单胎低危初产孕妇终止妊娠的时机  

Timing of termination of pregnancy in singleton low-risk pregnant women

作　　者：吴凯佳 张永欣 张国华[1] 崔荣 WU Kaijia;ZHANG Yongxin;ZHANG Guohua(Department of Obstetrics,the Fourth Hospital of Shijiazhuang,Hebei,Shijiazhuang 050200,China)

机构地区：[1]河北省石家庄市第四医院产科,050200

出　　处：《河北医药》2024年第7期1030-1032,1036,共4页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展计划项目(编号:201201143)。

摘　　要：目的探讨单胎低危初产孕妇不同分娩孕周的妊娠结局,为孕晚期适时终止妊娠提供科学依据。方法回顾性分析2021年4~7月于石家庄市第四医院阴道试产的单胎低危妊娠孕妇993例,根据分娩孕周分为3组:(1)孕39~39^(+6)周组,共358例,其中自然临产316例,引产42例;(2)孕40~40^(+6)周组,共376例,其中自然临产320例,引产56例;(3)孕41~41^(+6)周组,共259例,其中自然临产103例,引产156例。收集临床资料,分析3组间孕妇基本情况,比较组间中转剖宫产率、阴道助产率、产后出血率、巨大儿发生率、羊水污染率、新生儿窒息率以及新生儿转儿科率。结果3组间孕妇基本情况比较差异无统计学意义(P>0.05)。自然临产孕妇中,孕39~39^(+6)周组、孕40~40^(+6)周组阴道助产率、中转剖宫产率、羊水污染率及巨大儿发生率均明显低于孕41~41^(+6)周组。孕39~39^(+6)周、孕40~40^(+6)周引产孕妇中转剖宫产率、产后出血率、羊水污染率明显低于孕41~41^(+6)周引产孕妇。结论单胎低危初产孕妇最佳分娩孕周为孕39~39^(+6)周,最晚不应超过41周分娩,可有效改善分娩结局,降低产科并发症发生,提高产科质量。因此,临床可考虑孕39周以后对单胎低危妊娠孕妇,采用合理临床干预,适时终止妊娠,提高自然分娩率。Objective To investigate the pregnancy outcomes of singleton low-risk pregnant women who had a trial delivery in different gestational weeks,thus providing scientific basis for timely termination of pregnancy in the third trimester.Methods A retrospective analysis was performed on 993 singleton low-risk pregnant women who had a trial delivery in the Fourth Hospital of Shijiazhuang City from April to July 2021,they were divided into the 39-39+6 weeks gestation group(n=358)including 316 cases of natural labor and 42 cases of induced labor,the 40-40^(+6) weeks gestation weeks(n=376)including 320 cases of natural labor and 56 cases of induced labor,and the 41-41^(+6) weeks gestation group(n=259)including 103 cases of natural labor and 156 cases of induced labor.The clinical data were collected to analyze and the basic situation of pregnant women among the three groups.The rates of cesarean section on intermediate,vaginal midwifery,postpartum hemorrhage,macrosomia,contamination on amniotic fluid,neonatal asphyxia and neonatal transfer to pediatrics were compared among the three groups.Results There was no significant difference in the basic status of pregnant women among the three groups(P>0.05).The rate of vaginal midwifery,cesarean section on intermediate,contamination on amniotic fluid,and macrosomia of pregnant women with natural labor in the 39-39+6 weeks gestation group and the 40-40^(+6) weeks gestation group were significantly lower than those of the 41-41^(+6) weeks gestation group(P<0.05).The rate of cesarean section on intermediate,postpartum hemorrhage,and contamination on amniotic fluid of pregnant women with induced labor in the 39-39+6 weeks gestation group and 40-40^(+6) weeks gestation were significantly lower than those of the 41-41^(+6) weeks gestation group(P<0.05).Conclusion The optimal gestational week of singleton low-risk pregnant women is 39-39+6 weeks,and the latest should not exceed 41 weeks,which can effectively improve the outcome of labor,reduce the occurrence of obstetric complications,a

关 键 词：单胎 低危妊娠 分娩结局 临床干预 

分 类 号：R714.3[医药卫生—妇产科学]