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目的:分析不同分娩方式对巨大儿分娩结局的影响,以寻求恰当的产时处理方式,为临床实践提供依据。方法:选择2009年6月～2010年6月在乐清市第三人民医院分娩的98例出生体重>4 000 g的新生儿的资料进行回顾性分析,根据分娩方式分为阴道分娩组和剖宫产组,观察并比较两组分娩结局及新生儿有关情况。结果:两组所有胎儿均成功产出,没有出现婴儿死亡。剖宫产组的新生儿窒息率和羊水三度污染发生率均显著低于阴道分娩组(P<0.05)。两组产后出血(>500 ml)发生率的差异无统计学意义(P>0.05)。剖宫产组的患者总体满意率为88.23%(45/51),显著高于阴道分娩组的63.83%(30/47),差异具有统计学意义(P<0.05)。结论:对产前估计巨大儿的患者,适当放宽剖宫产的指征,有利于减少并发症的发生,改善巨大儿的预后,提高患者满意度。
OBJECTIVE: To analyze the effect of different modes of delivery on the outcome of giant childbirth in order to find the appropriate mode of delivery and to provide the basis for clinical practice. Methods: The data of 98 newborns with birth weight> 4 000 g who were delivered at the Third People ’s Hospital of Yueqing from June 2009 to June 2010 were retrospectively analyzed. According to the modes of delivery, they were divided into vaginal delivery group and cesarean section Production group, observe and compare the two groups of childbirth outcomes and neonatal situation. Results: All fetuses in both groups were successfully produced and no infant deaths occurred. Neonatal asphyxia and amniotic fluid third degree of incidence of cesarean section were significantly lower than the vaginal delivery group (P <0.05). There was no significant difference in the incidence of postpartum hemorrhage (> 500 ml) between the two groups (P> 0.05). The overall satisfaction rate of patients in the cesarean section group was 88.23% (45/51), significantly higher than 63.83% (30/47) in the vaginal delivery group, with statistical significance (P <0.05). Conclusion: Appropriate relaxation of indications for cesarean section in patients with prenatal macrosomia may help to reduce the incidence of complications, improve the prognosis of macrosomia, and improve patient satisfaction.