202例死产原因分析  

Etiological Analysis of 202 Cases of Stillbirth

作　　者：陈蔚琳[1] 罗雪梅[1] 刘欣燕[1] 刘俊涛[1] 

机构地区：[1]中国医学科学院北京协和医院,北京100730

出　　处：《实用妇产科杂志》2014年第6期440-443,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨死产原因,为制定降低死产发生的措施提供依据。方法:回顾性分析北京协和医院2003年1月1日至2012年12月31日住院分娩的202例死产(≥20周)的临床资料,包括孕妇年龄、产次、母体合并疾病、胎儿情况、死产诊断孕龄和出生体重、胎儿和胎盘脐带病理等。结果:死产的原因依次为:母体因素60例,胎盘脐带因素48例,胎儿因素44例,不明原因50例。不明原因死产与初产、孕周有关(P<0.05);母体因素死产与孕周、出生体重、产次有关(P<0.05);胎儿因素死产与孕周相关(P<0.05)。早期死产和晚期死产主要病因构成差异有统计学意义(P<0.05)。结论:加强围生期保健,建立三级妇幼保健,早期筛查胎儿畸形、防治妊娠期并发症及合并症、妊娠晚期加强产前监护,及时发现胎儿生长受限等有助于减少死产的发生。Objective：To explore the cause of 202 cases of stillbirth in Peking Union Medical College Hospital,with the aim to give some evidence to decrease stillbirth rate. Methods：The data of 202 cases of still- birth in Peking Union Medical College Hospital from Jan 1 st 2003 to Dec 31 st 2012 were analyzed retrospectively. The data included maternal age, parity, maternal complication, fetal related pathology, gestational age （GA） at birth, birth weight, and pathological examination of the placenta and umbilical cord. Results ：The causes of stillbirth included pregnancy complications （60 cases）, placenta-umbilical cord factors （48 cases）, fetal related factors （44 cases）, and unexplained causes（50 cases）. Pregnancy complications, fetal related factors and unexplained causes were associated with gestational age （P 〈 0.05）. It was different in the constituent ratio of primary cause between early and late stillbirth（ P 〈 0.05）. Conclusions： Preparing tertiary prevention of birth defects,enhancing health education and prenatal examination among the floating pregnant women in rural area and urban area can contribute to reduceing perinatal mortality.

关 键 词：死产 小于胎龄儿 高危妊娠 围生期保健 

分 类 号：R714[医药卫生—妇产科学]