摘要
目的:探讨早发型胎儿生长受限(FGR)合并血流异常对围产结局的影响。方法:选取2016年5月1日至2021年4月30日北京大学第三医院住院分娩的77例早发型FGR患者,根据孕期胎儿血流情况分为血流异常组30例和血流正常组47例。比较两组孕妇的期待时间、孕妇及围产儿结局。结果:①血流异常组孕妇合并妊娠期高血压疾病(HDP)及应用糖皮质激素比例高于血流正常组(P<0.05)。②血流异常组患者平均期待时间、诊断孕周在孕28~30周、孕30~32周及合并HDP患者的期待时间均短于血流正常组(P<0.05);合并HDP孕妇期待时间短于未合并HDP患者(P<0.05)。③血流异常组患者剖宫产率、因胎儿窘迫剖宫产率、羊水过少发生率高于血流正常组(P<0.05);分娩孕周、胎盘体积、胎盘重量均低于血流正常组(P<0.05)。④血流异常组新生儿出生体质量低于血流正常组(P<0.05);血流异常组新生儿1分钟Apgar评分≤7分、早产、脑室出血及入住新生儿重症监护室(NICU)率均高于血流正常组(P<0.05)。⑤血流异常是影响孕妇期待时间(β-2.252,95%CI-3.292~-1.212)、因胎儿窘迫剖宫产(OR 6.595,95%CI 1.022~36.659)、分娩孕周(β-2.250,95%CI-3.290~-1.209)、早产(OR 6.386,95%CI 2.113~19.305)及入住NICU(OR 1.184,95%CI 1.040~8.852)的独立危险因素。结论:早发型FGR合并血流异常不是终止妊娠指征,应加强监测尽可能延长孕周。
Objective:To discuss the effect of early-onset fetal growth restriction(FGR)with abnormal blood flow on perinatal outcomes.Methods:77 patients with early-onset FGR who were hospitalized and delivered in the Peking University Third Hospital from May 1,2016 to April 30,2021 were selected.According to the blood flow during pregnancy,they were divided into 30 cases in the abnormal blood flow group and 47 cases in the normal blood flow group.The expected time,maternal and neonatal outcomes were compared.Results:①The proportion of pregnant women with hypertensive disorders of pregnancy(HDP)and the use of glucocorticoids in the abnormal blood flow group was higher than that in the normal blood flow group(P<0.05).②The mean expectant time in abnormal blood flow group,the expectant time of the diagnosis gestational age during 28-30 weeks,30-32 weeks and the expectation time of patients with HDP in the abnormal blood flow group were shorter than those in normal blood flow group(P<0.05).The expectant time of pregnant women complicated with HDP was shorter than that of pregnant women without HDP(P<0.05).③The rate of cesarean section,cesarean section due to the fetal distress and oligohydramnios in abnormal blood flow group was higher than those in the normal blood flow group(P<0.05).The gestational weeks of delivery,placenta volume and weight were lower than those of the normal blood flow group(P<0.05).④The neonatal birth weight in abnormal blood flow group was lower than that in normal blood flow group(P<0.05).The rate of 1min Apgar score≤7,preterm delivery,intraventricular hemorrhage and admission to NICU in the abnormal blood flow group were higher than those in the normal blood flow group(P<0.05).⑤Abnormal blood flow was an independent risk factor for the expectant time(β-2.252,95%CI-3.292--1.212),cesarean section due to fetal distress(OR 6.595,95%CI 1.022-36.659),the gestational weeks of delivery(β-2.250,95%CI-3.290--1.209),preterm delivery(OR 6.386,95%CI 2.113-19.305),and admission to NICU(OR 1.184,95%CI 1.040-8.852).Conclusions:Early-onset FGR with abnormal blood flow is not the indication for termination of pregnancy,but we should strengthen the surveillance and extend the gestational age as long as possible.
作者
杨俊娟
王媛媛
尹韶华
高雨菲
张龑
YANG Junjuan;WANG Yuanyuan;YIN Shaohua;ZHANG Yan(Department of Obstetrics,Peking University Third Hospital,Beijing 100191,China;Department of Obstetrics,Women and Infants Hospital of Zhengzhou,Zhengzhou Henan 450052,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2022年第7期535-539,共5页
Journal of Practical Obstetrics and Gynecology
关键词
早发型胎儿生长受限
期待时间
围产结局
Early-onset fetal growth restriction
The expectant time
Perinatal outcomes
作者简介
通讯作者:张龑,E-mail:zhangyann01@126.com。
