高危妊娠孕产妇相关危险因素分析  

Analysis report of risk factors related to maternal pregnancy in high-risk pregnancy

作　　者：王建英[1] 陈瑶[1] 陈芳[1] 曹建用[1] Wang Jianying;Chen Yao;Chen Fang;Cao Jianyong(Department of Obstetrics,the Fifth Hospital Affiliated to Zhongshan University,Zhuhai 519000,China)

机构地区：[1]中山大学附属第五医院产科,珠海519000

出　　处：《中国实用护理杂志》2019年第13期961-964,共4页Chinese Journal of Practical Nursing

摘　　要：目的分析高危妊娠的高危因素、可转变因素转归率及妊娠结局,总结高危妊娠管理经验,使其合理化,规范化,提高孕妇和围生儿的健康,保障母婴安全。方法将2016年1月至2017年3月进行产检的6472例孕妇,根据高危妊娠相关管理办法及实施细则进行高危因素筛查,并对高危孕妇进行系统管理。结果1610例高危妊娠孕妇,≥3种高危因素者163例占10.12%,2种高危因素者391例占24.29%,1种高危因素者1056例占65.59%;前5位高危因素为流产史、年龄、妊娠高血压或轻度子痫前期、先兆早产和34周以上的孕妇胎膜早破;高危妊娠孕妇中,19~25岁249例占11.29%;26~30岁441例占18.27%;31~34岁536例占36.49%;≥35岁384例占23.85%。可转变危险因素妊娠高血压、先兆早产、内分泌疾病和产前出血,转正常率分别为32.77%占58/177、83.21%(109/131)、46.88%(45/96)和83.13%(69/83);剖宫产率最高的年龄段为≥35岁的孕产妇,随年龄的减少,剖宫产率逐渐下降;阴道助产率最高的年龄组为31~34岁高危妊娠孕产妇,但各组差异不多;围生儿死亡率最高的为≥35岁的孕产妇(χ^2=24.989、4.189、4.344,P<0.05)。≥35岁的孕产妇发生子痫、产褥感染和产后出血的风险均明显高于其他年龄的孕产妇,差异有统计学意义(χ^2=10.823、14.594、25.306,P<0.05)。结论高危妊娠的影响因素较多,对影响因素进行筛查、识别和管理,重视健康教育,促进医院管理和社区管理合作,加强高危妊娠的管理,有助于降低高危孕产妇严重不良妊娠结局,改善母婴预后。Objective To analyze the risk factors of high-risk pregnancy,the change factor conversion rate and pregnancy outcomes,summarize the experience of high-risk pregnancy management,make it rationalized and standardized,improve the health of pregnant women and perinatal children,and guarantee the safety of mother and baby.Methods The 6 472 pregnant women who were admitted to the hospital from January 2016 to March 2017 were screened for high-risk factors according to the relevant management methods and implementation rules of high-risk pregnancies,and systematic management of high-risk pregnant women was conducted.Results Among 6 472 pregnant women,1 610 pregnant women were high-risk pregnancies,and the incidence rate was 24.88%.Three or more high-risk factors accounted for 163 cases(10.12%),two high risk factors accounted for 391(24.29%),one risk factors accounted for 1056 cases(65.59%).The top five risk factors were abortion history,age,gestationathe or mild pre-eclampsia,preterm prematurity,and premature rupture of fetal membranes at more than 34 weeks.Among pregnant women with high risk,249 cases(11.29%)were between 19 and 25 years old;441 cases(18.27%)of 26-30 years old;536 cases(36.49%)of 31-34 years old;384 cases(100.00%)of the 35-year old.The incidence of high-risk pregnancy was closely related to age,and the incidence of high-risk pregnancy was 100%in patients over 35 years old,with the increase of age.The risk factors of hypertension,preterm birth,endocrine disease and prenatal hemorrhage could be change normal rates were 32.77%(58/177),83.21%(109/131),46.88%(45/96)and 83.13%(69/83)respectively.The age group with the highest cesarean section rate was≥35 years old.The c-section rate gradually decreased with age.The age group with the highest vaginal assist rate was 31-34 years old high-risk pregnant women without obviously differences between groups;the highest perinatal mortality rate was≥35 years old(P<0.05).The risk of eclampsia,puerperal infection and postpartum hemorrhage was significantly higher in

关 键 词：高危妊娠 高危因素 管理效果 

分 类 号：R714[医药卫生—妇产科学]