巨大儿228例临床分析-巨大儿.docx
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1、巨大儿228例临床分析:巨大儿 R729 D 1672-3783(2010)06-0014-03 目的:找寻诊断巨大儿的相关因素,并分析其分娩方式。 方法:将巨大儿228例纳入探讨,选择相应时间(2日内)分娩的正常足月儿228例作为比照,比较孕妇年龄、身高、体重、孕周、孕产次、分娩方式、妊娠合并症、分娩并发症和新生儿有关状况以及产前B超胎儿双顶径(BPD)与股骨长(FL),新生儿体重估计采纳罗来敏算法。 结果:巨大儿发生率有逐年增高的趋势;巨大儿组母亲身高、孕期体重增长、孕周、孕产次均高于比照组并有统计学差异;巨大儿组妊娠合并症以胎位异样、胎儿窘迫、妊娠糖尿病(GDM)为多,发生率高于比照组;
2、巨大儿组分娩并发症以持续性枕横(后)位、胎儿窘迫为多,发生率高于比照组;B超提示巨大儿组的BPD+FL16.5cm的发生率多于比照组。巨大儿的分娩方式以剖宫产为主,剖宫产率为68%, 高于比照组(30%)。巨大儿诞生前预估计与实际诞生体重之间比较差异有显著性统计学意义。结论:巨大儿的发生与产妇体重、身高、GDM、过期妊娠有关,超声检查对估计巨大胎儿有参考价值,巨大儿分娩前正确估计体重难度较大。巨大胎儿的分娩期并发症相对较多,巨大儿的分娩方式以剖宫产为相对平安。 巨大儿;诞生体重;发生率;剖宫产 Clinical analysis of fetal macrosomia:a report of
3、228 cases Liu Jianfei To search the related factors for detection of macrosomia, and analyse on the its delivery way.Methods:228 cases with fetal macrosomia were enrolled into this study.228 cases normal newborns giving birth at the corresponding time point(within 2 days) were compared with as contr
4、ol group.The age, height, weight, weeks of pregnancy,parity, delivery way,pregnancy coexisted diseases,labor complication ,related information about the newborn ,fetal diameters of biparietal diameter(BPD),femur length(FL) from antenatal Type-B ultrasonic check for the pregnant women were compared.L
5、uo Lai-min algorithm was used to the estimation of newborn weight.Results:The rate of macrosomia has been raising year by year.The maternal height,increase of maternal weight during pregnancy,weeks of pregnancy,parity for the macrosomia groupwas higher than control group, and there was significant s
6、tatistic difference between two groups.The abnormal position of fetus,fetal distress,gestational diabetes mellitus(GDM) was more among pregnancy coexisted diseases,the its rate on macrosomia was higher than on control group.The abnormal position of fetus,The occipitotransverse (retroposition)positio
7、n, fetal distress was more among labor complication,the its rate on macrosomia was higher than on control group.The rate of BPD+FL16.5cm from antenatal type-B ultrasonic check on the macrosomia was higher than on control group.The delivery way on macrosomia was mainly about the caesarean section, th
8、e rate of caesarean section was 68% higher than control group(30%).There was significant statistic difference between the estimation of neonatal weight and the real measuration of newborn birth weight.Conclusion:The occurrence of macrosomia was related to the maternal height,increase of maternal wei
9、ght during pregnancy,GDM,prolonged pregnancy etc.The antenatal type-B ultrasonic check had reference value for the diagnosis ofmacrosomia.The accurate estimation of neonatal weight was difficult.The rate of labor complication was comparatively more in macrosomia group.The caesarean section for the f
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