经产妇巨大儿相关因素及妊娠结局分析

Analysis of the Pregnancy Results and the Relevant Factors of Multiparas' Fetal Macrosomias

目的探讨经产妇发生巨大儿的相关因素与妊娠结局的关系。方法回顾分析2009年1月-2011年7月在蚌医二附院分娩的65例无严重内外科合并症的非妊娠期糖尿病经产妇巨大儿的资料,并与随机选择的同期分娩无妊娠期糖尿病、无严重内外科合并症经产妇正常体重儿作对照分析,及同期分娩的健康初产妇巨大儿比较分析。结果经产妇巨大儿平均孕周、孕末期体重、孕末期宫高、腹围、剖宫产率、产后出血量、异常产程、新生儿窒息率均显著高于经产妇正常体重儿(P<0.05);与初产妇巨大儿比较,外来流动人口比例增加,正规产检比例明显降低,过期妊娠增多,择期剖宫产率低,新生儿窒息率、产后出血率增加。结论加强经产妇围产期管理,产前正确预测经产妇巨大儿,选择适当的分娩方式,对预防产后出血、降低母婴并发症至关重要。

Objective To explore the pregnancy results and the relevant factors of multiparas＇ fetal macrosomias.Methods The data about 65 fetal macrosomias whose mothers were non-pregnant diabetic multiparas without severe medical or surgical comorbidities in our department from January 2009 to July 2011 were retrospectively analyzed and compared with those about the randomly-selected multiparas＇ babies with normal birth weight and primiparas＇ fetal macrosomias who were delivered at the same time.Results Average pregnancy time,weight of late pregnancy,abdomen circumference,height of uterus,rates of caesarean,rate of postpartum hemorrhage,abnormal labor and rate of new bombabies＇ asphyxia in the multiparas＇ fetal macrosomias group were all higher than those in the primiparas＇ normal weight babies group with significant difference（P0.05）.In comparison with the primiparas＇ fetal macrosomias,the multiparas＇ macrosomias showed increased percentage of floating population,increased number of postterm pregnancy,increased rate of new bom-babies asphyxia,increased rate of postpartum hemomhage,decreased percentage of regular antenatal care and decreased rate of time-selected caesarean section.Conclusion It was very important for the prevention of postpartum hemorrhage and reduction of the complications of mothers and babies to strengthen the management of multiparas＇ perinatal period,correctly forecast multiparas＇ fetal status and select appropriate delivery methods.