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目的分析160例妊娠晚期亚临床甲状腺功能减退症(SCH)孕妇的妊娠及胎儿结局,为临床防治SCH提供参考依据。方法选取2014年1月-2016年10月银川市妇幼保健院收治的160例预行分娩的SCH孕妇作为观察组,另选取同期来院预行分娩的120例妊娠晚期无SCH的正常孕妇作为对照组。观察并比较两组孕妇的妊娠结局及胎儿结局。结果两组孕妇的贫血、妊娠期高血压疾病、妊娠期糖尿病、胎膜早破、先兆流产发生率比较,差异均有统计学意义(均P<0.05);两组孕妇的前置胎盘、低蛋白血症、胎盘早剥、肝内胆汁淤积症、产后出血发生率比较,差异均无统计学意义(均P>0.05)。两组胎儿宫内窘迫、早产发生率比较,差异均有统计学意义(均P<0.05);两组出生体质量、胎龄、胎儿宫内生长受限、胎儿畸形、新生儿窒息、死胎发生率比较,差异均无统计学意义(均P>0.05)。妊娠晚期合并SCH是孕妇贫血、妊娠期高血压疾病、妊娠期糖尿病、胎膜早破、先兆流产、胎儿宫内窘迫、早产等不良妊娠结局的危险因素。结论妊娠晚期SCH是导致不良妊娠结局的危险因素,孕妇发生贫血、妊娠期高血压疾病、妊娠期糖尿病、胎膜早破及先兆流产的风险较高,易引起胎儿宫内窘迫与早产。妊娠晚期SCH孕妇需及早接受干预治疗,以改善妊娠结局。
Objective To analyze the pregnancy and fetal outcomes of 160 pregnant women with subclinical hypothyroidism (SCH) in the third trimester of pregnancy and provide a reference for clinical prevention and treatment of SCH. Methods From January 2014 to October 2016, 160 pregnant women with pre-delivery SCH were admitted to Yinchuan MCH. A total of 120 pregnant women with non-SCH in the same period were selected as the control group . Observe and compare the pregnancy outcomes and fetal outcomes of the two groups of pregnant women. Results There were significant differences in anemia, gestational hypertension, gestational diabetes mellitus, premature rupture of membranes and threatened abortion among the two groups (all P <0.05). The placenta previa There was no significant difference between the two groups (P> 0.05). There was no significant difference in the incidence of leucocytopenia, albuminosis, placental abruption, intrahepatic cholestasis and postpartum hemorrhage. There were significant differences in the incidence of fetal distress and preterm delivery between the two groups (all P <0.05). The birth weight, gestational age, fetal growth restriction, fetal malformation, neonatal asphyxia and stillbirth occurred in both groups The differences were not statistically significant (all P> 0.05). Pregnancy combined with SCH is anemia in pregnant women, gestational hypertension, gestational diabetes, premature rupture of membranes, threatened abortion, fetal distress, premature delivery and other adverse pregnancy outcomes risk factors. Conclusions SCH is a risk factor for adverse pregnancy outcome in late pregnancy. There is a high risk of anemia, gestational hypertension, gestational diabetes mellitus, premature rupture of membranes and threatened abortion in pregnant women, which may cause fetal distress and premature labor. SCH pregnant women in late pregnancy need early intervention to improve pregnancy outcomes.