非糖尿病性巨大儿240例临床分析

Clinical Analysis of 240 Cases of the Non-diabetic Featl Macrosomia.

目的探讨非糖尿病性巨大儿发生的相关因素、临床特征及并发症。方法回顾性对比分析2004年在我院住院分娩的240例非糖尿病性巨大儿与随机选择同期分娩的215例正常体重儿发生的相关因素、临床特征及并发症。结果非糖尿病性巨大儿组的平均孕龄、双顶径、股骨长、新生儿体重、男性新生儿比例、母亲年龄、孕末期体重、宫高、腹围、胎位异常、剖宫产率、产时出血量、产后出血、产后贫血等发生率均显著高于对照组,差异有显著性(P<0.05);而两组新生儿窒息、新生儿高胆红素血症、宫缩乏力、头盆不称、活跃期停滞发生率及母亲孕产次数、身高与对照组无显著性差异(P>0.05)。结论非糖尿病性巨大儿以男性为多;其发生与其母亲年龄、孕龄、体重等因素有关;可使剖宫率增高,分娩期并发症增加。为提高产科质量,降低围产期并发症,定期产前检查,根据妊娠情况指导孕妇合理膳食及运动,适时分娩是预防巨大儿发生的有效措施。

Objective To probe into the clinical characteristics,rerated factors and complications of the non - diabetic fetal macrosomia. Methods 240 cases of non - diabetic fetal macrosomia borning in the last year were matched with 215 cases of normal - birth - weight new - born selected at random for the retrospective case - control study, Results The mean gestational age, biparietal diameter, femur length, the mean body weight of new - born ,the ratio of male to female, maternal age,body weitht ,fundal size, abdominal circumference , abnormal fetal position, the ratio of cesarean section delivery, bleeding volume during delivery ,the rate of postpartum hemorrhage and postpartum anemia were significantly higher in the macrosomia group than in the control group. The difference of asphyxia,neonatal jaundice,hypotonic uterine contracions,cephalopelvic disproportion ,active phase arrest ,gravidity ,parity and height between the non - diabetic fetal macrosomia and the control group had no statistical significance. Conclusion Most of the non - diatetic macrosomia were male, their incidences were rerated to maternal age, gestational age and body weight, which led to the significant increase of maternal morbility and cesarean sections. Regular antenatal examination, pregnant women＇s reasonable diets and movement in accordance with their pregnancy,timely childbirth are effective measures to prevent the occurrence of fetal macrosomia and improving the obstetric quality,