170例巨大胎儿临床研究.docVIP

170例巨大胎儿临床研究【摘要】　目的：探讨巨大胎儿的产前诊断及分娩方式，降低母儿并发症。方法：回顾分析170例巨大胎儿的临床资料，并抽取同期分娩正常体重儿的足月孕妇作为对照组。结果：胎儿BPD、FL，产妇宫高、腹围等是诊断巨大胎儿的相关因素。超声下的BPD＋FL≥165 mm或宫高＋腹围≥140 cm可作为产前诊断巨大胎儿的一项可靠指标，巨大胎儿的分娩方式以剖宫产相对安全。 结论：加强孕期监护，预防巨大胎儿的发生，选择正确的分娩时机与分娩方式，可降低母婴并发症，保障母婴安全。 【关键词】　巨大胎儿；　分娩；　并发症 Analysis of 170 Fetal Macrosomia/ZHANG Li-ying.// Medical Innovation of China，2012，9(25)：025-026 【Abstract】　Objective：To investigate the prenatal diagnosis and delivery modd for fetal ncrcomia in order to decrease the complications in both mothers and neonates. Method：To review analyze the clinic data of 170 bigness fetus and random sample the pregnant woman who delivered mature and natural fetus，which was the contrast group. Result：The related factors of diagnosing large embrvo included the　BPD、FL of fetal and palace high and all round abdomen and so on. BPD + FL≥165 mm or palace high+all round abdomen ≥140 cm under ultrasonic could be a reliable index of diagnosing whether they were large embryos.For a large embryo，the comparatively safe way of delivery was dissecting womb.Conclusion：To strengthen the antenatal care during the pregnancy and decreasing the incidence of fetal macrosomia，to choose the best timing of labour and the best delivery pattem，all of tnese can decrease the complications of maternal and fetus and ensure their safety. 【Key words】　Fetal macrosomia；　Delivery；　Complication First-authors address：Zhumadian Henan Province， Maternety and Childrens Hospital，Zhumadian 463000， China doi：10.3969/j.issn.1674-4985.2012.25.012 胎儿体重达到或超过4000 g称为巨大儿，属高危妊娠。近年来，由于生活水平的提高，巨大儿的发生率明显上升，所致母婴并发症也相应增多。如子宫破裂、软产道严重撕裂伤、新生儿窒息、颅内出血、锁骨骨折、甚至死亡等。因此，在临产前对其诊断和分娩方式的选择显得尤其重要。为提高产前诊断巨大胎儿的准确性，现对170例巨大胎儿进行回顾性分析，从寻找识别巨大胎儿的相关因素，争取产前做出正确诊断，指导产程妥善处理，降低母婴并发症。 1　资料与方法 1.1　一般资料　本院2010年1月-2011年12月有2819例单胎足月孕妇分娩，其中巨大胎儿170例，发生率为6.03%，其中初产妇117例，经产妇53例，孕妇年龄最小20岁，最大42岁。新生儿出生时体重4000～4500 g 159例，占5.64%；4500 g者 11例，占0.39%。巨大儿孕周为38～40周者69例，占巨大儿的40.59%，≥40周者101例，占巨大儿的59.41%。男婴120例，占70.59%，女婴50例，占29.41%。 1.2　孕妇产前情况检查　宫高＋腹围≥1