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目的:探讨巨大儿分娩前的预测对分娩结局的影响,以降低母儿并发症。方法:对2007年9月～2009年8月分娩的339例巨大儿进行回顾性分析,以分娩前临床估计胎儿体重是否达到4 000 g为标准进行分组:产前预测达到4 000 g者为预测组(212例),产前预测<4 000 g者为忽略组(127例),比较两组分娩方式、母儿常见并发症。结果:剖宫产、选择性剖宫产预测组显著高于忽略组(P<0.01),阴道分娩、产钳助产预测组显著低于忽略组(P<0.05),两组阴道试产失败率无差别,胎儿窘迫、新生儿窒息、肩难产、产后出血预测组低于忽略组。结论:巨大儿不是剖宫产绝对指征,重视巨大儿产前预测诊断,加强分娩过程监护,适当放宽剖宫产指征,避免困难阴道助产,能有效降低母儿并发症。
OBJECTIVE: To investigate the effect of pre-labor gigantic pre-delivery on delivery outcomes and to reduce maternal and neonatal complications. Methods: A retrospective analysis was performed on 339 cases of giant children who gave birth between September 2007 and August 2009 to determine whether the estimated fetal weight before delivery was 4 000 g. The prenatal prediction of 4 000 g was the prediction (212 cases), prenatal prediction <4000 g neglected group (127 cases), the two groups of delivery mode, the common complications of mother and child. Results: The cesarean section and selective cesarean section prediction group were significantly higher than the neglected group (P <0.01), vaginal delivery and forceps midwifery prediction group was significantly lower than the neglected group (P <0.05), the failure rate of vaginal trial No difference, fetal distress, neonatal asphyxia, shoulder dystocia, postpartum hemorrhage prediction group was lower than the neglected group. Conclusion: Huge children are not the absolute indications of cesarean section. They should pay attention to the prenatal diagnosis of giant children, strengthen the monitoring of childbirth, appropriately relax the indications of cesarean section, avoid difficult vaginal delivery and reduce the complications of maternal and child.