基于“二胎”再育趋势的产科安全影响因素分析及对策探讨

发布时间：2018-01-12 15:40

本文关键词：基于“二胎”再育趋势的产科安全影响因素分析及对策探讨　出处：《上海交通大学学报(医学版)》2016年05期 　论文类型：期刊论文

【摘要】：目的通过比较"二胎"政策开放前后经产妇妊娠和分娩结局,探讨如何加强生育第二胎产科质量安全管理。方法收集2013年1月—2015年6月某院产科分娩第二胎的基本数据,进行统计分析。结果 "二胎"政策实施后,经产妇、瘢痕子宫再次妊娠比例呈上升趋势,高龄经产妇占比、妊娠期高血压疾病/糖尿病患病率、早产率、巨大儿/低体质量儿分娩率以及产后出血率显著增高。妊娠期高血压疾病经产妇中新生儿窒息、早产、低体质量儿、产后出血的发生风险增高;妊娠期糖尿病经产妇中早产、低体质量儿、巨大儿的发生风险增高。结论现阶段生育第二胎妇女中,高龄、瘢痕子宫再次分娩、妊娠并发高血压/糖尿病者增多,不良分娩结局风险增加;需对再生育者加强孕前检查、妊娠并发症防治以及重症产科出血、子宫破裂应急管理,保证母婴安全。
[Abstract]:Objective to compare the outcome of pregnancy and delivery before and after the opening of the "second child" policy. To discuss how to strengthen the quality and safety management of second birth obstetrics. Methods the basic data of second birth in a hospital from January 2013 to June 2015 were collected. Results after the implementation of the "second child" policy, the proportion of pregnant women with scar uterus was on the rise, the proportion of elderly women in pregnancy, the prevalence rate of hypertension complicating pregnancy / diabetes mellitus, and the rate of premature delivery. The delivery rate and postpartum hemorrhage rate of macrosomia / low body mass infants were significantly increased. The risk of neonatal asphyxia, premature delivery, low body mass and postpartum hemorrhage was increased in hypertensive disorder complicating pregnancy. Gestational diabetes mellitus (GDM) is at high risk of premature delivery, low body mass and macrosomia. Conclusion in the second trimester at present, the cicatricial uterus reproduces at an advanced age. Pregnancy complicated with hypertension / diabetes increased, the risk of adverse delivery outcome increased; It is necessary to strengthen pre-pregnancy examination, prevention and treatment of pregnancy complications, and emergency management of severe obstetric hemorrhage and uterine rupture to ensure the safety of mother and child.
【作者单位】：上海交通大学医学院附属国际和平妇幼保健院产科;
【分类号】：R714
【正文快照】： 党的十八届三中全会作出了关于调整完善生育政策的决策部署,上海市从2014年3月1日起全面实施“单独两孩”政策。从“双独两孩”,到现今的“单独两孩”,生育第二胎的意愿呈上升趋势。据统计,从2014年3月到12月底,上海市共批准单独夫妻再生育申请1.66万例,双独夫妻再生育申请6 9

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