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目的总结巨大儿的临床特点,产前诊断、分娩方式及分娩结局,减少母婴并发症。方法回顾性分析180例巨大胎儿的临床特点、产前诊断、分娩方式及分娩结局、并发症,并与随机抽取同期分娩正常体重儿组的分娩情况进行比较。结果巨大儿组宫高加腹围值≥140cm且胎儿双顶径(BPD)+股骨长(FL)≥16.5cm者占83.3%,巨大儿组较对照组易发生难产,剖宫产率及产时出血量增加,巨大胎儿剖宫产组较阴道分娩组新生儿窒息发生率及产伤发生率均明显减少(P﹤0.01,0.01)。结论宫高加腹围值≥140cm且BPD+FL≥16.5cm可作为预测巨大儿的一项指标,临床上拟诊或确诊巨大儿时,宜放宽剖宫产指征,尽量避免困难的阴道手术助产。
Objective To summarize the clinical features, prenatal diagnosis, mode of delivery and delivery outcomes of giant children, and to reduce the complications of mother and infant. Methods The clinical features, prenatal diagnosis, mode of delivery, delivery outcome and complications of 180 huge fetuses were retrospectively analyzed. The results were compared with those of children of normal birth weight at the same period. Results In the giant group, the mean abdominal mass was ≥140 cm and the percentage of BPD + 16.5 cm was 83.3%. The incidence of dystocia, cesarean section rate, and cesarean section were significantly higher in the giant group than in the control group When the amount of bleeding increased, macrosomia cesarean section than vaginal delivery group neonatal asphyxia and incidence of birth trauma were significantly reduced (P <0.01,0.01). Conclusions: The height of the uterus increases with abdominal circumference≥140cm and the BPD + FL≥16.5cm can be used as an index in predicting macrosomia. Clinically, it is necessary to relax the indications of cesarean section and try to avoid difficult vaginal surgery Midwifery.