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| The effect of opportunity of pregnancy termination and delivery mode on maternal and infant outcomes of pregnant women with expired pregnancy |
| 3201 Hospital of China Aviation Industry, Han zhong, Shanxi Province, 723000 |
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Abstract Objective:To explore the effect of delivery mode and opportunity of pregnancy termination on maternal and infant outcomes of pregnant women with expired pregnancy. Methods: The data of 1425 pregnant women from March 2014 to January 2018 in 3201 hospital of China aviation industry were collected and analyzed retrospectively. According to the gestational weeks, 1094 pregnant women were included into normal pregnancy group (37-40+6 gestational weeks), 239 pregnant women were included into excess time of pregnancy group (41+6 gestational weeks), and 92 pregnant women were included into overdue pregnancy group (42-45 gestational weeks). Mode of pregnancy termination, maternal complications, and neonatal outcomes were compared among the three groups. Results: There were significant different in rates of vaginal delivery, cesarean section and postpartum hemorrhage among the three groups (P<0.05). The rate of postpartum hemorrhage and cesarean section of women in overdue pregnancy group was the highest among the three groups, and those of women in excess time of pregnancy group were significant higher than those of women in normal pregnancy group. The rates of fetal distress, macrosomia, neonatal asphyxia, neonate transfer to NICU, and neonatal mortality had significant different among the three groups (P<0.05), and the rates of fetal distress, macrosomia, neonatal asphyxia, neonate transfer to NICU, and neonatal mortality were the highest in overdue pregnancy group, but were the lowest in normal pregnancy group. The levels of AFII and E3 of women in overdue pregnancy group were significant lower than those of women in excess time pregnancy group or normal pregnancy group (P<0.05). The rate of Ⅲ category fetal heart rate monitoring (before trial delivery) of women in overdue pregnancy group was significant higher than that of women in excess time pregnancy group or normal pregnancy group (P< 0.05). In 92 women with overdue pregnancy, , the rate of neonatal asphyxia of women experienced cesarean section directly was significant lower than that of women experienced vaginal delivery or trial delivery (P<0.05), and the Apgar score of newborns of women experienced cesarean section directly was significant higher than that of women experienced vaginal delivery or trial delivery (P<0.05). Conclusion: the overdue pregnancy is harmful to the parturient and perinatal infants, which leads to complications and adverse outcomes. The gestational weeks, placental function, amniotic fluid index, and changes of signs of pregnant women should be considered comprehensively, and guideline of highrisk pregnancy should be referred to. It is suggested that pregnant women with overdue pregnancy should be terminated by direct cesarean section to ensure the safety of mother and child.
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