妊娠晚期死胎临床特点分析及管理措施探讨  

Analysis of clinical characteristics and management measures of stillbirth during the third trimester of pregnancy

作　　者：刚君 孔海霞 陈沂 Gang Jun;Kong Haixia;Chen Yi(Department of Group Health Care,Beijing Daxing Maternal and Child Health Hospital,Beijing 102600,China;Daxing Teaching Hospital,Capital Medical University,Beijing 102600,China)

机构地区：[1]北京市大兴区妇幼保健院群体保健科,北京102600 [2]首都医科大学大兴教学医院,北京102600

出　　处：《实用妇科内分泌电子杂志》2024年第16期12-16,共5页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的分析妊娠晚期死胎的临床特点和相关危险因素,并提出针对性的预防措施。方法根据围产儿死亡报表,通过查阅本院电子病历系统收集并整理87例妊娠晚期死胎患者的临床资料,包括基本信息、孕周、死胎原因等,进行统计分析。结果2014~2022年,本院妊娠晚期死胎发生率为1.805%(87/48189),78.2%的死胎发生在院前阶段,62.1%的患者感知有胎动减少或消失,约46.0%的患者存在妊娠期合并症或并发症,胎儿生长受限的比例达25.3%。死胎的可能病因顺位依次为脐带因素、母体因素、胎儿因素、胎盘早剥,另有14例死胎原因不明。5类病因在年龄、产次、孕前体质量指数及孕周方面均差异无统计学意义(P0.05)。结论加强孕期宣教和管理,提高孕妇认知,嘱其在出现胎动变化和异常症状时及早就诊,同时积极治疗妊娠合并症及并发症,可能有助于减少死胎的发生。Objective To analyze the clinical characteristics and related risk factors of stillbirth in the third trimester of pregnancy,and to propose targeted preventive measures.Methods According to the perinatal death report,the clinical data of 87 cases of stillbirth in the third trimester of pregnancy were collected and sorted out through the electronic medical record system of the hospital,including basic information,gestational age,causes of stilbirth,etc.,for statistical analysis.Results From 2014 to 2022,the incidence of stillbirth in the third trimester of pregnancy in the hospital was 1.805%o(87/48189),78.2%of the stillbirth occurred in the pre-hospital stage,62.1%of the patients perceived the reduction or disappearance of fetal movement,about 46.0%of the patients had pregnancy complications or complications,and the proportion of fetal growth restriction was 25.3%.The possible causes of stillbirth were umbilical cord factors,maternal factors,fetal factors,placental abruption,and there were 14 cases of stillbirth with unknown causes.There were no significant differences in age,delivery time,pre-pregnancy body massindex and gestational age among the 5 types of causes(P>0.05).Conclusion Strengthening pregnancy education and management,improving pregnant women's awareness,asking them to see a doctor early when there are changes in fetal movement and abnormal symptoms,and actively treating pregnancy complications and complications may help reduce the occurrence of stillbirth.

关 键 词：妊娠晚期 死胎 临床特点 管理措施 

分 类 号：R714.2[医药卫生—妇产科学]