一例高龄、高危孕妇案例分析并文献复习

随着“全面二孩”政策的放开,高龄孕产妇的人数越来越多,孕妇年龄的增加,合并内外科疾病的概率也明显增加,这也导致高龄孕妇及围生儿的不良结局增加。在实行“全面二孩”政策前,国内诸多医院的头胎剖宫产率远高于世界卫生组织推荐的15%的水平;随着“二胎政策”的落地,当初选择剖宫产的高龄妇女再次孕育新生命。育龄女性随着年龄的增加,身体各项机能逐步下降,生殖系统的功能也逐步衰退,瘢痕子宫伴随着年龄的增加逐渐老化,收缩能力下降。如何确保具有瘢痕子宫,且合并多种内外科疾病的高龄产妇安全分娩,是产科医师面临的一个新难题。通过查阅相关文献及总结青海大学附属医院1例高龄妊娠合并脑动脉瘤、颈动脉瘤、妊娠期肝内胆汁淤积症、妊娠期糖尿病的资料加深产科医师对相关疾病的重视与理解。

A Case Analysis of Ederly and High-Risk Pregnant Women and Literature Review

With the liberalization of the second-child policy, the number of elderly mothers is increasing, thus the age of pregnant women is increasing, and the incidence of internal and surgical disease is also increasing, which also leads to an increase in the adverse outcomes of older pregnant women and perinatal children. Before the implementation of the "two-child policy", the rate of cesarean section in many hospitals in China was much higher than the 15% level recommended by the World Health Organization. With the "two-child policy" landing, the elderly women who originally chose cesarean section once again gave birth to new life. With the increase of age, the body functions of women of childbearing age gradually declines, and reproductive system function also gradually declines, while scar uterus gradually become aging and its contraction ability declines. How to ensure the safe delivery of elderly women with scarred uterus and a variety of internal and surgical diseases is a new difficult problem for obstetricians. By consulting relevant literatures and summarizing the cases of advanced pregnancy with cerebral aneurysm, carotid aneurysms, intrahepatic cholestasis of pregnancy, and gestational diabetes in Qinghai University Affiliated Hospital, this article deepen obstetricians′ attention and understanding of related diseases.