妊娠期高血压疾病合并胎儿生长受限分娩时机和方式分析.docVIP

妊娠期高血压疾病合并胎儿生长受限分娩时机和方式分析 　　【摘要】 目的 探讨妊娠期高血压疾病合并胎儿生长受限（FGR）的分娩时机和方式对妊娠结局的影响。方法 回顾性分析分娩的138例妊娠期高血压疾病合并胎儿生长受限患者分娩时机及方式与围产儿预后的关系。结果 138例FGR围产儿死亡41例，新生儿窒息59例。分娩孕周34～36+6周时新生儿窒息率、围生儿死亡率显著低于其他孕周（P＜0．01），剖宫产组新生儿窒息率、围生儿死亡率明显低于阴道分娩组（P＜0．05）。结论 分娩时机与方式是影响妊娠期高血压疾病合并胎儿生长受限围产儿预后的关键环节。剖宫产是主要的分娩方式。 　　?【关键词】 妊娠期高血压疾病；胎儿生长受限;分娩 　　 　　Analysis of delivery opportunity and way on the perinatal outcome in patients with hypertensive disorder complicating pregnancy with fetal growth restrictionREN Yan-fang，HUA Fang-fang．Department of Gynaecology and Obstetrics，The First Affiliated Hospital of Xinxiang Medical University，Henan Province，Weihui 453100，China?【Abstract】 Objective To investigate the influence of delivery opportunity and way on the perinatal outcome in patients with with hypertensive disorder complicating pregnancy with fetal growth restriction (FGR)．Methods Retrospective data analysis about 138 penatal infants with FGR born to mothers with hypertensive disorder complicating pregnancy were made．Results There were 41deaths and 59 asphxia in 138 perinatal infants．The rate of deaths and asphxia was the lowest when delivery gestation was 34～36+6 weeks（P＜0．01）．The rate of deaths and asphxia in cesarean delivery group was significantly lower compared with vaginal delivery group（P＜0．05）．Conclusion The delivery opportunity and way were important factors of influencing the perintal outcome in patients with hypertensive disorder complicating pregnancy with fetal growth restriction．Caesarean section was main delivery manner． 　　【Key words】 Hypertensive disorder complicating pregnancy；Fetal growth restriction；Delivery 　　 　　胎儿生长受限(fetal growth restriction，FGR)是引起分娩期围产儿发病与死亡的主要原因之一。妊娠期高血压疾病(hypertensive disorder complicating pregnancy)合并FGR时对围产儿威胁更大，围产儿死亡率显著升高，正确选择其分娩时机及分娩方式，是改善妊高征围产儿预后的关键环节。近年来，多数产科学者对重度子痫前期分娩方式的选择，意见已渐趋一致，剖宫产已成为重度子痫前期终止妊娠的主要手段。然而，对合并FGR时围生儿死亡率高，其分娩方式的选择，意见尚不一致。本文收集2003年1至2007年10月在我院分娩的妊娠期高血压疾病合并FGR围产儿138例，分析分娩时机及方式对围产儿预后的影响，探讨分娩期对FGR的有益处理方法，以其改善围产儿预后。 　　 　　1 临床资料