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目的:探讨胎儿生长受限(FGR)的高危因素及终止妊娠的方式、时机对FGR儿童预后的影响。方法:收集该院2011年1月~2013年11月间收治的158例FGR病例,对其临床资料进行回顾性分析。结果:①FGR的高危因素中,妊娠合并症为首要因素(42.40%),其中又以脐带因素占首位(29.11%),其次为妊娠期高血压疾病(22.15%)、胎盘因素和胎儿自身因素,不明原因占24.68%;②选择性剖宫产组发生胎儿窘迫、羊水粪染和新生儿窒息的概率明显低于急诊剖宫产组和阴道分娩组,差异有统计学意义(P<0.05)且预后最好;③孕周越长,新生儿体重越重,预后越好,差异均有统计学意义(均P<0.05)。结论:妊娠合并症是FGR的主要危险因素,应积极治疗产科合并症和并发症,尽量延长孕周,适当放宽剖宫产指征,选择恰当的方式和时机分娩可减少胎儿窘迫和新生儿窒息的发生,改善围产儿结局。
Objective: To investigate the risk factors of fetal growth restriction (FGR) and the way and timing of termination of pregnancy on the prognosis of children with FGR. Methods: A total of 158 cases of FGR were collected from January 2011 to November 2013 in our hospital. The clinical data were retrospectively analyzed. Among the risk factors of FGR, pregnancy complications were the most important factor (42.40%), of which umbilical cord factors (29.11%), followed by gestational hypertension (22.15%), placental factors and fetal factors, (24.68%) with unexplained causes; (2) the probability of fetal distress, meconium-stained amniotic fluid and neonatal asphyxia in selective cesarean section group was significantly lower than that in emergency cesarean section group and vaginal delivery group (P <0.05) The best prognosis; ③ longer gestational weeks, heavier newborns, the prognosis is better, the difference was statistically significant (P <0.05). Conclusion: Pregnancy complications are the main risk factors of FGR. Obstetric complications and complications should be actively treated. Gestational gestations should be prolonged as far as possible and cesarean indications should be appropriately relaxed. Choosing the appropriate mode and timing of childbirth can reduce fetal distress and neonatal asphyxia The occurrence of perinatal children to improve the outcome.