巨大儿与新生儿窒息(附391例分析)

HUGE INFANTS AND SUFFOCATION OF NEW BORN BABY (ATTACHING THE ANALYSIS OF 391 CASES)

1985～1992年间，本院共分娩活产儿23033例，围产期巨大儿的发生率为1．69％，窒息发生率为15．86％，经阴道自然分娩窒息的发生率最低为7.83％；而臀位助产和产钳窒息率分别高达100％和41．67％；剖宫产是手术产中窒息率最低的为12．03％。作者认为一旦确定为巨大儿，如果产妇条件允许，可经阴道自然分娩，但臀位及过期妊娠或试产中有梗阻现象，均应果断采取剖宫产结束分娩，不宜采取产钳助产。

There were 23 033 cases of survival infants through parturition in this hospital from1985 to 1992, including 391 cases of huge infants. The occurrence of huge infant in perinate is 1. 69. Comparing with the infants with normal body weight born in the same period which occurrence of suffocation is 4. 33 per cent, a highly obvious difference and higher suffocation and mortality of male infants could be found (P<0. 01). The occurrence of suffocation by normal vagina parturition is the lowest,e. g. 7. 83 per cent, while it is much higher by breech delivery and obstetric forceps, 100 percent and 41. 6 percent respectively. The occurrence of suffocation through caesarean is the lowest by the way of operation, e. g. 12. 03 per cent.The author suggests that once the huge infant occurs the vagina parturition should be adopt ed if the lying-in woman has better healthy condition, the normal position of foetus, no block in the vagina. In the case of breech and over-gestation or the head of foetus blocked in the first trying,the caesarean operation should be adopted resolutely. The use of obstetric forceps is inadvisable