目的探讨单胎濒死儿发生的围生期危险因素,为濒死儿综合诊治提供依据。方法该研究为病例对照研究。选取2006年1月—2015年12月在复旦大学附属妇产科医院出生的154例胎龄≥28周、1 min Apgar评分为0~1分的单胎新生儿为病例组(濒死组),按1...目的探讨单胎濒死儿发生的围生期危险因素,为濒死儿综合诊治提供依据。方法该研究为病例对照研究。选取2006年1月—2015年12月在复旦大学附属妇产科医院出生的154例胎龄≥28周、1 min Apgar评分为0~1分的单胎新生儿为病例组(濒死组),按1∶4比例随机选取616例同期出生的单胎非濒死儿(1 min Apgar评分>1分)为对照组,采用单因素分析和多因素logistic回归分析评估濒死儿发生的围生期危险因素。结果濒死组胎龄和出生体重均显著低于对照组(P<0.05)。濒死组胎儿水肿、脐带脱垂、羊水Ⅲ度污染、胎盘早剥、臀位、重度子痫前期、母亲产时全麻、产前胎心监护异常、产前胎动减少发生比例显著高于对照组(P<0.05)。多因素logistic回归分析显示母亲产时全麻(OR=34.520)、产前胎动减少(OR=28.168)、胎盘早剥(OR=15.641)、羊水Ⅲ度污染(OR=6.365)、产前胎心监护异常(OR=5.739)、臀位(OR=2.614)是濒死儿发生的危险因素(P<0.05),胎龄较大(OR=0.686)是濒死儿发生的保护因素(P<0.05)。结论临床需对产前胎心监护异常、胎动减少、早产、胎盘早剥、臀位、羊水Ⅲ度污染、全麻手术的产妇引起重视,做好新生儿复苏准备,防范濒死儿的发生。展开更多
Splenic injury caused by abdominal trauma during pregnancy is rare. Splenic injury associated with fetal death in utero following a fall from a tree top is even rarer. The authors report a case of splenic trauma assoc...Splenic injury caused by abdominal trauma during pregnancy is rare. Splenic injury associated with fetal death in utero following a fall from a tree top is even rarer. The authors report a case of splenic trauma associated with fetal death in utero following a fall from the top of a tree in a 19-year-old pregnant woman at 30 weeks amenorrhoea. She was referred from a 1st level health facility for trauma that had occurred the day before admission. She was in poor general condition (WHO performance status IV) and had a cardiovascular collapse. Ultrasound was used to diagnose haemoperitoneum and fetal death in utero. A CT scan was used to diagnose splenic lesions. Treatment consisted of splenectomy and caesarean section after resuscitation.展开更多
文摘目的探讨单胎濒死儿发生的围生期危险因素,为濒死儿综合诊治提供依据。方法该研究为病例对照研究。选取2006年1月—2015年12月在复旦大学附属妇产科医院出生的154例胎龄≥28周、1 min Apgar评分为0~1分的单胎新生儿为病例组(濒死组),按1∶4比例随机选取616例同期出生的单胎非濒死儿(1 min Apgar评分>1分)为对照组,采用单因素分析和多因素logistic回归分析评估濒死儿发生的围生期危险因素。结果濒死组胎龄和出生体重均显著低于对照组(P<0.05)。濒死组胎儿水肿、脐带脱垂、羊水Ⅲ度污染、胎盘早剥、臀位、重度子痫前期、母亲产时全麻、产前胎心监护异常、产前胎动减少发生比例显著高于对照组(P<0.05)。多因素logistic回归分析显示母亲产时全麻(OR=34.520)、产前胎动减少(OR=28.168)、胎盘早剥(OR=15.641)、羊水Ⅲ度污染(OR=6.365)、产前胎心监护异常(OR=5.739)、臀位(OR=2.614)是濒死儿发生的危险因素(P<0.05),胎龄较大(OR=0.686)是濒死儿发生的保护因素(P<0.05)。结论临床需对产前胎心监护异常、胎动减少、早产、胎盘早剥、臀位、羊水Ⅲ度污染、全麻手术的产妇引起重视,做好新生儿复苏准备,防范濒死儿的发生。
文摘Splenic injury caused by abdominal trauma during pregnancy is rare. Splenic injury associated with fetal death in utero following a fall from a tree top is even rarer. The authors report a case of splenic trauma associated with fetal death in utero following a fall from the top of a tree in a 19-year-old pregnant woman at 30 weeks amenorrhoea. She was referred from a 1st level health facility for trauma that had occurred the day before admission. She was in poor general condition (WHO performance status IV) and had a cardiovascular collapse. Ultrasound was used to diagnose haemoperitoneum and fetal death in utero. A CT scan was used to diagnose splenic lesions. Treatment consisted of splenectomy and caesarean section after resuscitation.
