|
|
Effects of modes of delivery on pregnancy outcomes of primiparas of advanced maternal age after 37 weeks |
JIANG Haili1,REN Mingbao1,LU Chang1,and MA Huashu2 |
1.Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University,Beijing100026,China; 2. Department of Obstetrics, Xingtai People’s Hospital Affiliated to Hebei Medical University, Xingtai 054000, China |
|
|
Abstract Objective To explore the cesarean section rate and the clinical features of trial of vaginal delivery in primiparas of advanced maternal age after 37 weeks. Methods A retrospective study was conducted of the primiparas of advanced maternal age after 37 weeks of pregnancy in Beijing Obstetrics and Gynecology Hospital between January and July 2018. Data on the age, gravidity, history of adverse pregnancy, pregnancy complications, gestational weeks, mode of delivery, fetal distress, neonatal asphyxia of these primiparas was collected for statistical analysis. Results Among the 746 cases of delivery, 303 cases (40.62%)chose cesarean section and 443 cases (59.38%)requested trial of vaginal delivery, 75 of whom (16.93%)were transferred to cesarean section, 368(83.07%)had successful vaginal delivery and 38 cases (10.32%)delivered by forceps. In the group aged 35 to 37 and the group above 38 years old, the rate of transferred cesarean section was 17.24% and 15.15%, respectively, (P=0.870) and the rate of forceps delivery was 7.43% and 15.15%, respectively (P=0.021). The rates of neonatal asphyxia in the groups of elective cesarean section, transferred cesarean section and normal vaginal delivery were 5.30%,40.00% and 21.47%, respectively(P=0.000). Conclusions The chances of transferred cesarean section are not increased in the group above 38 years old. The rate of fetal distress in the transferred cesarean section group increases, but the rate of neonatal asphyxia does not. After adequate assessment, most of the primiparas of advanced maternal age after 37 weeks of pregnancy can have successful vaginal delivery.
|
Received: 20 September 2018
|
|
|
|
|
[1] |
Chen C P, Chern S R, Tsai F J, et al. Down syndrome due to unbalanced homologous acrocentric rearrangements and its recurrence in subsequent pregnancies:prental diagnosis by amniocentesis [J].Taiwan J Obstet Gynecol, 2009, 48(4): 403-407.
|
[2] |
陈美秀.高龄初产妇剖宫产相关因素分析[J]. 中国妇幼保健, 2005, 20(15): 1866-1867.
|
[3] |
戚 红, 边旭明,杨剑秋.不同分娩方式对低危孕产妇分娩结局及卫生经济学指标的影响[J]. 中华妇产科杂志, 2007, 42(12):818-821.
|
[4] |
侯 磊, 李光辉, 邹丽颖, 等.全国剖宫产率及剖宫产指征构成比调查多中心研究[J]. 中华妇产科杂志, 2014, 49(10): 728-735.
|
[5] |
周建新,阮 焱. 二孩政策实施前后剖宫产率及剖宫产指征的变化分析[J]. 中国临床医生杂志, 2018, 46(7): 734-737.
|
[6] |
陈 宇, 郑晓莉, 张为远. 不同年龄段高龄孕产妇临床特点与妊娠结局[J]. 中华妇产科杂志, 2017, 52(8): 508-513.
|
[7] |
段 涛,胡娅莉,吕时铭.产前诊断[M].北京:人民卫生出版社,2010:19-30.
|
[8] |
Ulla W, Sven C, Mikael N, et al.Advanced maternal age and stillbirth risk in nulliparous and parous women[J].Obstet & Gynecol, 2015, 126(2):355-362.
|
[9] |
陈 宇,伍绍文,张为远.高龄孕产妇的潜在风险, 中华妇产科杂志,2017,52(8):566-568.
|
[10] |
Renz-Polster H,David M R,Buist A S,et al.Cesarean section delivery and the risk of allergic disorders in childhood[J]. Clin Exp Allergy, 2005, 35:1466-1472.
|
[11] |
Roduit C,Scholtens S, de Jongste J C. Asthma at 8 years of age in children born by caesarean section,Thorax,2009,64:107-113.
|
[12] |
Tita A T N, Landon M B, Spong C Y,et al.Timing of elective repeat cesarean delivery at term and neonatal outcomes[J].N Engl J Med,2009,360(15):1570-1571.
|
[13] |
刘洪莉,漆洪波,罗 欣,等,择期再次剖宫产终止妊娠的时机及母儿结局[J],中华围产医学,2014,4,4(17): 224-229.
|
|
|
|