胎儿生长受限的原因分析和孕妇分娩方式的选择

Cause analysis of fetal growth restriction and selection of delivery mode of pregnant woman

目的探讨胎儿生长受限的影响因素及不同分娩方式对分娩结局的影响。方法选择2017年1月至2020年1月就诊于本院的100例胎儿生长受限孕妇作为研究组,另选取同期100名正常孕妇作为对照组。收集两组孕妇的临床资料,分析胎儿生长受限发生的危险因素;比较剖宫产组与阴道分娩组孕妇的分娩结局。结果单因素分析结果显示,两组的妊娠期合并症、宫内窘迫、胎膜早破、羊水过少、前置胎盘、胎盘形态异常、单脐动脉、脐带过短、脐带缠绕情况比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,妊娠期合并症、宫内窘迫、胎膜早破、羊水过少、前置胎盘、胎盘形态异常、单脐动脉、脐带过短、脐带缠绕为胎儿生长受限的独立危险因素(P<0.05)。剖宫产组的羊水污染、新生儿窒息、胎儿窘迫发生率均明显低于阴道分娩组,差异具有统计学意义(P<0.05)。结论妊娠期合并症、宫内窘迫、胎膜早破、羊水过少、前置胎盘、胎盘形态异常、单脐动脉、脐带过短、脐带缠绕是胎儿宫内生长受限发生的危险因素。经剖宫产分娩的胎儿生长受限孕妇的分娩结局优于经阴道分娩。

Objective To investigate the influencing factors of fetal growth restriction and the influence of different delivery mode on the delivery outcome.Methods A total of 100 pregnant women with fetal growth restriction treated in our hospital from January 2017 to January 2020 were selected as study group,and another 100 normal pregnant women during the same period were selected as control group.The clinical data of two groups were collected to analyze the risk factors of fetal growth restriction;the delivery outcomes were compared between cesarean section group and vaginal delivery group.Results Univariate analysis result showed that there were significant differences in pregnancy complications,intrauterine distress,premature rupture of membranes,oligohydramnios,placenta previa,abnormal placental morphology,single umbilical artery,too short umbilical cord and umbilical cord entanglement between the two groups(P<0.05).Multivariate Logistic regression analysis result showed that pregnancy complications,intrauterine distress,premature rupture of membranes,oligohydramnios,placenta previa,abnormal placental morphology,single umbilical artery,too short umbilical cord and umbilical cord entanglement were independent risk factors for fetal growth restriction(P<0.05).The incidences of amniotic fluid pollution,neonatal asphyxia and fetal distress in the cesarean section group were significantly lower than those in the delivery group group(P<0.05).Conclusion Pregnancy complications,intrauterine distress,premature rupture of membranes,oligohydramnios,placenta previa,abnormal placental morphology,single umbilical artery,too short umbilical cord and umbilical cord entanglement are the risk factors of fetal growth restriction.The delivery outcome of pregnant women with fetal growth restriction delivered by cesarean section is better than that delivered by vagina.