The influence of macrosomia on the duration of labor, the mode of delivery and intrapartum complications
The influence of macrosomia on the duration of labor, the mode of delivery and intrapartum complications
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DOI：
10.1007/s00404-008-0630-7
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发表时间：
2008-12-01
影响因子：
2.6
通讯作者：
Koelbl, H.
中科院分区：
文献类型：
--
作者：
Siggelkow, W.;Boehm, D.;Koelbl, H.
目的本研究评估了一系列巨大胎儿的围产儿结局，母亲来自一般产科人群，计划阴道分娩。观察孕妇孕期体重增加情况、巨大儿对产程及分娩结局的影响。研究的主要问题是胎儿体重对分娩方式的影响，分娩的两个阶段的持续时间和分娩期并发症的发生率大于4,000 g的胎儿与正常体重fetals.Results比较，获得完整的数据为594例，其中包括215巨大婴儿和379随机评估正常体重的婴儿。关于分娩方式，当最初计划阴道分娩时，观察到母亲体重增加与二次剖宫产率之间存在直接相关性（P < 0.014）。出生体重增加与二次剖宫产率和阴道助产率的增加也有直接关系（P < 0.002）。在第一产程中，两组发生难产的发生率差异有统计学意义（P < 0.03）。会阴损伤的发生率和产后出血的发生率在两个group.Conclusions的一些危险因素确定是已知的分娩前，每一个女人，其中有一个怀疑，胎儿可能重达4,500克，应接受个别指导，特别是产时和围产期条件。
Objective This study assessed the perinatal outcome in a series of macrosomic fetuses with mothers from a general obstetric population in whom vaginal delivery was planned.Methods In all, 215 women with macrosomic infants were included from a total of 2,622 deliveries. The pattern of maternal weight gain in pregnancy, the influence of fetal macrosomia on the duration of labor and the delivery outcome were investigated in this group. The main issues studied were the impact of fetal weight on the mode of delivery, the duration of the two stages of delivery and the incidence of intrapartum complications in fetuses larger than 4,000 g in comparison with normal-weight fetuses.Results Complete data were obtained for 594 patients, including 215 macrosomic infants and 379 randomly assessed normal-weight infants. With regard to the mode of delivery, a direct correlation was observed between maternal weight gain and the incidence of secondary cesarean section (P < 0.014) when vaginal delivery was initially planned. There was also a direct correlation between increasing birth weight and a higher incidence of secondary cesarean section and assisted vaginal delivery (P < 0.002). In the first stage of labor, there was a statistically significant difference for obstructed labor between the two groups (P < 0.03). The rate of perineal injuries and the incidence of postpartum hemorrhage were similar in the two groups.Conclusions As some of the risk factors identified are known prior to delivery, every woman in whom there is a suspicion that the fetus may weigh up to 4,500 g should receive individual guidance regarding special intrapartum and perinatal conditions.