259例巨大儿高危因素分析及并发症探讨.docVIP

259例巨大儿高危因素分析及并发症的探讨 　　[摘要] 目的 探讨巨大儿的高危因素及其并发症。 方法 将2010年2月～2013年12月期间在我院住院分娩的巨大儿259例作为观察组，随机收集同期正常分娩的单胎正常体重的新生儿259例对照组。分别记录两组孕妇年龄、孕次、产次、孕前体重、产前体重、身高、宫高、腹围、胎儿性别、孕周、分娩方式、新生儿体重指标、胎儿双顶径及母婴并发症等情况，对比分析巨大儿的高危因素及其并发症。 结果 两组产妇孕周均在36～43周，观察组的妊娠天数、分娩前宫高、孕妇腹围、妊娠合并症，妊高症、GDM、胎膜早破、巨大儿经阴道分娩的新生儿窒息、锁骨骨折、臂丛神经损伤、产后出血、产道损伤等均明显高于对照组，两组差异均有统计学意义（P0.05）；观察组宫高+腹围≥140 cm 147例，占56.76%（147/259）；胎儿双顶径≥9.5 cm 214例，占82.63%（214/259）；胎儿股骨长≥7.5 cm 217例，占83.78%（217/259）。 结论 妊娠天数、分娩前宫高、孕妇腹围、胎儿双顶径、股骨长是巨大儿发生的高危因素，巨大儿较正常体重儿的并发症明显增加，掌握巨大儿高危因素及并发症对产前诊断和围产期预防有一定的指导作用。 　　[关键词] 巨大儿；高危因素；并发症；新生儿 　　[中图分类号] R714.2 [文献标识码] B [文章编号] 1673-9701（2015）14-0044-03 　　[Abstract] Objective To investigate the high-risk factors of macrosomia and it’s complications. Methods A total of 259 cases of macrosomia patients in our department from February 2010 to December 2013 were chosen as the observation group， and a random collection of 259 cases of normal and single-birth newborns with normal weight in the same period were chosen as the control group. The maternal age， gravidity， parity， pre-pregnancy weight， prenatal weight， height， uterine height， abdominal circumference， fetal sex， gestational age， mode of delivery， newborns weight， fetal biparietal diameter as well as maternal and fetal complications of the two groups were recorded respectively， and the high-risk factors and complications of the macrosomia were compared and analyzed. Results The maternal gestational ages of all the parturients in the two groups were from 36 weeks to 43 weeks. The observation group was significantly higher than the control group in gestation days， the prenatal uterine height， pregnant abdominal circumference， pregnancy complications， pregnancy-induced hypertension， GDM， premature rupture of membranes， macrosomia neonatal asphyxia by vaginal delivery， clavicle fracture， brachial plexus injury， postpartum hemorrhage， birth canal injury etc， and the differences of the two groups were statistically significant （P 　　[Keywords] Macrosomia；