230例巨大儿不同分娩方式对造成母婴并发症的影响

目的探讨巨大儿的不同分娩方式对造成母婴并发症的影响及防范措施。方法回顾性分析长桥人民医院2008年01月～2011年12月230例出生为巨大儿的临床资料。根据其不同的分娩方式造成的母婴并发症进行分组，并进行分析，寻找降低巨大儿并发症的防护措施。结果阴道顺产组、阴道助产组、剖宫产组新生儿并发症发生率分别为14．46％、75．00％、2．22％，主要并发症有肩难产、窒息、锁骨骨折、臂丛神经损伤等，差异有统计学意义（P〈0．01）；产妇并发症发生率分别为25．3％、100％、2．96％，主要并发症有产道损伤、产后出血及产后感染等，差异有统计学意义（P〈0．01）。结论阴道分娩组（尤其是助产组）造成母婴的并发症远高于剖宫产组。故对分娩前诊断为巨大儿者，建议选择剖宫产术来降低母婴并发症。

Impact on Maternal Complication by Different Modes of Delivery of 230 Fetal Macrosomias

Objective To investigate the impact and preventive measures of fetal macrosomias with different modes of delivery on the maternal complication.Methods A retrospective study was conducted on clinical data of 230 fetal macrosomias in Changqiao People＇s Hospital from January 2008 to December 2011.Results The incidence rate of neonatal complication in vagina delivery group,vagina midwifery group and cesarean section group are 14.46%,75.00% and 2.22%,and the main complications are shoulder dystocia,fetal distress,fracture of the clavicle,brachial plexus injury and etc.,in which the differences are statistically significant（P 〈 0.01）.The incidence rate of maternal complication are 25.3%, 100% and 2.96%,and the main complications are birth canal injury, postpartum hemorrhage and postpartum infection,in which the differences are statistically significant（P 〈 0.01）.Conclusion The incidence of maternal complication in vagina delivery group（especially vagina midwifery grope）,is much higher than the cesarean section group.So it is recommended to choose caesarean section to reduce the maternal complication if it is diagnosed to be fetal macrosomia before delivery.