过期妊娠147例临床分析

Clinical Analysis of 147 Cases of Postterm Pregnancy

目的 降低过期妊娠的发生率 ,减少过期妊娠对母儿的负面影响。方法 对 147例过期妊娠与随机抽取的 147例足月妊娠的产前检查、分娩处理及围产儿情况进行统计比较 ,并从生理生化上观察。结果 过期妊娠组胎儿监护异常 4 5例 ,占 30 .61% ,足月妊娠组 18例 ,占 12 .2 4 % ,异常率差异显著 ,P <0 .0 1。剖宫产中过期妊娠组新生儿Ⅱ度窒息 5例 ,占 8.92 % ,足月组 4例 ,占 2 .72 % ,阴道产中过期妊娠组Ⅱ度窒息 11例 ,占 15 .38% ,足月组 9例 ,占 4 .81% ,P <0 .0 5。两组临产、分娩及产后 1小时生理、生化测定结果 ,无明显差异 ,P >0 .0 5。新生儿Ⅱ度窒息率两组均为阴道产较剖宫产高。结论 过期妊娠易造成胎儿缺氧 ,致使难产率增加 ,剖宫产率升高 ,建议 4 1周终止妊娠。过期妊娠的关键在于正确推算预产期 。

Objective To reduce the incidence rate of postterm pregancy and decrease the negative effect of postterm prenancy on patients and neonate. Methods Retrospective analysis to antental care delivery treatment and neonate of 147 cases of postterm pregnancy was made. Results B-type ultrasonography discovered that circular calcifition and oligohydramnios was found in 82 patients,55.78%; abnormal fetus exteral electronic monitoring in 45 cases, 30%; caesarean section in 82 cases,55.78%, in which Ⅱ° distress of neonate in 9 cases; vaginal delivery in 65 cases, 44.21%, in whichⅡ°distress of neonate in 10 cases,Ⅱ° stress rate of neonate rose remarkably in vaginal delivery. Conclusion Pestterm pregrany easily causes fetus oxygen defect, and cause the dystocia rate to rise and cacesarean rate increase. So we propose that pregnangy be ended before 41 weeks. The key of postterm pregancy lies in correectly expecting the date of confinement and choosing the mode of delivery according to funtional state of placenatal and fatural degree of cervis.