Crump W J
School of Primary Medical Care, University of Alabama, Huntsville.
J Fam Pract. 1988 Jan;26(1):41-4.
The outcome of 116 postdate pregnancies managed by 14 family physicians in small community hospitals is compared with the outcome of term gestations in the same setting. The postdate pregnancies in this relatively unselected population showed an increase in incidence of macrosomia and fetal heart rate abnormalities similar to those reported from referral centers. The increases in incidence of meconium staining and low Apgar scores reported previously were not found. The postdate patients had more frequent induction, augmentation, and amniotomy, as well as a significant increase in primary cesarean section, decreased use of epidural anesthesia, and fewer assisted deliveries. These data suggest that the community physicians were attaining a favorable outcome in the postdate pregnancy by an active approach to induction and management of labor combined with abdominal delivery of the macrosomic infant showing evidence of fetal distress.
将14位家庭医生在小型社区医院管理的116例过期妊娠的结局与同一环境中足月妊娠的结局进行比较。在这个相对未经筛选的人群中，过期妊娠的巨大儿发生率和胎儿心率异常有所增加，与转诊中心报告的情况相似。未发现先前报道的胎粪污染发生率和低阿氏评分的增加。过期妊娠患者引产、加强宫缩和人工破膜更为频繁，同时剖宫产率显著增加，硬膜外麻醉的使用减少，助产分娩也较少。这些数据表明，社区医生通过积极引产和产程管理方法，结合对显示胎儿窘迫迹象的巨大儿进行剖宫产，在过期妊娠中取得了良好的结局。
