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[妊娠24至32周分娩病例的母体、胎儿及新生儿临床特征]

[The maternal, fetal and neonatal clinical characteristics in cases delivered between 24 and 32 weeks' gestation].

作者信息

Ikenoue T

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1986 Aug;38(8):1198-208.

PMID:3746037
Abstract

The clinical characteristics of 346 infants delivered between 24 and 32 weeks' gestation in our perinatal medical center were reviewed retrospectively in order to investigate the fetal development and maturation process in human pregnancy. Sixty nine infants were stillborn. The remaining 277 live-born infants were admitted in the neonatal intensive care unit. The one hundred and ninety three surviving infants were discharged from the neonatal unit. The neonatal survival rate by gestational week at birth was characterized by an abrupt increase at 26 weeks of gestation and a stepwise increment thereafter. Fetal cardiovascular responses to acute stress such as hypoxemia became different at 26 weeks of gestation from those of more preterm young infants. The capability to respond to various respiratory intensive support became evident at 28 weeks of gestation. The neurological development stability seems to be obtained at 30 weeks' of gestation. The neurological developmental disorders were not directly related to the length of gestational age at birth in the range of 26 and 32 weeks. The intrauterine growth retardation became clinically evident from 28 weeks. Those infants whose growth was retarded in utero showed a remarkably adverse outcome both in mortality and mobility in this series.

摘要

为研究人类孕期胎儿的发育和成熟过程,我们对在围产期医学中心出生的346例孕24至32周婴儿的临床特征进行了回顾性分析。69例婴儿为死产。其余277例活产婴儿被收入新生儿重症监护病房。193例存活婴儿从新生儿病房出院。出生时按孕周计算的新生儿存活率在孕26周时突然上升,此后逐步增加。胎儿对急性应激如低氧血症的心血管反应在孕26周时与更小孕周的婴儿不同。对各种呼吸强化支持的反应能力在孕28周时明显显现。神经发育稳定性似乎在孕30周时获得。在26至32周范围内,神经发育障碍与出生时的孕周长度没有直接关系。宫内生长迟缓从孕28周起在临床上变得明显。在本系列中,那些在子宫内生长受限的婴儿在死亡率和活动能力方面都显示出明显不良的结局。

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