不同分娩方式对足月胎儿生长受限孕妇妊娠结局的影响

Effects of different delivery modes on pregnancy outcomes of pregnant women with full-term fetal growth restriction

目的:通过比较不同分娩方式对胎儿生长受限(FGR)孕妇妊娠结局的影响,为胎儿生长受限孕妇选择合适的分娩方式。方法:将2006～2008年在郑州大学第三附属医院分娩的145例足月FGR孕妇作为研究对象,比较不同分娩方式新生儿不良妊娠结局(窒息或羊水污染发生)的比例;比较不同指征行剖宫产的FGR孕妇不良妊娠结局发生比例;比较发生不良妊娠结局组及妊娠结局正常组新生儿的体重。结果:①剖宫产组较阴道分娩组新生儿不良结局的发生率低,但差异没有统计学意义。②以羊水过少或胎窘为指征的FGR孕妇新生儿不良妊娠结局发生率高。③不良妊娠结局组新生儿体重更低。结论:影响生长受限胎儿预后的主要是新生儿的出生体重而不是分娩方式,伴有羊水过少或是疑诊胎窘的FGR病例选择性的剖宫产相对安全。

Objective：To choose appropriate delivery modes for pregnant women with fetal growth restriction（FGR） by comparing the effects of different delivery modes on pregnancy outcomes of pregnant women with FGR. Methods：145 pregnant women with full-term FGR who deliveried in the hospital from 2006 to 2008 were selected as study objects,the proportions of adverse pregnancy outcomes（asphyxia and amniotic fluid pollution） of the neonates born by different delivery modes were compared;the proportions of adverse pregnancy outcomes of FGR pregnant women with different indicators of cesarean section were compared;the body weights of neonates in adverse pregnancy outcomes group and normal pregnancy outcomes group were compared. Results：The incidence of neonatal adverse pregnancy outcomes in cesarean section group was lower than that in vaginal delivery group,but there was no significant difference between the two groups.The incidence of neonatal adverse pregnancy outcomes in FGR pregnant women with indicators of oligohydramnios and fetal asphyxia was high.The body weight of neonates in adverse pregnancy outcomes group was lower. Conclusion：The main effect factor of prognosis of fetuses with FGR is birth weight of neonates,rather than delivery modes,it is safe for the cases with FGR combined with oligohydramnios or suspicious fetal asphyxia to choose cesarean section