延期妊娠临床处理选择探讨.docVIP

延期妊娠临床处理选择探讨 　　[摘要] 目的 探讨延期妊娠引产时机及方式的选择对产妇剖宫产率、并发症率及新产儿窒息率等的影响,为临床处理选择提供参考,以期有效减少剖宫产率及分娩并发症。方法 对本院2006年1月～2008年1月收治382例孕41～41+6周、无妊娠合并症及并发症的产妇分成两组,一组予引产(205例):如宫颈评分≥7分,予人工破膜引产;如宫颈评分≤6分,予催产素引产;另一组为自然临产组(177例):即在严格监护下等待自然临产,将两组的母儿结局进行统计学分析比较。结果 引产组较自然临产组剖宫产率有明显增加,差异有显著性(P0.05)。结论 对于无妊娠合并症及并发症的延期妊娠,在现有多种手段对胎儿进行密切监护的条件下可以等待自然临产。 　　[关键词] 延期妊娠; 引产; 母儿并发症 　　[中图分类号] R714.21 [文献标识码] A [文章编号] 1673-9701(2010)03-01-03 　　 　　Clinical Management of Delayed Pregnancy 　　TANG Huaiyun ZHANG Zhiping 　　Department of Obstetrics and Gynecology,Lianyungang Municipal Maternal and Child Health Care Hospital of Jiangsu Province,Lianyungang 222001,China 　　 　　[Abstrat] ObjectiveTo explore the effects of the suitable induction time and manner in delayed pregnancy(41 weeks) on cesarean section rate,complication rate and the asphyxia rate of new births in an effort to effectively reduce the cesarean section rate and obstetric complications. MethodsWe divided into two groups 382 cases 41~41+6 week pregnants in our hospital from Jan 2006 to Jan 2008,with no pregnancy complications,one group was induced labor group 205 cases:if the cervical score ≥7 points,induction of labor was prepared by artificial rupture of membrane;if the cervical score ≤6 points,induction of labor was prepared with oxytocin)and the other was natural labor group(177 cases:waiting for natural labor by strict monitoring). The outcomes of the two groups were statistically analyzed and compared. ResultsThe cesarean section rate was significantly increased in the induced labor group compared with natural labor group,with a significant difference(P0.05). ConclusionWaiting for natural labor is possible due to many existing means of strict monitoring in delayed pregnancy. 　　[Key words]Delayed pregnancy; Induced labor; Maternal and fetal complications 　　 　　过期妊娠对母婴的危害早已被公认,并得到孕妇和产科医生???关注,其发生率占妊娠总数的3%～15%,是胎儿窘迫、胎粪吸入综合征、过熟综合征、新生儿窒息、围产儿死亡及巨大儿的重要原因[1],为降低围产儿的病死率,应加强产前监测和及时处理,因此现在较多医院产科均采取达孕41周即予引产,以减少过期妊娠的发生。本文分析2006年1月～2008年1月