辅助生殖技术妊娠的产程特征及分娩结局分析

Analysis of labor process characteristics and delivery outcomes of assisted reproductive technology pregnancy

目的探讨辅助生殖技术(assisted reproductive technology,ART)妊娠中单胎初产妇经阴道试产的产程特征及分娩结局。方法选取2018年1月1日至2019年12月31日首都医科大学附属北京妇产医院产房经阴道分娩的单胎孕妇3945例,将ART妊娠的孕妇纳入ART组(795例),匹配自然妊娠的孕妇为对照组(3150例),回顾性分析两组妊娠期的产程特征、并发症及分娩结局。结果ART组妊娠合并甲状腺功能减低发生率明显高于对照组(14.5%比10.7%),产妇难产、会阴侧切、产后出血≥1000 ml和新生儿窒息(Apgar评分5 min<7分)的发病率均明显高于对照组(33.0%比28.8%,41.4%比36.4%,3.0%比1.6%,0.5%比0.1%),差异均有统计学意义(P<0.05)。结论ART妊娠容易发生难产、严重产后出血和新生儿窒息,应关注产程进展,制定分娩预案,减少分娩并发症发生。

Objective To explore the characteristics of the labor process and delivery outcomes of single primipara in assisted reproductive technology(ART)pregnancy through vagina.Methods A total of 3945 single-child pregnant women who gave birth via vagina in the delivery room of Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 1st,2018 to December 31st,2019 were selected.The pregnant women with ART pregnancy were included in the ART group(795 cases),while those with natural pregnancy were in the control group(3150 cases).The characteristics of labor process,complications and delivery outcomes of the two groups during pregnancy were retrospectively analyzed.Results The incidence of hypothyroidism in pregnancy in ART group was significantly higher than that in control group(14.5%vs.10.7%),and the incidence of dystocia,perineal lateral incision and postpartum hemorrhage≥1000 ml and neonatal asphyxia(Apgar score at 5 min<7)were significantly higher than those in control group(33.0%vs.28.8%,41.4%vs.36.4%,3.0%vs.1.6%,0.5%vs.0.1%),the differnces were statistically significant(all P<0.05).Conclusions ART pregnancy is prone to dystocia,severe postpartum hemorrhage and neonatal asphyxia.We should pay attention to the progress of labor process,make delivery plans and reduce the occurrence of delivery complications.