国际生殖健康/计划生育 ›› 2020, Vol. 39 ›› Issue (4): 287-290.

• 论著 • 上一篇    下一篇

128例妊娠晚期胎死宫内的临床分析

张春霞,刘艳,王恬,王言言,霍琰   

  1. 063210  河北省唐山市,华北理工大学研究生学院(张春霞,刘艳);河北北方学院研究生学院(王恬,王言言);河北省人民医院产科(霍琰)
  • 收稿日期:2020-03-19 修回日期:2020-04-16 出版日期:2020-07-15 发布日期:2020-07-15
  • 通讯作者: 霍琰,E-mail:hy196867@126.com E-mail:hy196867@126.com

Clinical Analysis of 128 Cases of Fetal Death in the Third Trimester of Pregnancy

ZHANG Chun-xia,LIU Yan,WANG Tian,WANG Yan-yan,HUO Yan   

  1. Graduate School,North China University of Science and Technology,Tangshan 063210,Hebei Province,China(ZHANG Chun-xia,LIU Yan);Graduate School,Hebei North University,Zhangjiakou 075000,Hebei Province,China(WANG Tian,WANG Yan-yan);Department of Obstetrics,Hebei General Hospital,Shijiazhuang 050051,China(HUO Yan)
  • Received:2020-03-19 Revised:2020-04-16 Published:2020-07-15 Online:2020-07-15
  • Contact: HUO Yan,E-mail:hy196867@126.com E-mail:hy196867@126.com

摘要: 目的:分析妊娠晚期(≥28周)胎死宫内的原因,寻找围生期需值得注意的事项及有效干预措施,以期降低其发生率。方法:2011年1月1日—2018年12月31日在河北省人民医院产科收治的孕晚期发生胎死宫内者128例,其中适龄组(20~35岁)110例,高龄组(≥35岁)18例。单胎妊娠114例,双胎妊娠14例。对所有胎死宫内孕妇的临床资料进行回顾性分析。结果:114例单胎妊娠孕妇发生胎死宫内的主要原因为妊娠期高血压疾病(34/114,29.8%),其次为脐带因素(19/114,16.7%)、胎盘或胎膜因素(16/114,14.0%)以及羊水因素(15/114,13.2%);其中孕足月组较孕未足月组因胎盘或胎膜因素发生死胎的比例较高,差异有统计学意义(25% vs. 9%,P<0.05)。14例双胎妊娠孕妇发生胎死宫内的主要原因为单绒毛膜双羊膜囊单卵双胎的相关并发症(6/14,42.9%)。结论:督促孕妇定期产检,尽早确定双胎妊娠的绒毛膜性,对妊娠期合并症及并发症做到早发现、早诊断、早处理,高危孕妇适时终止妊娠,可减少胎死宫内的发生。

关键词: 死胎;, 妊娠末期;, 高血压, 妊娠性;, 年龄组;, 危险因素

Abstract: Objective: To investigate the factors of fetal death in the third trimester of pregnancy, and to discuss the matters needing attention and the effective intervention, in order to reduce the incidence of the perinatal fetal death. Methods:From January 1, 2011 to December 31, 2018, there were 128 cases of fetal death in the third trimester of pregnancy in the obstetrics department of Hebei General Hospital, including 110 cases of the age-appropriate women (aged 20-35 years) and 18 cases of the aged group (aged ≥35 years). And there were 114 cases of single pregnancy and 14 cases of twin pregnancy. The clinical data were retrospectively analyzed. Results:The main causes of fetal death in 114 cases of single pregnancy included gestational hypertension (34/114, 29.8%), umbilical cord-related factors (19/114, 16.7%), placenta or fetal membrane-related factors (16/114, 14.0%), and amniotic fluid-related factors (15/114, 13.2%). The proportion of fetal death due to the placenta- or fetal membrane-related factors in the full-term birth group was higher than that in the preterm group (25% vs. 9%, P<0.05). The main cause of 14 cases of twin pregnancy and fetal death is the related complications of the single chorionic double amniotic sac twin pregnancy (6/14, 42.9%). Conclusions:It is possible to reduce the incidence of fetal death by the comprehensive measures, such as regular prenatal exam, to determine the chorionic status of twin pregnancy as early as possible, to detect, diagnose and treat pregnancy complications as early as possible, and to terminate pregnancy timely in high-risk pregnancy.

Key words: Fetal death;, Pregnancy trimester, third;, Hypertension, pregnancy-induced;, Age groups;, Risk factors