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目的:了解≥4 000 g的巨大胎儿产前诊断、分娩方式及对母儿的影响。方法:回顾性分析163例巨大胎儿的发生率及其特点、相关因素、产前预测方法、对母胎的影响及预后。结果:巨大胎儿发生率为5.75%,与过期妊娠、孕妇身材较高、体重指数过大、产前充分休息、新生儿性别为男婴等相关。巨大胎儿易造成手术产率增加、产后出血、新生儿窒息、产伤甚至肩难产等,新生儿中、重度窒息及产伤主要分布在阴道分娩组。结论:应加强产前检查与干预,寻求预测巨大胎儿更加准确的方法,对巨大胎儿的诊治因人而异,选择最合适的分娩时机和方式。
OBJECTIVES: To understand the prenatal diagnosis, delivery patterns and effects on maternal and fetal macrosomia of ≥ 4000 g. Methods: A retrospective analysis of 163 cases of huge fetus incidence and its characteristics, related factors, prenatal prediction methods, the impact on the fetus and prognosis. Results: The incidence of huge fetuses was 5.75%, with prolonged pregnancy, pregnant women with higher body mass index, too much, prenatal full rest, newborn baby boy and other related. Huge fetus easily lead to increased surgical yield, postpartum hemorrhage, neonatal asphyxia, birth injury or even shoulder dystocia, neonatal, severe asphyxia and birth trauma mainly distributed in the vaginal delivery group. Conclusions: Prenatal care and intervention should be strengthened to seek a more accurate method of predicting huge fetus. The diagnosis and treatment of huge fetuses varies from person to person, and the most suitable timing and mode of delivery are selected.