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目的探讨分娩方式及妊娠终止时机对过期妊娠结局的影响。方法选取2013年10月—2015年10月过期妊娠孕妇35例作为观察组,足月妊娠住院分娩的延期妊娠孕妇35例作为对照组。收集剖宫产分娩与阴道顺产分娩过期妊娠孕妇的胎儿预后情况(胎儿窘迫、新生儿窒息、产后出血);比较两组产妇的分娩结局及胎儿预后情况,包括羊水指数(amniotic fluid index,AFI)≤5.0 cm、羊水量<300 ml、胎儿窘迫、新生儿窒息。计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果观察组剖宫产15例(42.86%),顺产20例(57.14%)。经剖宫产分娩的胎儿窘迫3例,新生儿窒息2例,产后出血1例;顺产的胎儿窘迫9例,新生儿窒息4例,产后出血2例。观察组胎儿窘迫率、新生儿窒息率(34.29%、17.14%)明显高于对照组(11.43%、2.86%),比较差异有统计学意义(均P<0.05)。观察组AFI≤5.0 cm、羊水量<300ml情况与对照组比较差异无统计学意义(均P>0.05)。结论过期妊娠产妇的最佳分娩方式为剖宫产;加强对延期妊娠的定期检查,防止出现过期妊娠,可改善妊娠结局。
Objective To explore the effect of mode of delivery and the timing of termination of pregnancy on the outcome of pregnancy. Methods Totally 35 pregnant women with expired pregnancy from October 2013 to October 2015 were selected as the observation group, and 35 pregnant women with postpartum pregnancy in full-term pregnancy were used as the control group. (Fetus distress, neonatal asphyxia and postpartum hemorrhage) were compared between the delivery of cesarean section and vaginal delivery. The amniotic fluid index (AFI) ≤ 5.0 cm, amniotic fluid volume <300 ml, fetal distress, neonatal asphyxia. Count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results In observation group, 15 cases (42.86%) had cesarean section and 20 cases (57.14%) had spontaneous delivery. Fetal distress caused by cesarean delivery in 3 cases, 2 cases of neonatal asphyxia, postpartum hemorrhage in 1 case; 9 cases of fetal distress in the first trimester, 4 cases of neonatal asphyxia, postpartum hemorrhage in 2 cases. Fetal distress rate and neonatal asphyxia rate (34.29%, 17.14%) in the observation group were significantly higher than those in the control group (11.43% and 2.86%, respectively), with statistical significance (all P <0.05). Observation group AFI ≤ 5.0 cm, amniotic fluid volume <300ml compared with the control group no significant difference (all P> 0.05). Conclusions The best mode of delivery for overdue pregnant women is cesarean section. The regular examination of delayed pregnancy is strengthened to prevent the outdated pregnancy and improve the pregnancy outcome.