美国妇产科医师学会“晚期足月和过期妊娠指南2014版”要点解读

doi:10.7504/fk2015010121

摘要/Abstract

摘要：

过期妊娠（postterm pregnancy）指孕周达到或超过42 周（从末次月经算起）仍未分娩，晚期足月妊娠（late-term pregnancy）指孕周达41+0周至41+6周。世界各地报道的发生率不同，部分原因在于不同地区对超过预产期后的处理方式有所不同。准确判定孕周对于过期妊娠的诊断和处理至关重要。由于晚期足月妊娠和过期妊娠所致的围生儿病率与死亡率升高，需要加强胎儿状况的监测和及时的引产。为此，美国妇产科医师学会（ACOG）在循证医学研究的基础上，颁布了该指南，期望对晚期足月和过期妊娠的规范处理有指导价值。

关键词: 过期妊娠, 晚期足月妊娠

Key words: postterm pregnancy, late-term pregnancy

中图分类号:

Ｒ714.21

柯亚亚，白宇翔，漆洪波. 美国妇产科医师学会“晚期足月和过期妊娠指南2014版”要点解读[J]. 中国实用妇科与产科杂志, DOI: 10.7504/fk2015010121.

参考文献

［1］   Spong CY. Defining “term” pregnancy: recommendations from the Defining “Term” Pregnancy Workgroup［J］. JAMA，2013，309:2445-2446.

［2］   Campbell MK,Ostbye T,Irgens LM.Post-term birth:risk factors and outcomes in a 10-year cohort of Norwegian births[J].Obstet Gynecol,1997,89:543-548.

［3］   Stotland NE, Washington AE, Caughey AB. Prepregnancybody mass index and the length of gestation at term［J］.Am J Obstet Gynecol，2007，197:378.e1-378.e5.

［4］   Clausson B, Cnattingius S, Axelsson O. Outcomes of post-term births: the role of fetal growth restriction and malformations［J］. Obstet Gynecol，1999，94:758-762.

［5］   Morris JM, Thompson K, Smithey J, et al. The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study［J］.BJOG，2003，110:989-994.

［6］   Balchin I, Whittaker JC, Lamont RF, et al. Maternal and fetal characteristics associated with meconiumstained amniotic fluid［J］. Obstet Gynecol，2011，117:828-835.

［7］   McLean FH, Boyd ME, Usher RH,et al. Postterm infants: too big or too small? ［J］.Am J Obstet Gynecol，1991，164:619-624.

［8］   Trimmer KJ, Leveno KJ, Peters MT,et al. Observation on the cause of oligohydramnios in prolonged pregnancy［J］.Am J Obstet Gynecol，1990，163:1900.

［9］   Caughey AB, Musci TJ. Complications of term pregnancies beyond 37 weeks of gestation［J］.Obstet Gynecol，2004，103:57-62.

［10］    Boyce A, Magaux MJ, Schwartz D. Classical and “true” gestational post maturity［J］.Am J Obstet Gynecol，1976，125:911.

［11］    Gardosi J. Dating of pregnancy: time to forget the last menstrual period［J］.Ultrasound Obstet Gynecol，1997，9:367-368.

［12］    Savitz DA, Terry JW Jr, Dole N, et al. Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination［J］. Am J Obstet Gynecol，2002，187:1660-1666.

［13］    Caughey AB, Nicholson JM, Washington AE. First- vs second-trimester ultrasound: the effect on pregnancy dating and perinatal outcomes［J］.Am J Obstet Gynecol，2008，198:703.e1-703.e5; discussion 703.e5-703.e6.

［14］   Boulvain M, Irion O, Marcoux S, et al. Sweeping of the membranes to prevent post-term pregnancy and to induce labour: a systematic review［J］.Br J Obstet Gynaecol，1999，106:481

［15］    Hill MJ, McWilliams GC, Garcia-Sur, et al. The effect of membrane sweeping on prelabor rupture of membranes: a randomized controlled trial［J］. Obstet Gynecol，2008，111(6):1313.

［16］   Boulvain M, Stan CM, Irion O. Membrane sweeping for induction of labour［J］. Cochrane Database of Systematic Reviews,2005, Issue 1. Art. No.: CD000451. DOI: 10.1002/ 14651858.CD000451.pub2.

［17］    Nabhan AF, Abdelmoula YA. Amniotic fluid index versus single deepest vertical pocket as a screening test for preventing adverse pregnancy outcome［J］. Cochrane Database of Systematic Reviews,2008, Issue 3. Art. No.: CD006593. DOI: 10.1002/14651858.CD006593.pub2.

