应用分娩时机计算表对高危孕妇分娩结局的影响

摘要

Objective To explore the influence of delivery calculation sheet on the outcome of high risk pregnancy.Methods Totally 591 high risk pregnant women from August 2012 to August 2013 were recruited and divided into observation group (201 cases) and control group (390 cases).In observation group,the labor induction was performed on the optimal delivery time calculated by delivery calculation sheet;in control group,the labor induction was performed according to 《Guidance of Gynecology and Obstetrics and Family Planning Established》 constituted by Beijing Municipal Health Bureau.The maternal and neonatal outcomes were compared between the two groups.Results Compared with control group,observation group showed lower rate of cesarean section [19.9％ (40/201) vs 29.0％ (113/390),P ＜ 0.05],lower incidence of postpartum hemorrhage [11.9％ (24/201) vs 19.5％ (76/390),P ＜0.05] and lower rate of macrosomia [3.0％ (6/201) vs 11.8％ (46/390),P ＜ 0.01].However,there was no significant difference regarding the incidence of neonatal asphyxia between the two groups [1.5％ (3/201) vs 3.1％ (12/390),P ＞ 0.05].Conclusion Programed delivery guided by delivery calculation sheet can improve the maternal and neonatal outcomes,including reducing the rate of cesarean section,incidence of postpartum hemorrhage and macrosomia.%目的 探讨应用分娩时机计算表对高危孕妇分娩结局的影响.方法 将2012年8月至2013年8月在民航总医院产科门诊建档并系统产检的591例高危孕妇,按照病历尾号奇偶数分为研究组(201例)和对照组(390例).研究组采用分娩时机计算表计算最佳分娩时限,给予引产;对照组按照北京市卫生局制定的《妇产科与计划生育诊疗常规》,给予常规处理,进行引产.比较2组的母婴结局.结果 研究组和对照组剖宫产率分别为19.9％(40/201)和29.0％ (113/390),差异有统计学意义(P＜0.05);产后出血发生率分别为11.9％(24/201)和19.5％(76/390),差异有统计学意义(P＜0.05);巨大儿发生率分别为3.0％(6/201)和11.8％ (46/390),差异有统计学意义(P＜0.01);新生儿窒息发生率分别为1.5％(3/20l)和3.1％(12/390),差异无统计学意义(P＞0.05).结论 应用分娩时机计算表指导计划分娩可以降低剖宫产率,减少产后出血发生率,降低巨大儿出生率,改善母婴结局.