延期妊娠临床处理选择的探讨

Clinical Management of Delayed Pregnancy

目的探讨延期妊娠引产时机及方式的选择对产妇剖宫产率、并发症率及新产儿窒息率等的影响,为临床处理选择提供参考,以期有效减少剖宫产率及分娩并发症。方法对本院2006年1月～2008年1月收治382例孕41～41+6周、无妊娠合并症及并发症的产妇分成两组,一组予引产(205例):如宫颈评分≥7分,予人工破膜引产;如宫颈评分≤6分,予催产素引产;另一组为自然临产组(177例):即在严格监护下等待自然临产,将两组的母儿结局进行统计学分析比较。结果引产组较自然临产组剖宫产率有明显增加,差异有显著性(P<0.05),其他母儿并发症差异无统计学意义(P>0.05)。结论对于无妊娠合并症及并发症的延期妊娠,在现有多种手段对胎儿进行密切监护的条件下可以等待自然临产。

Objective To explore the effects of the suitable induction time and manner in delayed pregnancy（41 weeks） on cesarean section rate, complication rate and the asphyxia rate of new births in an effort to effectively reduce the cesarean section rate and obstetric complications. Methods We divided into two groups 382 cases 41-41＋6 week pregnants in our hospital from Jan 2006 to Jan 2008 ,with no pregnancy complications, one group was induced labor group 205 eases ： if the cervical score ≥ 7 points, induction of labor was prepared by artificial rupture of membrane;if the cervical score ≤6 points,induction of labor was prepared with oxytocin ）and the other was natural labor group（ 177 cases：waiting for natural labor by strict monitoring）. The outcomes of the two groups were statistically analyzed and compared. Results The cesarean section rate was significantly increased in the induced labor group compared with natural labor group, with a significant difference（P〈0.05）, and there was no significant difference in the maternal and fetal complications between the two groups （P〉0.05）. Conclusion Waiting for natural labor is possible due to many existing means of strict monitoring in delayed pregnancy.