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医学临床研究  2020, Vol. 37 Issue (11): 1654-1656    DOI: 10.3969/j.issn.1671-7171.2020.11.017
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高龄产妇极早期和早期早产并发症及母婴结局分析
朱莉1, 曾玥2, 许茜1
1.上海市静安区江宁路街道社区卫生服务中心,上海 200040;
2.中国人民解放军海军特色医学中心,上海 200052
Analysis of Complications and Maternal and Infant Outcomes of Very Early and Early Preterm Delivery in Elderly Women
ZHU Li, ZENG Yue, XU Xi
Community Health Service Center, Jiangning Road, Jing'an District, Shanghai, 200040
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摘要 目的】探讨高龄产妇极早期和早期早产并发症及母婴结局。【方法】选择2018年3月至2019年6月在上海市静安区江宁路街道社区卫生服务中心分娩的高龄产妇78例病例作为研究对象,依据产妇分娩的孕周将其分为极早期早产组27例(孕期在24~28周),早期早产组51例(孕期在28~33+4周),比较两组产妇年龄、体质量指数(BMI)、既往史、分娩方式、新生儿出生时的体质量、Apgar评分、新生儿监护室(NICU)住院天数、合并妊娠高血压、糖尿病等情况。【结果】78例早产新生儿中,其中极早期早产儿27例,占34.62%,早期早产儿51例,占65.38%,且早期早产儿在新生儿出生体重、Apgar评分及NICU上均明显优于极早期早产儿组(P<0.05)。两组在未足月胎膜早破、胎盘异常、胎位异常等并发症发生率比较差异无统计学意义(P>0.05);但早期早产组的妊娠期糖尿病发生率显著高于极早期早产组,而极早期早产组在宫颈功能不全上的比率显著高于早期早产组(P<0.05);两组孕妇总剖宫共4例,占18.81%,其中极早期早产组剖宫产率明显低于早期早产组(P<0.05);早期早产组胎盘异常孕妇剖宫产率明显增加(P<0.05)。【结论】胎膜早破是高龄产妇极早期和早期早产最为常见的并发症之一,因此要高度重视导致胎膜早破的危险因素,治疗妊娠合并疾病,做好孕前检查和相关干预措施,对于合并宫颈功能不全者考虑行宫颈环扎术,在保证母婴的安全下尽可能延长孕周,改善母婴结局。
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朱莉
曾玥
许茜
关键词 分娩, 过早婴儿, 早产胎膜早破/并发症妊娠结局    
Abstract:【Objective】To investigate the complications and maternal and infant outcomes of very early and early preterm delivery in elderly women.【Methods】A total of 78 elderly pregnant women who delivered at Jiangning Road community health service center in Jing'an District of Shanghai from March 2018 to June 2019 were selected as the research objects. According to the gestational weeks of delivery, they were divided into extremely early preterm delivery group (27 cases with gestational period of 24-28 weeks) and 51 cases of early premature delivery group (pregnancy period of 28-33+4 weeks),The maternal age, body mass index (BMI), past history, mode of delivery, birth weight, Apgar score, length of stay in NICU, pregnancy induced hypertension and diabetes mellitus were compared between the two groups.【Results】Among 78 cases of premature infants, 27 cases (34.62%) were very early preterm infants and 51 cases (65.38%) were early preterm infants. The birth weight, Apgar score and NICU of early preterm infants were significantly better than those of very early preterm infants (P<0.05). There was no significant difference between the two groups in the incidence of premature rupture of membranes, placental abnormalities, abnormal fetal position and other complications (P>0.05); however, the incidence of gestational diabetes mellitus in the early preterm birth group was significantly higher than that in the very early preterm birth group, and the rate of cervical dysfunction in the very early preterm birth group was significantly higher than that in the early preterm birth group (P<0.05); there were 4 cases of cesarean section in the two groups, accounting for 18.81%, and the cesarean section rate in the extremely early preterm birth group was significantly lower than that in the early preterm birth group (P<0.05); The cesarean section rate of pregnant women with abnormal placenta in early preterm delivery group was significantly increased (P<0.05).【Conclusion】 Premature rupture of membranes (PROM) is one of the most common complications of very early and early preterm delivery in elderly women. Therefore, we should attach great importance to the risk factors leading to premature rupture of membranes, treat pregnancy associated diseases, do a good job of pre pregnancy examination and relevant intervention measures, and consider cervical cerclage for cervical insufficiency, so as to prolong the gestational weeks as far as possible under the safety of mothers and infants, and improve the maternal and infant outcomes.age, and improve the outcome of mothers and infants.
Key wordsObstetric Labor, Premature    Infant, Premature    Fetal Membranes, Premature Rupture/CO    Pregnancy Outcome
收稿日期: 2020-10-14     
PACS:  R722  
通讯作者: E-mail:173742775@qq.com   
引用本文:   
朱莉, 曾玥, 许茜. 高龄产妇极早期和早期早产并发症及母婴结局分析[J]. 医学临床研究, 2020, 37(11): 1654-1656.
ZHU Li, ZENG Yue, XU Xi. Analysis of Complications and Maternal and Infant Outcomes of Very Early and Early Preterm Delivery in Elderly Women. JOURNAL OF CLINICAL RESEARCH, 2020, 37(11): 1654-1656.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.11.017     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I11/1654
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