Shime J, Gare D J, Andrews J, Bertrand M, Salgado J, Whillans G
Am J Obstet Gynecol. 1984 Mar 1;148(5):547-52. doi: 10.1016/0002-9378(84)90745-2.
The perinatal events in 184 term control pregnancies and 129 prolonged pregnancies were prospectively compared. Fetal surveillance consisted of weekly biophysical profile testing. Thirty-two infants were dysmature, and 10 of these had advanced dysmaturity. The incidence of advanced dysmaturity rose quickly after 44 weeks. This group was at greater risk for fetal distress, lower Apgar scores, and emergency cesarean section. The combination of oligohydramnios, a suboptimal nonstress test, and a low profile score was highly predictive of a neonate with advanced dysmaturity. In the control pregnancies, the rate of induction of labor was 13.81% compared with 39.84% in the prolonged pregnancies. The induced labor group had a 51.32% cesarean section rate. Our approach to prolonged pregnancy consists of elective induction of labor when the cervix is favorable and biweekly profile testing when it is not; however, the high incidence of advanced dysmaturity after 44 weeks warrants delivery.
对184例足月对照妊娠和129例过期妊娠的围产期事件进行了前瞻性比较。胎儿监测包括每周进行一次生物物理评分检测。32例胎儿发育不成熟，其中10例为严重发育不成熟。严重发育不成熟的发生率在44周后迅速上升。该组胎儿窘迫、阿氏评分较低及急诊剖宫产的风险更高。羊水过少、无应激试验结果不理想及生物物理评分较低三者结合，对严重发育不成熟的新生儿具有高度预测性。在对照妊娠中，引产率为13.81%，而在过期妊娠中为39.84%。引产组的剖宫产率为51.32%。我们对过期妊娠的处理方法是，宫颈条件适宜时择期引产，不适宜时每两周进行一次生物物理评分检测；然而，44周后严重发育不成熟的高发生率表明需要进行分娩。
