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目的:探讨羊水胎便污染孕妇的胎盘病理改变及对新生儿结局的影响。方法:对150例不同程度(Ⅰ度、Ⅱ度、Ⅲ度)羊水胎便污染孕妇的胎盘进行病理分析,各组例数均为50例,各组之间互为对照,并对新生儿结局数据加以统计学分析。结果:Ⅲ度羊水胎便污染组与Ⅱ度及Ⅰ度羊水胎便污染组相比,易发生胎盘病理学改变和胎心监护异常,差异有统计学意义(P<0.05),Ⅲ度羊水胎便污染组胎盘病理学改变主要是组织形态改变和胎盘感染,两者之和与Ⅱ度及Ⅰ度羊水胎便污染组相比,差异有统计学意义(P<0.05),在新生儿不良结局方面,Ⅲ度羊水胎便污染组与Ⅱ度及Ⅰ度羊水胎便污染组相比,有增加倾向,但无统计学意义(P>0.05)。结论:胎盘组织形态改变和胎盘感染是Ⅲ度羊水胎便污染的主要原因,Ⅲ度羊水胎便污染新生儿不良结局的发生有增加倾向,胎心监护是评价胎儿宫内安危的良好指标,及时发现胎儿宫内异常情况,适时终止妊娠。
Objective: To investigate the placental pathological changes of pregnant women contaminated with amniotic fluid and their effects on neonatal outcome. Methods: The placenta of 150 pregnant women of different degree (grade Ⅰ, Ⅱ, Ⅲ) of amniotic fluid contamination were pathologically analyzed. The number of cases in each group was 50 cases. The control groups were compared with each other, and the neonatal outcome data To be statistical analysis. Results: The placental pathological changes and abnormal fetal heart rate were more likely to occur in grade Ⅲ amniotic meconium-stained group than those in grade Ⅱ and grade Ⅰ amniotic fluid meconium-stained group (P <0.05) The pathological changes of the placenta were mainly the changes in the morphology and placental infection. The sum of the two was significantly higher than those of the second degree and the first degree of meconium-stained amniotic fluid (P <0.05). In the newborn, the third degree There was a tendency of increase in meconium - stained amniotic fluid contamination group compared with that of grade Ⅱ and Ⅰ degree meconium - stained amniotic fluid, but there was no statistical significance (P> 0.05). CONCLUSION: The change of placenta morphology and placental infection are the main causes of third degree amniotic fluid contamination. The incidence of third trimester amniotic fluid contamination of newborn infants tends to increase. Fetal heart monitoring is a good indicator to evaluate the safety of intrauterine infection. Fetal Intrauterine abnormalities, timely termination of pregnancy.