特大儿54例临床分析

Clinical analysis on the characteristics of 54 cases of extra macrosomia

目的 :探讨特大儿发生的有关高危因素及分娩方式和妊娠结局的关系。方法 :对于 5 4例特大儿进行回顾性分析。结果 :特大儿发生率 0 46% ,1997年 7月～ 2 0 0 2年 6月每年的特大儿发生率分别为 0 40 %、0 43 %、0 41%、0 40 %、0 49% ,呈上升趋势。本文特大儿组孕母平均年龄、体重指数增大、妊高征、糖尿病、胎膜早破、手术产、产后出血、围产儿结局不良发生率均明显提高 ,直接影响母儿预后。结论 :特大儿的发生与孕妇体重、孕周、产次有关 ,更主要的是孕期营养吸收与消耗在妊娠基础上的失衡所致。因此定期产前检查、科学膳食、适量运动、适时分娩是预防特大儿发生的有效措施。提高特大儿产前诊断率 ,选择适宜分娩方式 ,适当放宽剖宫产指征 ,是减少分娩并发症 。

Objective To explore the relationship between related high-risk factors,delivery mode and pregnant outcome of extra macrosomia.Methods Fifty-four cases delivering extra macrosomia in our hospital were analyzed retrospectively.Results The annual incidences of extra macrosomia from 1997 to 2002 were 0.40%,0.43%,0.41%,0.40% and 0.49% respectively with the total incidence of 0.46%.The parturient's average age,the parturient's body mass index and the incidence of pregnancy induced hypertension,diabetes mellitus.Fetal membranes premature rupture,operation,puerperal hemorrhage,poor perinatal outcome were significantly higher in extra macrosomia group than those in normal subjects.All factors directly influenced the prognosis and the infants. Conclusion Extra macrosomia is related to the weight of pregnant women,gestational week and delivery times.And it is more closely related to the unbalance between the absorption and consumption of nutrition on the basis of pregnancy.It could be an effective measure to regular antenatal care,scientific diet,proper exercise and terminate pregnancy timely.Enhancing the rate of prenatal diagnosis,selcting proper delivery mode and widening the index for cesarean section may play an important role in reducing delivery complications and ensuring the safety of parturient and neonates. [