Clinical observation on fetal weight estimation on delivery mode and perinatal outcome of primipara with macrosomia
Objective To observe the influence of fetal weight estimation on delivery mode and perinatal outcome of primipara with macrosomia.Methods A total of 206 full-term singleton primiparas delivered in Haidian Maternal and Child Health Hospital from January 2022 to December 2023 were selected,and were divided into group A(estimated fetal weight<4 000 g,118 cases)and group B(estimated fetal weight≥4 000 g,88 cases)according to the estimated fetal weight.The delivery mode and delivery outcome of the two groups were compared.Results Among the 206 primiparas,the age ranged from 21 to 39 years,with an average age of(30.6±3.4)years.Compared with group B,the proportion of vaginal delivery in group A was higher(61.9%vs.40.9%),and the proportion of cesarean section was lower(32.2%vs.56.8%),the differences of delivery modes between the two groups were statistically significant(P<0.05).The trial production rate of group A was significantly higher than that of group B(90.7%vs.59.1%),and the difference was statistically significant(P<0.05).The postpartum hemorrhage volume(volumetric method)and corrected postpartum hemorrhage volume in group A were higher than those in group B[350(300,500)ml vs.300(300,380)ml,440(230,720)ml vs.360(160,560)ml],and the differences were statistically significant(P<0.05).There were no significant differences in the proportion of fetal distress,shoulder dystocia and neonatal asphyxia between the two groups(all P>0.05).Conclusions For primiparous with macrosomia,underestimated the fetal weight can increase the trial delivery rate and vaginal delivery rate,and also increase the postpartum hemorrhage,but does not increase the delivery complications such as fetal distress,shoulder dystocia,neonatal asphyxia.It is suggested that pregnant women whose estimated fetal weight is less than 4 500 g and willing to give birth through vagina should increase the opportunity of trial delivery with full notification.
macrosomiafetal weight estimationvaginal deliverycesarean sectionmaternal and infant outcomeperinatal period
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