259例死胎的病因分析  

Etiological Analysis of 259 Cases of Stillbirth

作　　者：杨晓燕[1] 周玮[1] 李子玮 YANG Xiaoyan;ZHOU Wei;LI Ziwei(Department of Obstetrics and Gynecology,Women and Children's Hospital of Chongqing Medical University,Chongqing 400021,China)

机构地区：[1]重庆医科大学附属妇女儿童医院妇产科,重庆400021

出　　处：《实用妇产科杂志》2022年第8期606-609,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨死胎的病因及其发生率,分析其临床特征,以降低死胎的发生。方法:回顾性分析2015年1月至2020年12月重庆市妇幼保健院产科住院分娩的83430例孕妇及其围产儿资料,其中死胎259例,分析相关因素状态下死胎的发生率。结果:①总体死胎发生率为3.10‰,年龄≥40岁的高龄孕妇死胎发生率为9.14‰,经产妇死胎发生率3.79‰。②母体因素死胎发生率前3位为生殖器结构异常(14.76‰)、感染(14.47‰)、重度子痫前期(12.32‰);脐带及胎盘因素前3位为脐带过短(18.60‰)、脐带真结(16.50‰)、胎盘早剥(11.94‰);胎儿因素中胎儿结构及染色体异常死胎发生率为5.17‰,胎儿生长受限死胎发生率为9.22‰。③双胎妊娠死胎发生率为17.63‰,双胎之一存活活产率为37.07%,早产率为79.07%。结论:高龄(≥40岁)妊娠、经产妇、双胎妊娠是发生死胎的重点人群应加强围产期保健管理,积极治疗妊娠期并发症及合并症,提高助产技术,以降低死胎的发生。Objective:To investigate the causes of stillbirth, analyze the clinical features, so as to reduce the rate of stillbirth.Methods:A retrospective analysis was performed on 83430 births including 259 stillbirthin Chongqing Health Center for Women and Children from January 2015 to December 2020.According to the high-risk factors of stillbirth, the rates that per 1000 live births and stillbirths were received.Results:①The total incidence of stillbirth was 3.1‰;The incidence of the≥40 years was 9.14‰.The incidence of stillbirth in postmenopausal women was 3.79‰.②The top three maternal factors were pregnancy-induced genital dysplasia(14.76‰),infection(14.47‰),severe preeclampsia(12.32‰).The top three factors of umbilical cord and placenta were short umbilical cord(18.60‰),true umbilical cord(16.50‰),and placental abruption(11.94‰).Fetal structure and chromosomal abnormalities, fetal growth restriction incidences were 5.17‰,9.22‰,respectively.③The incidence of twin stillbirth was 17.63‰.The survival rate of one twin was 37.07%,and the premature birth rate was 79.07%.Conclusions:Pregnancies of advanced age, maternity women, and twin pregnancies are the key populations of stillbirth.Maternal care and education should be strengthened in this population.Reinforce perinatal care, prevention of pregnancy complications, active treatment of complications, close monitor during labor, and improving midwifery technology are key measures to reduce the incidence of stillbirth.

关 键 词：死胎 临床特征 高危因素 

分 类 号：R714.2[医药卫生—妇产科学]