巨大儿发生相关因素及分娩方式选择探讨(1)
【摘要】目的：探究与分析巨大儿发生相关因素及分娩方式选择。方法：选取我院自2015年1月至2015年7月收治的120例巨大儿作为观察组，另选择同期收治的正常体重新生儿120例作为对照组，对比两组孕产妇合并症、分娩方式、分娩期并发症。结果：观察组与对照组相比，头盆不称、妊高征、羊水较少、胎位异常及糖尿病发生率均明显偏高(P<0.05)。观察组与对照组相比，产后出血、软产道裂伤、新生儿窒息、臂丛神经损伤及肩难产发生率均明显偏高(P<0.05)。观察组与对照组相比自然分娩率较低，产钳助产率及剖宫产率较高(P<0.05)。结论：对于巨大儿的发生需做好积极有效的预防措施，明确产前诊断，选择合理的分娩方式，以减少母儿并发症发生率。
【关键词】巨大儿；分娩方式；并发症；相关因素
Related factors of macrosomia and childbirth choiceLIU Yafen， ZHANG Fengge. Department of Obstetrics and Gynecology，Shunyi District Maternal and Children Health Care Hospital， Beijing 101300， China
【Abstract】Objectives： To explore the related factors of macrosomia and delivery mode choices. Methods： 120 macrosomia treated in our hospital from January 2015 to July 2015 were selected as observation group， and 120 normal newborns in the same period were selected as control group. The maternal complications， delivery methods， childbirth complications of the two groups were compared. Results： The incidence of cephalopelvic disproportion， pregnancy induced hypertension， abnormal amount of amniotic fluid， abnormal fetal position and diabetes was higher in observation group than control group， with statistically significant difference (P<0.05). The incidence of postpartum hemorrhage， soft birth canal laceration， neonatal asphyxia， and shoulder dystocia， brachial plexus injury was higher in observation group than control group， with statistically significant difference (P<0.05). The rate of natural delivery was lower while forceps midwifery rates and cesarean section rate was higher in observation group， all with statistically significant difference (P<0.05). Conclusions： Positive and effective preventive measures should be taken to prevent the occurrence of macrosomia， and prenatal diagnosis is also necessary to choose reasonable way of delivery and reduce the incidence of complications.
【Key words】Macrosomia； Childbirth way； Complications； Related factors
【中图分类号】R714.43【文献标志码】A
巨大儿(fetal macrosomia)是指新生儿出生后1h内体重等于或大于4000g者，其发生发展原因与生活水平提高、产妇孕期营养过剩相关，对母婴健康造成了诸多威胁，易导致阴道分娩困难，产后出血、DIC、膀胱功能障碍、子宫脱垂、新生儿窒息等并发症[1，2]。因此，对于巨大儿发生相关因素进行分析，选择适当的分娩时机及分娩方式至关重要。现我院就收治的120例巨大儿作为观察组，将其与正常体重新生儿进行对比。结果总结报告如下。
1资料与方法
1.1一般资料
选取我院自2015年1月至2015年7月收治的120例巨大儿作为观察组，纳入标准：全部产妇在孕前及孕期未患有重要的脏器疾病；新生儿无出生缺陷；签署了关于本次试验的知情权同意书[3]，产妇年龄在23～30岁，平均年龄为(26.5±1.1)岁，孕周在37～42周，平均孕周为(39.5±1.6)周，新生儿体重在4000～4500g，平均新生儿体重为(4250.2±50.6)g，新生儿性别男67例，女53例。另选择同期收治的正常体重新生儿120例作为对照组，产妇年龄在25～32岁，平均年龄为(27.7±1.2)岁，孕周在38～41周，平均孕周为(40.2±1.5)周，新生儿体重在3000～3900g，平均新生儿体重为(3290.5±60.9)g，新生儿性别男69例，女51例。 (柳亚芬 张凤格)
【关键词】巨大儿；分娩方式；并发症；相关因素
Related factors of macrosomia and childbirth choiceLIU Yafen， ZHANG Fengge. Department of Obstetrics and Gynecology，Shunyi District Maternal and Children Health Care Hospital， Beijing 101300， China
【Abstract】Objectives： To explore the related factors of macrosomia and delivery mode choices. Methods： 120 macrosomia treated in our hospital from January 2015 to July 2015 were selected as observation group， and 120 normal newborns in the same period were selected as control group. The maternal complications， delivery methods， childbirth complications of the two groups were compared. Results： The incidence of cephalopelvic disproportion， pregnancy induced hypertension， abnormal amount of amniotic fluid， abnormal fetal position and diabetes was higher in observation group than control group， with statistically significant difference (P<0.05). The incidence of postpartum hemorrhage， soft birth canal laceration， neonatal asphyxia， and shoulder dystocia， brachial plexus injury was higher in observation group than control group， with statistically significant difference (P<0.05). The rate of natural delivery was lower while forceps midwifery rates and cesarean section rate was higher in observation group， all with statistically significant difference (P<0.05). Conclusions： Positive and effective preventive measures should be taken to prevent the occurrence of macrosomia， and prenatal diagnosis is also necessary to choose reasonable way of delivery and reduce the incidence of complications.
【Key words】Macrosomia； Childbirth way； Complications； Related factors
【中图分类号】R714.43【文献标志码】A
巨大儿(fetal macrosomia)是指新生儿出生后1h内体重等于或大于4000g者，其发生发展原因与生活水平提高、产妇孕期营养过剩相关，对母婴健康造成了诸多威胁，易导致阴道分娩困难，产后出血、DIC、膀胱功能障碍、子宫脱垂、新生儿窒息等并发症[1，2]。因此，对于巨大儿发生相关因素进行分析，选择适当的分娩时机及分娩方式至关重要。现我院就收治的120例巨大儿作为观察组，将其与正常体重新生儿进行对比。结果总结报告如下。
1资料与方法
1.1一般资料
选取我院自2015年1月至2015年7月收治的120例巨大儿作为观察组，纳入标准：全部产妇在孕前及孕期未患有重要的脏器疾病；新生儿无出生缺陷；签署了关于本次试验的知情权同意书[3]，产妇年龄在23～30岁，平均年龄为(26.5±1.1)岁，孕周在37～42周，平均孕周为(39.5±1.6)周，新生儿体重在4000～4500g，平均新生儿体重为(4250.2±50.6)g，新生儿性别男67例，女53例。另选择同期收治的正常体重新生儿120例作为对照组，产妇年龄在25～32岁，平均年龄为(27.7±1.2)岁，孕周在38～41周，平均孕周为(40.2±1.5)周，新生儿体重在3000～3900g，平均新生儿体重为(3290.5±60.9)g，新生儿性别男69例，女51例。 (柳亚芬 张凤格)