孕40周后妊娠结局及处理方法分析

目的通过对孕40周后妊娠结局的分析,了解孕期延长对胎儿及新生儿的影响及终止妊娠的最佳时机与方法。方法采用回顾性研究,对我院2002年1月-2006年1月孕足月无合并症的初产妇资料进行分析,总例数24210例,其中415例孕周为40～40 6,384例孕周为41～41 6,93例为过期妊娠。结果过期妊娠剖宫产率为73.1%,胎儿窘迫率为69.8%,明显高于其他孕周组;孕41～41 6周胎儿剖宫产率和胎儿窘迫率高于孕41周前孕妇(P<0.01);孕周为41～41 6引产组剖宫产率为51.3%,自然临产组剖宫产率为33.9%,有统计学意义(P<0.01),胎儿窘迫率和新生儿窒息率分别为43.5%和0.9%,33.9%和0,无统计学意义(P>0.05)。引产组宫颈Bishop评分小于4分者剖宫产率为66.6%,高于评分7分以上者剖宫产率为40.8%,有统计学意义(P<0.01)。结论妊娠41周后,胎儿在宫内有缺氧的危险,应适时终止妊娠,宫颈条件不成熟者,予促宫颈成熟后引产终止妊娠。

Pregnant Outcome in Women Over 40 Gestational Weeks

Objective To study the pregnant outcome of those women who were over 40 gestational weeks.Method A retrospective study was conducted in 24,210 normal nulliparous women who had delivered between January,2002 and January,2006.The rates of cesarean delivery,fetal distress,and neonatal asphyxia were compared between those over 41 weeks and the others.Results The rates of cesarean delivery(73.1%)and fetal distress(69.8%)in the >42 weeks pregnant group were significantly increased than those of the others(P<0.01).A higher rate of cesarean delivery was found in the >41 weeks pregnant group than that of the spontaneous onset of labor in the induced women(P<0.01),there was no significant difference in the rates of fetal distress and neonatal asphyxia between them(P>0.05).The lower the Bishop score,the higher the rate of cesarean delivery.Conclusions Pregnancy >41 weeks might increase the risk of intrauterine hypoxia and induced delivery is indicated.If the cervix condition is not matured,it is necessary to take measures for promoting maturation and properly terminating the pregnancy.