巨大儿183例分娩结局临床分析

目的探讨巨大儿产科分娩处理的合理性。方法回顾性分析2005年1月～2008年12月在我院出生的183例巨大儿产科分娩处理方法及并发症资料，并与同期分娩的正常体重儿产妇分娩方式与分娩结果进行比较。结果巨大儿组的剖宫产率、机转异常、头盆不称、新生儿室息及新生儿产伤均高丁正常体重儿组，差异有统计学意义。巨大儿经产妇组和初产妇组相比较，经产妇巨大儿产检建卡、正规产前检查，剖宫产率及择期手术率明显低于初产妇巨大儿组，而新生儿窒息、新生儿产伤、会阴裂伤及产后出血明显高于初产妇巨大儿组。结论重视巨大儿的产前诊断、产前预测，加强流动人口围产期保健，选择适当的分娩方式，减少母婴损伤，避免发生医疗纠纷。

Clinical Analysis of Delivery Results in 183 Macrosomic Infants

Objective To explore the rationality of obstetrical delivery treatment fur macrosomic infant. Methods The data of delivery treatment and complications of 183 macrosomie infants who were born in Cixi Third People＇s Hospital between January 2005 and December 2008 were reviewed,and were compared with the normal birth weight infants of the same period about the delivery mode and delivery outcome. Results Rates of cesarean delivery,abnormal mechanism of labor,eehalopelvic disproportion,neonatal asphyxia and neonatal birth injury in the macrosomia were higher than in normal birth weight. The difference was statistically significant. And lower incidences of check-built card, regular prenatal care,cesarean section and elective surgery were observed in multigravidae than in primigravidae who were delivery maerosomic,while the rates of neonatal asphyxia,neonatal birth injury,perineal laceration,and postpartum hemorrhage were significantly higher in muhigravidae. Conclusion In order to reduce maternal and infant injury,to prevent medical disputes,we should emphasize on prenatal diagnosis of macrosomia,antenatal prediction of macrosomia,perinatal care for the floating population,and select the appropriate mode of delivery .