학술논문
改良版Robson分类系统对重度子痫前期产妇剖宫产率的分析 / Analysis of cesarean section rate of parturients with severe preeclampsia by modified Robson classification
Document Type
Academic Journal
Author
Source
中国产前诊断杂志（电子版） / Chinese Journal of Prenatal Diagnosis(Electronic Version). 15(4):55-62
Subject
Language
Chinese
ISSN
1674-7399
Abstract
目的 寻找可以降低重度子痫前期剖宫产率的目标人群.方法 回顾性分析2017年1月1日至2019年12月31日在嘉定妇幼保健院剖宫产分娩的25386例产妇的信息,将其按照改良版Robson分类法进行分类.并按照2020年我国妊娠期高血压疾病诊治指南将患有妊娠期高血压疾病者分为重度子痫前期组(severe pre-eclampsia,sPE)、子痫前期(pre-eclampsia,PE)和妊娠期高血压组(gestational hypertension,GH),未发生妊娠期高血压疾病者为非高血压组(Non-hypertension,Non-Hyp),比较各组产妇改良版Robson分类中的剖宫产率、人群构成比及剖宫产权重情况.结果 4组改良版Robson分类系统中剖宫产率、人群构成比、及剖宫产权重比较均显著性统计学意义(P＜0.01).其sPE组剖宫产率最高70.18％,明显高于PE组、GH组及Non-Hyp组,其三组剖宫产率分别为47.38％,55.01％,36.90％.以改良版Robson分类系统中的相关因素预测剖宫产的曲线下面积为0.806(95％CI:0.801～0.812);虽然sPE者的分娩方式不同,但在胎盘早剥、产后出血、新生儿窒息及死产方面没有统计学意义(P＞0.05).结论 重度子痫前期组中的单胎头位足月的初产妇、经产妇,以及早产产妇是我们需要重点关注的人群.建议病情稳定且血压控制良好者的重度子痫前期患者,可通过促宫颈成熟提高阴道分娩率,不仅可降低sPE者的剖宫产率,且不增加母儿并发症.
Objective To find the target population that can reduce the rate of cesarean section in severe preeclampsia(sPE).Methods The information of 25386 parturients who delivered by cesarean section in Jiading Maternal and Child Health Hospital from January 1,2017 to December 31,2019 were retrospectively analyzed and classified according to the improved Robson classification.The patients with hypertensive disorder complicating[1]were divided into sPE group,pre-eclampsia(PE)group and gestational hypertension(GH)group,and those without hypertensive disorder complicating were Non-hypertension(Non-Hyp)group.The cesarean section rate,population constituent ratio and cesarean weight of each group Modified Robson classification were compared.Results There were significant differences in cesarean section rate,population constituent ratio and cesarean weight among the four groups(P＜0.01).The highest rate of cesarean section in sPE group was 70.18％,which was significantly higher than that in PE group(47.38％),GH group(55.01％)and Non-Hyp group(36.90％).In addition,the area under the curve of cesarean section predicted by the relevant factors in the modified Robson classification was 0.806(95％CI:0.801～0.812);Although the delivery mode of sPE was different,there was no significant difference in placental abruption,postpartum hemorrhage,neonatal asphyxia and stillbirth(P＞0.05).Conclusion we should pay more attention to the singleton head position parturients in the sPE group,whether they are full-term or not.It is suggested that sPE with stable condition and well controlled blood pressure can increase the vaginal delivery rate by promoting cervical maturation,which can not only reduce the rate of cesarean section of sPE,but also do not increase maternal and fetal complications.
Objective To find the target population that can reduce the rate of cesarean section in severe preeclampsia(sPE).Methods The information of 25386 parturients who delivered by cesarean section in Jiading Maternal and Child Health Hospital from January 1,2017 to December 31,2019 were retrospectively analyzed and classified according to the improved Robson classification.The patients with hypertensive disorder complicating[1]were divided into sPE group,pre-eclampsia(PE)group and gestational hypertension(GH)group,and those without hypertensive disorder complicating were Non-hypertension(Non-Hyp)group.The cesarean section rate,population constituent ratio and cesarean weight of each group Modified Robson classification were compared.Results There were significant differences in cesarean section rate,population constituent ratio and cesarean weight among the four groups(P＜0.01).The highest rate of cesarean section in sPE group was 70.18％,which was significantly higher than that in PE group(47.38％),GH group(55.01％)and Non-Hyp group(36.90％).In addition,the area under the curve of cesarean section predicted by the relevant factors in the modified Robson classification was 0.806(95％CI:0.801～0.812);Although the delivery mode of sPE was different,there was no significant difference in placental abruption,postpartum hemorrhage,neonatal asphyxia and stillbirth(P＞0.05).Conclusion we should pay more attention to the singleton head position parturients in the sPE group,whether they are full-term or not.It is suggested that sPE with stable condition and well controlled blood pressure can increase the vaginal delivery rate by promoting cervical maturation,which can not only reduce the rate of cesarean section of sPE,but also do not increase maternal and fetal complications.