Fliegner J R
Department of Obstetrics and Gynaecology, University of Melbourne.
Aust N Z J Obstet Gynaecol. 1987 Aug;27(3):205-9. doi: 10.1111/j.1479-828x.1987.tb00987.x.
In Victoria in the triennium 1982-1984, perinatal losses between 22 and 28 weeks' gestation accounted for 32% of the overall perinatal wastage of 12.7 per 1,000 births. Over the same period only 1.2% of babies were delivered weighing less than 1,500g, but this group made up 40% of the total stillbirths and 50% of the neonatal deaths. By contrast the perinatal wastage was only 7 per 1,000 births in babies born weighing more than 1,500g and this included lethal congenital malformations. The major antenatal risk factors contributing to the high mid-trimester fetal wastage were premature labour (17.7%), multiple pregnancy (13.9%), cervical incompetence (12.9%), antepartum haemorrhage (12.9%), premature rupture of the membranes (11.5%), lethal congenital malformations (10.6%) and hypertensive disorders (7.4%). Cognizant of the frequency of preventable factors, the Consultative Council on Maternal and Perinatal Mortality and Morbidity in Victoria recommends that, where feasible, the mother of these high-risk pregnancies be transferred to a centre where facilities are available to monitor the pregnancy and labour, and which offers intensive care facilities for the baby.
在1982 - 1984三年期的维多利亚州,妊娠22至28周的围产期损失占每1000例出生中12.7例的总体围产期损耗的32%。在同一时期,只有1.2%的婴儿出生时体重低于1500克,但这一组占死产总数的40%,新生儿死亡的50%。相比之下,出生体重超过1500克的婴儿围产期损耗仅为每1000例出生7例,这其中包括致命的先天性畸形。导致孕中期胎儿高损耗的主要产前风险因素包括早产(17.7%)、多胎妊娠(13.9%)、宫颈机能不全(12.9%)、产前出血(12.9%)、胎膜早破(11.5%)、致命的先天性畸形(10.6%)和高血压疾病(7.4%)。鉴于可预防因素的发生率,维多利亚州孕产妇和围产期死亡率及发病率咨询委员会建议,在可行的情况下,将这些高危妊娠的母亲转到有设施监测妊娠和分娩,并为婴儿提供重症监护设施的中心。