［18］    Alfirevic Z, Walkinshaw SA. A randomised controlled trial of simple compared with complex antenatal fetal monitoring after 42 weeks of gestation［J］.Br J Obstet Gynaecol，1995，102:638-643.

［19］    Lalor JG, Fawole B, Alfirevic Z, et al.Biophysical profile for fetal assessment in high risk pregnancies[J]. Cochrane Database of Systematic Reviews,2008,Issue 1. Art. No.: CD000038. DOI: 10.1002/14651858.CD000038. pub2.

［20］   Manning FA, Harman CR, Morrison I, et al. Fetal assessment based on fetal biophysical profile scoring. IV. An analysis of perinatal morbidity and mortality［J］.Am J Obstet Gynecol，1990，162:703-709.

［21］    Chamberlain PF, Manning FA, Morrison I, et al. Ultrasound evaluation of amniotic fluid volume. I. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome［J］. Am J Obstet Gynecol，1984，150:245-249.

［22］    Hannah ME, Hannah WJ, Hellman J, et al. Induction of labor as compared with serial antenatal monitoring in post-term pregnancy［J］. N Engl J Med,1992,326:1587.

［23］    Alexander JM, McIntire DD, Leveno KJ.Prolonged pregnancy: induction of labor and cesarean births［J］. Obstet Gynecol，2001，97:911.

［24］    Coassolo KM, Stamilio DM, Pare E, et al. Safety and efficacy of vaginal birth after cesarean attempts at or beyond 40 weeks of gestation［J］. Obstet Gynecol，2005，106:700-706.

［25］    ACOG Practice bulletin no. 115: Vaginal birth after previous cesarean delivery［J］. Obstet Gynecol，2010,116(2 Pt 1):450-463.

（2015-01-08收稿）

[1]	王晶, 陈维, 王子莲. 早产的预测[J]. 中国实用妇科与产科杂志, 2021, 37(11): 1095-1101.
[2]	顾向应. 中期妊娠稽留流产规范化诊治的中国专家共识[J]. 中国实用妇科与产科杂志, 2021, 37(9): 928-932.
[3]	白诗雨，张建平. 黄体支持在复发性妊娠丢失中的作用[J]. 中国实用妇科与产科杂志, 2021, 37(4): 427-431.
[4]	赵爱民，李聪聪. 复发性流产的诊治现状与未来[J]. 中国实用妇科与产科杂志, 2020, 36(11): 1033-1035.
[5]	王晓秋，李大金. 反复胚胎植入失败和流产与子宫内膜免疫因素[J]. 中国实用妇科与产科杂志, 2020, 36(11): 1036-1040.
[6]	王海燕. 复发性流产与自身免疫性疾病[J]. 中国实用妇科与产科杂志, 2020, 36(11): 1040-1045.
[7]	邵雨菡，颜军昊. 染色体异常与自然流产[J]. 中国实用妇科与产科杂志, 2020, 36(11): 1045-1050.
[8]	李雪，张弘. 复发性流产患者子宫颈机能不全的诊断和治疗[J]. 中国实用妇科与产科杂志, 2020, 36(11): 1050-1054.
[9]	李凡，乔宠. 复发性流产患者易栓症的筛查[J]. 中国实用妇科与产科杂志, 2020, 36(11): 1054-1057.
[10]	胡立豪，张建平. 低分子肝素在复发性流产中的应用及监测[J]. 中国实用妇科与产科杂志, 2020, 36(11): 1057-1061.
[11]	鲍时华. 原因不明复发性流产的诊治[J]. 中国实用妇科与产科杂志, 2020, 36(11): 1061-1065.
[12]	吴胜男，金莉萍. 复发性流产的内分泌因素[J]. 中国实用妇科与产科杂志, 2020, 36(11): 1069-1073.
[13]	自然流产诊治中国专家共识编写组. 自然流产诊治中国专家共识（2020年版）[J]. 中国实用妇科与产科杂志, 2020, 36(11): 1082-1090.
[14]	中华医学会计划生育学分会. 早期妊娠稽留流产治疗专家共识[J]. 中国实用妇科与产科杂志, 2020, 36(1): 70-73.
[15]	孙笑，时春艳. 未足月胎膜早破抗生素使用[J]. 中国实用妇科与产科杂志, 2018, 34(2): 160-164.