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分娩豫定日超過 POSTDATE PREGNANCY

대한산부인과학회지 1971년 14권 6호 p.39 ~ 48
신면우,
소속 상세정보
신면우 (  ) 
서울대학교 의과대학 산부인과학교실

Abstract


A total of 3,559 births which occurred after 30weeks of gestation at The Seoul National University Hospital during the period from January 1, 1967 to December 31, 1970 were reviewed. The duration of prtegnancy was calculated by Nagele´s rule with ? correction for cycles greater-or, less- than 28 days. A pregnancy lasting 42 weeks or more from the first day of the last ,menstrual period was considered postdate, this arbitrary period being the* one most commonly described in the literature . Patients whose menstrual cycles were grossly irregular were not included in this study. The purpose of this study were: (1) to asses the importance of certain conditions suggested as being significant in the etiology of prolonged pregnancy; (2) to determine the effect of prolonged gestation upon the fetus; and (3). to delineate a plan for the management of patients in whom pregnancy is prolonged past the expected, date of confinement. Of these 3,559 births, 563 were postdate pregnancy. The following factors were analyzed: distribution of over-all births in relation to, length of gestation, age, parity, birth weight, fetal distress, perinatal. death,duration of labor, and method of delivery. The findings in paints in whom pregnancy prolonged were compared with over-all clinic experience for the same period.
The results obtained in this study were as following.
1. A series of 563 postdate pregnancies is presented. The incidence of prolonged pregnancy was 15. 6 per cent, with the highest incidence occurring in the 25 to 29 year age group.
2. Of these 563 births, 51.2 per cent were to multiparas and 48.8 per cent were to primiparas.
3. The incidence of heavier babies in. postdate deliveries was apparent and has been. noted also by other investigators.
4. Fetal distress. ocurred more commonly in the postdate group (9.6 per cent) than in the control group (5.7 per cent), especially in primiparous patients (11. 4%). A trend toward a greater incidence of fetal distress as the postdate period lengthens was noted.
5. Perinatal mortality rate in the postdate group was -55.1 per thousand as compared to a 64.9 per thousand perinatal mortality in over-all deliveries. A trend toward a greater rate of fetal mortality as the baby weight increases and the postdate period lengthens was noted, especially in primiparous patient.
6. A trend toward a prolonged labor was noted in primiparous paients with postdate pregnancy.
7. A significantly increased incidence of operative delivery was noted. In particular,the primiparous patient with postdate pregnancy frequently came to operative delivery. The cesarean section rate was increased in the postdate group compared to the control group.

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