【摘要】 目的探讨分析对高龄初产高危妊娠与结局产生影响的相关因素。方法回顾性分析了2881例住院高危初产孕妇的妊娠结局和分娩并发症情况,并着重分析1036例高龄初产高危妊娠孕妇的高危因素以及终止妊娠的原因。结果高危孕妇妊娠结局主要以剖宫产和顺产为主,其中正常年龄初产高危孕妇的妊娠结局明显优于高龄初产高危孕妇,差异有统计学意义(P<0.05);高龄初产孕妇分娩并发症的发生率为62.36%,高于正常年龄初产孕妇的29.81%,高龄初产孕妇分娩并发症的发生情况胎儿窘迫、产后出血、胎儿畸形、胎膜早破均高于正常年龄初产孕妇,差异均具有统计学意义(P<0.05)。其胎膜早破发生率为最高;高危妊娠因素中最主要的因素为妊娠并发症(45.85%);终止妊娠的原因中最主要的是妊娠期高血压、妊娠合并症和胎儿畸形及死胎。结论医院需完善孕期保健服务,提高孕妇自我保健意识的同时加强综合管理,做到有效的单病种专业管理,进而提高对高龄初产高危妊娠的处理水平。更多还原

【Abstract】 Objective To investigate and analyze related factors influencing high risk pregnancy and outcome in elder primipara. Methods A retrospective analysis was made on pregnancy outcome and complications in labor in 2881 hospitalized high risk primipara, especially on high risk factors and termination of pregnancy causes in 1036 elder high risk primipara. Results Main pregnancy outcome in high risk puerpera included cesarean section and natural labor, while high risk primipara in normal age had obviously better pregnancy outcome than high risk elder primipara, and their difference had statistical significance(P<0.05). Elder primipara had higher incidence of complications in labor as 62.36% than 29.81% of primipara in normal age. Incidences of fetal distress, postpartum hemorrhage, fetal malformation and premature rupture of membranes as complications were all higher in elder primipara than primipara in normal age, and the difference had statistical significance(P<0.05). Elder primipara had incidence of premature rupture of membranes as the highest one. The main high risk pregnancy factor was complications in labor(45.85%). Main termination of pregnancy causes included gestational hypertension, complication of pregnancy, fetal malformation and stillbirth. Conclusion Improving antenatal care service by hospital and self-health consciousness in puerpera, enhancing comprehensive management and controlling single disease are necessary for improving management in high risk elder primipara.更多还原