Delivery mode on near-term or term pregnancy complicated with fetal growth restriction
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摘要:
目的探讨近足月头位胎儿生长受限（FGR）的适宜分娩方式。 方法采用回顾性分析方法，收集2010年1月~2015年9月分娩孕周≥36周、单胎、头位分娩的FGR病例且符合入选标准与排除标准的孕妇146例，按其分娩方式分为研究组（阴道分娩）和对照组（剖宫产分娩），并对两组资料进行比较分析。 结果研究组的孕妇与对照组相比，妊娠合并症发生率无显著差异，分娩时间较对照组延迟5 d（t=3.941，P < 0.001），住院时间缩短3 d（t=-3.870，P < 0.001）；而研究组的羊水混浊和新生儿窒息率与对照组比较无显著性差异（χ2=1.490，P=0.222；χ2=0.216，P=0.642），入住新生儿重症监护病房或病婴室的概率明显下降（59.1% vs 85.3%，χ2=12.280，P < 0.001），住院时间缩短3 d（t=-3.230，P=0.002）。 结论妊娠36周后的FGR病例，采取阴道分娩不增加其围产儿不良结局，并可减少母儿住院时间。 Abstract:ObjectiveTo investigate the optimal way of delivery on near-term or term pregnancy complicated with fetal growth restriction. MethodsA retrospective study was conducted on clinical data of 146 singleton, head delivery pregnant women with fetal growth restriction and delivered≥36 weeks of gestation from January 2010 to September 2015. Comparison of maternal and fetal outcomes was performed between the study group (delivered vaginally) and the control group (delivered by cesarean section). ResultsNo statistical difference of pregnancy complications was observed between the study group and the control group. The pregnant women in the study group delivered later than those in the control group (t=3.941, P < 0.001). The hospital stay of the pregnant women in the study group was also shorter than those in the control group (t=-3.870, P < 0.001). The rates of the meconium-stained amniotic fluid and neonatal asphyxia were not statistically different between the study group and the control group (χ2=1.490, P=0.222; χ2=0.216, P=0.642). Comparing to the control group, the rate of the neonates admitted to the neonatal intensive care unit (NICU) in the study group was decreased (χ2=12.280, P < 0.001) and the hospital stay of the neonates in the study group was shorter (t=-3.230, P=0.002). ConclusionThe pregnant women with fetal growth restriction who delivered after 36 weeks of gestation, those who delivered vaginally would not increase the risk of adverse perinatal outcomes than those who delivered by cesarean section. And the hospital stay of the mothers and neonates could also be decreased in the women who delivered vaginally. -
Key words:
- fetal growth restriction /
- mode of delivery /
- pregnancy outcome /
- perinatal outcome
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表 1 两组FGR孕妇妊娠一般情况及妊娠结局比较
对照组（n=78） t/χ2值 P值 年龄（岁） 26.41±3.86 28.32±5.30 2.506 0.013 产次（次） 1.21±0.41 1.08±0.27 2.224 0.028 妊娠合并症（例） 20（29.4%） 33（42.3%） 2.613 0.106 分娩孕周（周） 38.77±1.23 38.00±1.15 3.941 < 0.001 母亲住院时间（d） 3.21±1.54 6.59±7.55 -3.87 < 0.001 
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表 2 两组FGR孕妇围产儿结局比较
研究组（n=68） 对照组（n=78） t/χ2值 P值 羊水混浊（例） 11（16.2%） 19（24.4%） 1.49 0.222 1 min Apgar评分≤7分（例） 1（1.5%） 2（2.6%） 0.216 0.642 出生体质量（g） 2360±290 2201±245 3.585 < 0.001 入住NICU（例） 39（59.1%） 64（85.3%） 12.28 < 0.001 新生儿住院时间（d） 5.05±5.32 8.11±5.86 -3.23 0.002
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