4827例孕产妇妊娠期病种分布及妊娠结局

摘要

目的:了解2014年度孕产妇妊娠期病种分布情况和分娩的母儿结局.方法:对我院4827例孕产妇临床资料进行回顾性分析,统计分析患者一般资料、病种分布及分层分析高龄(≥35岁)、未定期产检(产检＜5次)、不同分娩方式的病种分布和母儿结局相关指标.结果:①4827例孕产妇中病种分布前3名依次为:胎膜早破(21.11％)、妊娠期糖尿病(20.20％)、脐带绕颈(14.38％).②高龄孕产妇中病种分布前3名依次为:妊娠期糖尿病(34.72％)、瘢痕子宫(33.33％)、妊娠期甲状腺功能减退症(16.67％).③未定期产检孕产妇病种分布前3名为胎膜早破(23.36％)、瘢痕子宫(22.43％)、前置胎盘(10.28％),主要来自于基层转诊或急诊.④剖宫产与阴道分娩病种分布相比,前置胎盘、妊娠期糖尿病、瘢痕子宫、妊娠期胆汁淤积、羊水过少及胎儿窘迫等严重威胁母儿生命疾病的发生率明显升高(P＜0.05).⑤4827例孕妇均健康出院,共计4907例新生儿,4811例存活,死亡新生儿26例,未定期产检孕产妇的新生儿死亡率、非正常体质量儿及转儿科率高于全体新生儿.结论:不同特征的孕妇妊娠期疾病分布不同,高龄及未定期产检孕产妇中严重威胁母儿安危的病种明显升高.%Objective:To understand the distribution of pregnant women diseases and the maternal and fetal outcomes.Methods:A retrospective analysis of 4827 patients in our hospital was conducted,and the general information,disease distribution,stratified analysis of advanced age (≥ 35),irregular inspection (＜ 5 times),diseases distribution of different delivery modes and pregnant outcomes were analyzed.Results:(①Among the 4827 pregnant women,the most common diseases were ranked as follows:premature rupture of membranes (21.11％),gestational diabetes mellitus (20.20％) and umbilical cord around the neck (14.38％).②Among the advanced age pregnant women,the most common diseases were:gestational diabetes mellitus(34.72％),scar uterus(33.33％) and hypothyroidism during pregnancy (16.67％).③Among the irregular inspection pregnant women,the most common diseases were:premature rupture of membranes(23.36％),scar uterus(22.43％),placenta previa(10.28％).Most of the patients are from referral or emergency treatment.④Compared with the diseases distribution of vaginal delivery,the incidence of serious diseases threatening maternal life like placental previa,gestational diabetes mellitus,scar uterus,cholestasis,oligohydramnios and fetal distress were significantly increased in cesarean section group (P ＜ 0.05).⑤Pregnancy outcome:4827 pregnant women were recovered and discharged.4881 cases survived and 26 cases died among 4907 perinatal.The neonatal adverse outcomes of pregnant women in the irregular inspection group were significantly higher than those in other group.Conclusions:The diseases distribution during pregnancy was different in each group.The incidence of diseases which seriously threaten the maternal and fetal were increased in advanced and irregular inspection pregnant women.