490例高危妊娠管理的回顾性分析

Retrospective analysis on management of 490 cases of high-risk pregnancy

[目的]分析高危妊娠原因的变化情况,降低高危妊娠发生率及孕产妇和围生儿死亡率。[方法]对上海市浦东新区大团社区户籍范围内实行系统管理的孕妇2 060例进行筛查,并将2004—2006年系统管理的孕妇997例设为A组,2007—2009年系统管理的孕妇1 063例设为B组。[结果]A组高危妊娠的发生率为20.3%,剖宫产率为64.4%,高危因素的前4位依次为乙肝表面抗原阳性、≥36孕周胎位不正、剖宫产史和≥2次流产;B组高危妊娠的发生率为27.1%,剖宫产率为70.1%,高危因素的前4位依次为剖宫产史、乙肝表面抗原阳性、≥2次流产和≥36孕周胎位不正。[结论]随着剖宫产率的增高,高危妊娠的发生率也增高。只有采取必要的干预措施,降低剖宫产率,才能降低高危妊娠发生率,有效地保障母婴安全。

[Objective] To analyze high-risk pregnancy and decrease the incidence of high-risk pregnancy and the death rate of pregnant women and infants. [Methods] In Pudong New Area of Shanghai,a series of 2 060 pregnant women under system management were screened for high-risk pregnancy,of whom 997 under 2004-2006 system management were allocated into group A and 1 063 under 2007-2009 system management into group B. [Results] In group A,the incidence of high-risk pregnancy was 20.3%,and the rate of cesarean section 64.4%.The first 4 high-risk factors were positive antigen of hepatitis B,abnormal fetal position for more than 36 weeks during pregnancy,experience of cesarean,abortion for more than twice.In group B,the incidence of high-risk pregnancy was 27.1%,and the rate of cesarean section 70.1%.The first 4 high-risk factors were experience of cesarean,positive antigen of hepatitis B,abortion for more than twice,abnormal fetal position for more than 36 weeks during pregnancy. [Conclusion] With the increase in cesarean section rate,high-risk pregnancy is increased.Only through necessary interventions can we decrease the cesarean section rate and high-risk pregnancy and ensure the security of mother and baby.