of giant fetus (giant child), and provide the basis for health care and clinical management during pregnancy. Methods A total of 6 893 single-fetus medical records were selected from prenatal screening in the Maternal and Child Health Hospital of Fujian Province from June 2014 to May 2015. Among them, 471 were single children with huge fetuses (fetal weight ≥ 4000g), 4 000 g Of 6 422 fetuses as a control, analysis of the two groups during pregnancy and childbirth. Results Giant children with gestational diabetes mellitus, premature rupture of membranes, polyhydramnios, postpartum hemorrhage rate and cesarean section rate were higher than the control group, the incidence of oligohydramnios was lower than that of the control group; macrosomia group vaginal delivery postpartum hemorrhage And neonatal asphyxia (2.8%, 19.2%) were higher than those of cesarean section (0.4%, 5.5%). There was no significant difference between the two births in the control group. Conclusions Should pay attention to the clinical features and diagnosis of giant children, to strengthen screening and management of gestational diabetes mellitus, to strengthen fetal growth and development of intrauterine monitoring, early diagnosis, choose the appropriate mode of delivery to reduce the complications of mother and child.