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目的:探讨妊娠合并症对晚发型胎儿生长受限(fetal growth restriction,FGR)的影响。方法:收集2013年本院130例诊断胎儿生长受限病例并随机抽取130例正常对照病例的临床资料,对两组的妊娠高血压疾病、贫血、甲状腺功能减退症、妊娠期糖尿病(GDM)、妊娠期肝内胆汁淤积症(ICP)的发生率进行比较分析,分别检测两组红细胞叶酸值并进行比较分析。根据对症处理及胎儿治疗情况,进一步将生长受限的胎儿分为干预组和非干预组两个亚组,比较两组新生儿出生体重达到相应孕周标准体重的比率、早产、胎儿窘迫、新生儿窒息、新生儿肺炎的发病率之间的差异。结果:FGR组妊娠高血压疾病、贫血、妊娠期甲状腺功能减退症的发生率明显高于对照组(P<0.05),GDM、ICP的发生率无显著差异(P>0.05)。FGR组红细胞叶酸值明显低于非FGR对照组,差异有统计学意义(P<0.05)。干预组新生儿出生体重达到相应孕周标准体重的比率明显高于非干预组(P<0.05),干预组早产、胎儿窘迫、新生儿窒息、新生儿肺炎的发病率明显低于非干预组(P<0.05)。结论:妊娠期高血压疾病是引起胎儿生长受限的主要因素,同时贫血、叶酸缺乏、妊娠期甲状腺功能减退症等也直接影响胎儿的生长发育,根据病因给予干预性治疗可以明显改善妊娠结局。
Objective: To investigate the effect of pregnancy complications on late fetal growth restriction (FGR). Methods: The clinical data of 130 cases of fetal growth restriction diagnosed in our hospital from 2013 and randomized control group of 130 cases were collected. The incidence of pregnancy-induced hypertension, anemia, hypothyroidism, gestational diabetes mellitus (GDM) The incidence of intrahepatic cholestasis of pregnancy (ICP) were compared and analyzed, the two groups of erythrocyte folic acid were detected and compared. According to the symptomatic treatment and fetus treatment, the fetuses with limited growth were further divided into two subgroups: intervention group and non-intervention group. The birth weight of the two groups was compared with that of the corresponding gestational weeks. Preterm birth, fetal distress, Asphyxia, neonatal pneumonia, the difference between the incidence. Results: The incidences of pregnancy-induced hypertension, anemia and hypothyroidism during pregnancy in FGR group were significantly higher than those in control group (P <0.05). There was no significant difference in the incidence of GDM and ICP (P> 0.05). FGR group was significantly lower than that of non-FGR control group, the difference was statistically significant (P <0.05). The incidence of neonatal birth weight reaching the gestational week standard weight was significantly higher in the intervention group than in the non-intervention group (P <0.05). The incidence of preterm birth, fetal distress, neonatal asphyxia and neonatal pneumonia in the intervention group was significantly lower than that in the non-intervention group P <0.05). Conclusion: Hypertensive disorder in pregnancy is the main factor that causes fetal growth restriction. At the same time, anemia, folic acid deficiency and hypothyroidism in pregnancy also directly affect the growth and development of the fetus. Interventional treatment according to the cause can significantly improve the pregnancy outcome.