一家三级医疗中心对过期妊娠产妇和胎儿结局的分析

Ramadevi G., Sailaja C. H., Anuragamayi Y., Madhuri C. H., Sujatha Ryali
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摘要

背景:由于胎儿的发病率和死亡率不断上升,管理过期妊娠正成为一个具有挑战性的问题。这项研究旨在分析印度妇女过期妊娠的母体和胎儿结局,同时考虑到她们的胎儿成熟较早。这项前瞻性观察研究历时 18 个月,共有 100 个病例,主要针对孕龄达到或超过 40 周的孕妇,不包括患有某些并发症的孕妇:方法:在获得伦理委员会的批准和符合条件的参与者的知情同意后,进行详细的病史询问和检查,并在分娩和产后护理前进行密切监测。纳入标准包括头位单胎妊娠,排除标准包括非头位妊娠、先天性畸形和各种内科并发症:结果显示,年龄在 20 至 35 岁、妊娠 40 至 40 周零 6 天的初产妇占多数。58%的产妇为自然分娩,90%为阴道分娩,而所有多产妇均为阴道分娩后引产。14%的产妇进行了剖宫产,主要原因是引产失败和胎儿窘迫。42周或42周以后出生的婴儿最常出现带蜕膜的液体,这与围产期死亡率和新生儿重症监护室入院率较高有关:结论:事实证明,严密的监测对避免胎儿危险至关重要,这强调了及时干预以减轻与过期妊娠相关的并发症的重要性。这项研究揭示了印度人口过期妊娠的独特考虑因素和结果,为类似环境下的孕产妇和新生儿护理提供了宝贵的见解。
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Analysis of maternal and foetal outcome of post-dated pregnancy in a tertiary care centre
Background: Managing pregnancy with post-dates is becoming a challenging issue due to increasing fetal morbidity and mortality. The study aimed to analyse the maternal and fetal outcomes of post-term pregnancies among Indian women, considering their earlier fetal maturation. Conducted over 18 months with 100 cases, the prospective observational study focused on pregnant mothers at or beyond 40 weeks gestational age, excluding those with certain medical complications. Methods: After obtaining approval from the ethics committee and informed consent from eligible participants, detailed histories and examinations were conducted, with close monitoring until delivery and postnatal care. Inclusive criteria encompassed singleton pregnancies with cephalic presentation, while exclusions included non-cephalic presentation, congenital anomalies, and various medical complications. Results: Revealed a predominance of primigravida women aged 20 to 35 years at 40 to 40 weeks and 6 days gestation. Spontaneous delivery occurred in 58%, with 90% delivering vaginally, while all multigravida births were vaginal post-induction. Cesarean sections were performed in 14%, primarily due to failed induction followed by fetal distress. Meconium-stained liquor was most prevalent at 42 weeks or later, correlating with higher perinatal mortality and NICU admissions in infants born beyond 42 weeks. Conclusions: Vigilant monitoring proved crucial in averting fetal jeopardy, emphasizing the importance of timely interventions to mitigate complications associated with post-term pregnancies. This study sheds light on the unique considerations and outcomes of post-dated pregnancies in the Indian population, contributing valuable insights for maternal and neonatal care in similar settings. 
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