| 引用本文： |
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郑玉容,陈美如,蔡育璇,等.巨大胎儿477例临床分析[J].同济大学学报（医学版）,2012,33(4):100-103. [点击复制]
- ZHENG Yu-rong,CHEN Mei-ru,CAI Yu-xuan,et al.Clinical analysis of 477 cases of fetal macrosomia[J].同济大学学报（医学版）,2012,33(4):100-103. [点击复制]
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| 摘要: |
| 目的 探讨巨大胎儿的高危因素、产前诊断及分娩方式,降低母儿并发症。方法 将477例巨大儿(出生体质量≥4 000 g)纳入研究,选择相应时间(2日内)分娩的477例出生体质量<4 000 g的正常足月儿作为对照,比较孕妇孕期体质量增加情况、孕周、诊断、分娩方式及并发症。结果 巨大儿组母亲孕期体质量增长、分娩孕周均高于对照组,差异有统计学意义。巨大胎儿中双顶径(biparietal diameter,BPD)+股骨长度(femur length,FL)＞16.5 cm者占89.02%。剖宫产组新生儿窒息率及产伤较阴道分娩组明显降低,巨大胎儿难产率与正常体质量胎儿相比明显升高。结论 孕期体质量增加过快、过期妊娠是巨大儿的主要高危因素。BPD+FL＞16.5 cm可作为产前诊断巨大胎儿的一项可靠指标。对巨大胎儿应避免困难的阴道助产,适当放宽剖宫产指征。 |
| 关键词: 巨大胎儿 分娩 并发症 |
| DOI：10.3969/j.issn1008-0392.2012.04.023 |
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| 基金项目:广东省科技计划（2009B03081240) |
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| Clinical analysis of 477 cases of fetal macrosomia |
| ZHENG Yu-rong,CHEN Mei-ru,CAI Yu-xuan,CHEN Lu-jia |
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| Abstract: |
| Objective To evaluate the risk factors, prenatal diagnosis and delivery mode for fetal macrosomia. Methods The clinical data of 477 cases of fetal macrosomia (birth weight≥4 000 g) and 477 cases of matched normal full-term babies were included in the study. The weight gain during pregnancy of the mothers, the gestational age, the diagnosis, the delivery mode and the complications were compared between two groups. Results The weight gain during pregnancy of the mothers of the fetal macrosomia was higher and the gestational age lasted longer than those in the control group, which has the significant difference. In 89.02% fetal macrosomia cases, the biparietal diameter (BPD) + femur length (FL)＞16.5 cm. The incidence rate of asphyxia and birth injury during cesarean section was less than that in vaginal delivery. The rate of dystocia in fetal macrosomia increased significantly compared to that in normal body weight fetus. Conclusion The excessive weight gain during pregnancy and the prolonged pregnancy are main risk factors for fetal macrosomia. BPD + FL＞16. 5cm can be a reliable indicator for the diagnosis of fetal macrosomia. Cesarean sectionin fetal macrosomia may avoid the difficult midwifery in vagina delivery. |
| Key words: fetal macrosomia parturition complications |
