不同病因医源性早产的围生儿结局分析  

Analysis of Perinatal Outcome in Different Causes of Iatrogenic Preterm

作　　者：任为[1] 肖梅[1] 

机构地区：[1]湖北省妇幼保健院,湖北武汉430070

出　　处：《实用妇产科杂志》2015年第10期776-780,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨不同病因医源性早产(IPD)与围生儿结局的关系。方法:回顾性分析2008年1月至2012年12月在我院分娩的医源性早产病例992例,根据剖宫产终止妊娠的IPD的不同病因,分为妊娠期高血压疾病(HDP)组351例,前置胎盘组260例,瘢痕子宫组145例,胎盘早剥组115例,妊娠期肝内胆汁瘀积症(ICP)组78例,羊水过少组43例。比较6组产妇的一般情况、分娩孕周分布、新生儿出生情况及主要并发症的发生率和新生儿出生后第7天存活率情况。结果:各组存活率均随孕周增加而增加,各组存活率比较差异有统计学意义,P<0.01。单胎新生儿体重由轻到重依次为:HDP组、羊水过少组(或胎盘早剥组)、ICP组、前置胎盘组(或瘢痕子宫组);黄疸发生率由高到低依次为:ICP组(或瘢痕子宫组或HDP组)、羊水过少组、胎盘早剥组(或前置胎盘组);贫血发生率由高到低依次为:胎盘早剥组、前置胎盘组、瘢痕子宫组,瘢痕子宫组与ICP组、HDP组、羊水过少组比较差异无统计学意义;颅内出血发生率胎盘早剥组高于其他各组,P<0.05。双胎各种新生儿主要并发症的发生率均高于单胎,P<0.01。结论:不同病因IPD的新生儿存活率显著不同,随孕周增加而增加,但出生情况、主要并发症的发生率不同,双胎新生儿主要并发症的发生率均高于单胎。Objective：To investigate the relationship between different causes of iatrogenic preterm delivery （~ IPD）and perinatal outcomes. Method：s： The clinical data of 992 cases of iatrogenic preterm labor were retro- spective analysiszed. According to different causes of termination of pregnancy in cesarean section, all the cases were divided into 6 groups ：351 cases of hypertensive disorder complicating pregnancy（HDP） group,260 cases of placenta praevia group, 145 cases of uterine scar group, 115 cases of placental abruption group,78 cases of intra- hepatic cholestasis of pregancy（ICP） group,43 cases of hypamnion group. The general characteristis, gestational age distribution, birth and the incidence of major complications and neonatal birth after seventh days survival situ- ation were compared among the 6 groups. Results：The survival rate increased with gestational age increases, but in different causes of IPD the survival rate were different P 〈0. 01 ;single fetal birth weight from light to heavy in the order was HDP group,oligohydramnios group, placental abruption group, ICP group, placenta previa group and scar uterus group;the incidence of jaundice from high to low in the order was ICP group,scar uterus group, HDP group,oligohydramnios group, placental abruption group, placenta praevia group; the incidence of anemia from high to low in the order was placental abruption group, placenta previa group, uterine scar group, ICP group, HDP group,and hypamnion group; the incidence of intracranial hemorrhage of abruption group were more than other groups, P 〈0. 05. The incidence of major complications of newborn twins were higher than that of singleton, P 〈0.01. Conclusions：In different causes of IPD,survival rate may increase with the gestational age increased, but the birth,the incidence of major complications and survival rate is different;the incidence of major complica- tions of twins is higher than that of singleton.

关 键 词：医源性 早产 新生儿 结局 

分 类 号：R714.21[医药卫生—妇产科学]