887例孕妇孕周、年龄与羊水Ⅲ度粪染关系研究

A study on relationship between gestational week, age and Ⅲ° amniotic fluid mecouium of 887 normal term pregnant women

目的探讨正常足月妊娠妇女孕周、年龄与羊水Ⅲ度粪染的关系。方法采用病例回顾性分析的研究方法，对2008年1—8月在上海浦东新区妇幼保健院足月单胎、无手术指征行剖宫产术终止妊娠的887例病例的，胳床资料进行统计学分析。结果孕妇在孕38^＋-39周羊水Ⅲ度粪染的发生率为17．7％，孕39^＋-40周的发生率为33．9％，孕40^＋～41周的发生率为60．5％，孕41^＋周后的发生率为62．3％。孕妇在25～29岁年龄段羊水Ⅲ度粪染的发生率为34．9％，30～34岁的发生率为45．8％，35岁后的发生率为68．4％。结论建议正常足月妊娠妇女在孕40周后进行人工干预，尽早中止妊娠。孕妇孕39周后应加强胎儿宫内监护，尽早发现胎儿宫内窘迫的可能，减少新生儿窒息率的发生。

Objective To investigate relationship between gestational weeks, age and Ⅲ°arrmiotic fluid meconium of normal term pregnant women. Methods The clinical data of 887 term parturient women with singleton pregnancy who underwent cesarean section to terminate pregnancy without any operation indications in Shanghai Pudongxinqu Maternal and Child Health Hospital in a period from January to August in 2008 were analyzed respectively. Results The incidence of Ⅲ°amniotic fluid meconium of pregnant women in 38 ^＋ 1 - 39 weeks of gestation was 17.7%, that in 39 ^＋- 40 weeks of gestation was 33.9% and that in 40 ^＋1 -41 weeks of gestation was 60.5 % and 62.3 % in more than 41 ^＋1weeks of gestation. And the incidence of Ⅲ° amniotic fluid meconium was 34.9% in 25 -29 years age group, 45.8% in 30 - 34 years age group, 68.4% in older than 35 years age group respectively. Conclusion We recommend that normal term pregnant women at more than 40 gestational weeks of gestation should be intervened and their pregnancy should be terminated artificially as earlier as possible. After 39 weeks of gestation, the fetal intrauterine monitoring should be enhanced to identify development of fetal distress as early as possible, so as to reduce incidence of neonatal asphyxia.