过期妊娠分娩方式及终止妊娠时机与胎儿预后的分析研究

Analysis of Delivery Mode and Time of Ending Pregnancy for Prolonged Pregnancy and Fetus Prognosis

目的:探讨过期妊娠分娩方式及终止妊娠时机与胎儿预后的关系。方法:以病例对照研究方法分析2009年1月-2012年12月共86例过期妊娠及684例延期妊娠病例。结果:过期妊娠剖宫产胎儿窘迫率及新生儿窒息率显著低于阴道产,而产后出血率比较差异无统计学意义;过期妊娠组的胎儿窘迫率及新生儿窒息率均显著高于延期妊娠组,但羊水过少发生率比较差异无统计学意义。结论:加强宣教,定期产验,延期妊娠时加强胎儿监护,积极采取恰当的处理,终止妊娠,以减少过期妊娠的发生;发生过期妊娠时放宽剖宫产指征,及时终止妊娠,均有利于降低胎儿窘迫、新生儿窒息、新生儿死亡率。

Objective：To explore the relationship between delivery mode and time of ending pregnancy of prolonged pregnancy with fetus prognosis.Method：86 cases of prolonged pregnancy and 684 cases of delayed pregnancy from January 2009 to December 2012 were analyzed by case-control method.Result：The fetal distress rate and neonatal asphyxia rate of prolonged pregnancy caesarean section were significantly lower than those of vaginal delivery,but there was no significant difference in postpartum hemorrhage rate;the fetal distress rate and neonatal asphyxia rate of prolonged pregnancy were significantly higher than those of delayed pregnancy,but there was no significant difference in the incidence rate of oligohydramnios.Conclusion：Strengthening education,regular prenatal examination, reinforcing fetus supervision in delayed pregnancy,handling actively and properly and ending the pregnancy should be taken to decrease delayed pregnancy. Relaxing the indication cesarean section,ending pregnancy in time when delayed pregnancy is occurred both can help reduce the occurrence rate of fetal distress, asphyxia neonatorum and newborn mortality.