136例孕晚期死胎分析

Analysis of 136 cases of stillbirth in the third trimester

目的分析死胎发生的相关因素,为降低死胎的发生率提供依据。方法回顾性分析2017年12月至2018年11月山西省妇幼保健院孕晚期(≥28周)死胎的临床资料,对包括产妇年龄、受教育程度、孕产次、剖宫产次数、是否规律产检等进行统计分析。结果①分娩产妇共9 441例,其中晚孕期死胎136例,发生率为1.44%。死胎原因中前3位依次为:胎儿因素79例(41.80%),母体因素52例(27.51%),原因不明29例(15.34%)。②产妇文化程度低、未规律产检的死胎发生率高(P<0.05)。③<20岁组的死胎发生率高于20~35岁及≥35岁组,但差异无统计学意义(P>0.05)。结论加强健康宣教,重视孕前检查和保健,重视对抗磷脂抗体综合征等自身免疫性疾病的筛查和管理,规范产前检查,早期诊断、干预和治疗妊娠合并症/并发症,加强胎儿监测,适时终止妊娠,降低死胎的发生率。

Objective Analysis of the relevant factors of the occurrence of stillbirth, to provide a basis for reducing the occurrence of stillbirth. Methods Retrospectively analyzed the clinical data of 136 stillbirth(≥ 28 weeks of gestation)from December 2017 to November 2018 in Shanxi Maternal and Children’s Health Care Hospital. Including maternal age,eduction level, number of pregnancies,and the number of cesarean section, whether regular antenatal examination etc. Results ① There were 9 441 cases of childbirth, including 136 cases of stillbirth in late pregnancy, the incidence rate was 1.44 %. The top three causes of stillbirth were: fetal factors in 79 cases(41.80 %), maternal factors in 52 cases(27.51 %), and unknown causes in 29 cases(15.34 %).② The incidence of stillbirth was higher in mothers with lower education level and no regular antenatal examination(P<0.05).③ The incidence of stillbirth in the≤20-year-old group was higher than that in the 20~35 age group and the ≥35-year-old group, but the difference was not statistically significant(P>0.05).Conclusion Strengthen health education, pay attention to pre-pregnancy examination and health care, pay attention to screening and management of autoimmune diseases such as anti-phospholipid antibody syndrome, standardize prenatal examination, early diagnosis, intervention and treatment of pregnancy complications/complications, strengthen fetal monitoring, timely terminate pregnancy to reduce the incidence of stillbirth.