单纯肥胖孕妇产时并发症分析及影响

Analysis and Influence of Complications in Maternal Obesity Women

目的探讨妊娠期单纯肥胖对分娩及相关并发症的影响。方法随机抽取2009年1月-2016年12月在该院住院分娩的肥胖孕妇150例作为肥胖组,同期住院分娩的正常体重指数孕妇200例作为对照组,比较研究两组试产失败改行剖宫产术、产后出血、巨大儿、胎儿畸形、总产程、肩难产、会阴切口延迟愈合、产钳助产、新生儿窒息发生率的差别。结果妊娠期单纯肥胖孕妇除产后出血发生率(χ^2=2.140,P=0.143)、会阴切口延迟愈合发生率(χ^2=0.080,P=0.771)及新生儿窒息发生率(χ^2=0.170,P=0.679)两组比较(肥胖组依次是4.00%、1.33%、2.67%,正常组依次是1.50%、1.00%、2.00%),均差异无统计学意义(P>0.05)。肥胖组孕妇胎儿畸形发生率2.00%、巨大儿发生率4.00%、肩难产发生率3.33%、产钳助产发生率4.00%普遍高于正常体重孕妇的0.00%(χ^2=4.030,P=0.044)、0.50%(χ^2=5.360,P=0.020)、0.50%(χ^2=4.080,P=0.043)、0.50%(χ^2=5.360,P=0.020),差异有统计学意义(P<0.05)。肥胖孕妇组产程中试产失败改行剖宫产23例(15.33%),经阴道分娩者平均总产程(16.3±1.81)h,此两项指标与正常孕妇组11例(5.50%)(χ^2=9.450,P=0.002)、(12.7±1.94)h(t=17.680,P=0.000)比较差异有统计学意义(P<0.01)。结论妊娠期单纯肥胖同样对产妇和胎儿两方面均有不良影响,但通过严密监护和正确处理可以降低分娩并发症的发生率。

Objective To explore the effect of simple obesity during pregnancy on childbirth and related complications.Methods Randomly selected 150 cases of obese pregnant women and 200 cases of non-obese pregnant women who delivery in the hospital from January 2009 to 2016 December. Comparing with the incidence of caesarean, postpartum hemorrhage, fetal macrosomia, fetal malformations, the total of labor, shoulder dystocia, episiotomy delayed healing, forceps delivery, fetal distress. Results There were no differences in the incidence of postpartum hemorrhage(χ^2=2.14, P=0.143), episitotomy delayed healing(χ^2=0.080, P=0.771) and neonatal asphyxia(χ^2=0.170, P=0.679) between the two groups(the obese group were 4.00%, 1.33%, 2.67%, and the normal group were 1.50%, 1.00%, 2.00%),all the difference was statistically significant(P>0.05). Obese group pregnant women the incidence of fetal malformation was 2.00%,macrogyny was 4.00%, shoulder dystocia was 3.33%, forceps was 4.00%, were generally higher than those of normal weight pregnant women 0.00%(χ^2=4.03, P=0.044), 0.50%(χ^2=5.360, P=0.020), 0.50%(χ^2=4.080, P=0.043), 0.50%(χ^2=5.360, P=0.020), and the difference was statistically significant(P<0.05). In the obese pregnant women’s group, 23 cases(15.33%) of trial labor failure were changed to cesarean section during labor, and the average total labor duration of transvaginal delivery was(16.3±1.81) h, which were statistically different from the 11 cases(5.50%)(χ^2=9.450, P=0.002) and(12.7±1.94)h(t=17.680, P=0.000) of normal pregnant women’s group(P<0.01). Conclusion Obesity in pregnant stage have bed influence both on pregnant women and on fetus, but intensive care and the correct treatment can reduce the incidence of delivery complications for simple obeses pregnant women.