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目的:建立基于医院门诊“一对一”高龄准、孕、产妇的服务项目,使其规范化,提高分娩质量,预防出生缺陷。方法:将前来孕前检查的高龄求孕妇女和前来保健咨询的高龄孕妇纳入对象,随机分为研究组和对照组。研究组提供规范的“一对一”孕前保健门诊咨询,对照组按常规门诊产检,跟进调研两组孕妇分娩结局。结果:两组对照,产检次数均值〔(9.3±1.42)次;(4.2±1.34)次〕,按时自我监护胎动(100.00%;79.75%),了解入院时机(100.00%;76.69%),主动保健咨询(93.98%;63.19%),研究组明显优于对照组,差异有统计学意义(P<0.01);研究组重度子痫前期(0.90%)低于对照组(2.15%),差异有统计学意义(P<0.05);研究组妊娠期糖尿病(8.73%),产后出血量均值(196.3±14.12)ml显著低于对照组〔14.11%;(278.9±15.10)ml〕,差异有统计学意义(P<0.001);研究组低体重儿发生率(3.55%)低于对照组(7.60%),研究组巨大儿发生率(2.37%)低于对照组(6.99%),差异有统计学意义(P<0.05);研究组新生儿畸形发生率(0.30%)显著低于对照组(1.82%),差异有统计学意义(P<0.001)。结论:建立规范的“一对一”门诊孕前保健咨询十分必要,促进了《母婴保健法》的贯彻和实施,值得推广。
OBJECTIVE: To establish a service project based on hospital outpatient “one to one” senior citizens of pregnancy, expectant mothers and maternity, standardize them, improve the quality of childbirth and prevent birth defects. METHODS: Elderly pregnant women who came to the pre-pregnancy examination and pregnant women who came to health consultation were enrolled and randomly divided into study group and control group. The research group provided the standard “one to one ” pre-pregnancy health consultation, the control group according to routine out-patient examination, follow-up investigation of two groups of pregnant women childbirth outcomes. Results: The average number of control and the number of births in both groups was (9.3 ± 1.42) times and (4.2 ± 1.34) times, respectively. The time of admission was 100.00% and 79.75% (93.98%, 63.19%), the study group was significantly better than the control group, the difference was statistically significant (P <0.01); study group severe preeclampsia (0.90%) was lower than the control group (2.15% (P <0.05). The average gestational diabetes mellitus (8.73%) and postpartum hemorrhage (196.3 ± 14.12) ml in study group were significantly lower than those in control group [14.11% (278.9 ± 15.10) ml〕, the difference was statistically significant (P <0.001). The incidence of low birth weight infants in study group (3.55%) was lower than that in control group (7.60%), while the incidence of macrosomia in study group (2.37%) was lower than that of control group (6.99% (P <0.05). The incidence of neonatal malformations in the study group (0.30%) was significantly lower than that in the control group (1.82%), with statistical significance (P <0.001). Conclusion: It is necessary to establish a standardized “one to one” outpatient prenatal care consultation and promote the implementation and enforcement of the Maternal and Infant Health Act, which is worth promoting.