117例自发性早产临床分析
发布时间:2018-02-28 02:10
本文关键词: 自发性早产 保胎时间 分娩方式 早产儿预后 出处:《吉林大学》2014年硕士论文 论文类型:学位论文
【摘要】:目的:研究不同病因导致的自发性早产的发病及终止妊娠孕周、保胎时间、早产儿预后及不同分娩方式对早产儿预后的影响。 方法:回顾性分析2009年至2012年于我院分娩的117例自发性早产,比较分析不同孕周、不同原因、不同保胎时间及分娩方式对新生儿结局的影响。 结果:①导致自发性早产病因最主要为宫内感染,约占研究总数的34.19%;其次为瘢痕子宫、双胎妊娠,均占总数的17.95%;随后依次为胎位异常(主要指臀位),,占总数的11.11%,羊水过多者占总数的9.40%,生殖道异常者占总数的8.55%等。其中32周前臀位所占比例较大,约占24.24%;32周后则比例降低,约占5.95%。而宫内感染、瘢痕子宫及双胎妊娠则无孕周差异性,孕32周前后均为诱发早产的主要原因。 ②对比其它引起早产的病因及危险因素,宫内感染者保胎时间最短,且存在宫内感染者即使抗感染治疗,早产亦常不可避免。 ③32周前剖宫产分娩可明显降低新生儿窒息及颅内出血的发生率(P<0.05);32周后剖宫产明显降低颅内出血发生率(P<0.05),但在新生儿窒息方面剖宫产与顺产无明显差异(P>0.05)。 ④未足月胎膜早破早产较自发性早产者新生儿感染率明显增高(P<0.05)。 结论:①宫内感染是自发性早产的最主要病因,因宫内感染引发先兆早产的保胎时间最短。②在充分考虑早产儿存活可能性的基础上,剖宫产能显著降低新生儿窒息及颅内出血发生率。③发生胎膜早破者较未发生胎膜早破者新生儿感染率明显增高。④产前积极防治感染,能有效减少早产发生,降低围生儿死亡率及患病率。
[Abstract]:Objective: to study the influence of spontaneous preterm delivery (SPC) on the prognosis of preterm infants by different etiological factors, including gestational weeks, pregnancy retention time, prognosis of preterm infants and different delivery methods. Methods: 117 cases of spontaneous preterm delivery in our hospital from 2009 to 2012 were analyzed retrospectively. Results the most common cause of spontaneous preterm labor was intrauterine infection, which accounted for 34.19% of the total number of studies, followed by scar uterus and twin pregnancy. The number of abnormal fetal position (mainly gluteal position, 11.11% of the total), amniotic fluid (9.40%), genital tract abnormality (8.55%%), and the ratio of breech position before 32 weeks was larger, and the proportion of 24.2424% decreased after 32 weeks, respectively, in the following order: 17.95% of the total number, 11.11% of the total number, 9.40% of the total number of amniotic fluid and 8.55% of the total number of patients with abnormal reproductive tract. However, intrauterine infection, scar uterus and twin pregnancy had no difference in gestational weeks, and 32 weeks after pregnancy were the main causes of preterm delivery. Compared with other causes and risk factors of premature delivery, intrauterine infection has the shortest time to protect the fetus, and even if the intrauterine infection is treated with anti-infection, premature delivery is often inevitable. The incidence of asphyxia and intracranial hemorrhage was significantly decreased by cesarean section after 332 weeks (P < 0.05) and the incidence of intracranial hemorrhage was significantly decreased after caesarean section (P < 0.05), but there was no significant difference between caesarean section and spontaneous delivery in asphyxia neonatorum (P > 0.05). (4) the infection rate of newborns with premature premature rupture of unmatured membranes was significantly higher than that of spontaneous premature delivery (P < 0.05). Conclusion Intrauterine infection is the main cause of spontaneous preterm delivery. The shortest duration of fetal preservation for threatened preterm delivery due to intrauterine infection is based on the full consideration of the possibility of survival of preterm infants. Cesarean section could significantly reduce the incidence of asphyxia and intracranial hemorrhage in newborns. 3. The infection rate of newborns with premature rupture of membranes was significantly higher than that of those without premature rupture of membranes. Reduce perinatal mortality and morbidity.
【学位授予单位】:吉林大学
【学位级别】:硕士
【学位授予年份】:2014
【分类号】:R714.7
【参考文献】
相关期刊论文 前10条
1 秦彩云;王瑜;;促肾上腺皮质激素释放激素在早产中的作用[J];临床医学;2012年01期
2 宗旦棣;王洁群;;IGFBP-1的测定及宫颈结构的变化在早产预测中的价值[J];中国妇产科临床杂志;2008年06期
3 张新玲,李小毛,郑荣琴,杨越波,侯红瑛;宫颈阴道分泌物中胰岛素样生长因子结合蛋白-1预测早产[J];广东医学;2002年04期
4 崔艳萍;;宫颈分泌物中胰岛素样生长因子结合蛋白-1预测早产的价值[J];国际医药卫生导报;2006年04期
5 李裕 ,李友兰 ,刘彬 ,胡绍琼 ,李祥麟 ,孟丹;宫颈分泌物白介素-6和催乳素含量对早产预测的研究[J];贵州医药;2002年02期
6 赵学燕;;504例早产相关因素分析[J];华夏医学;2012年05期
7 李志华;罗霏;;外阴阴道假丝酵母菌感染对妊娠结局的影响[J];当代医学;2013年01期
8 吴彬;申莉华;;未足月胎膜早破病因及相关因素分析[J];华夏医学;2012年06期
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