In222Cases Of Fetal Macrosomia Related Factors And Outcome Of Pregnancy Analysis

Objective:To investigate the relationship of related factors and outcome of pregnancyin fetal macrosomia.Methods:①The clinical data of222cases of fetal macrosomia related factors and pregnancyoutcome were analyzed retrospectively, and1686randomly selected patientshospitalization who delivered mature and normal weight fetus as control group.②Immunohistochemistry was used to measure Vascular Endothelial Growth Factorand soluble vascular endothelial growth factor receptor-1levels in placenta fromrandomly selected40normal pregnant women(group AGA) in control group andrandomly selected30women (group LGA) in fetal macrosomia group.Results:①For the group of neonatal macrosomia, biparietal diameter, femur length are higherthan that of the control group, the difference was statistically significant (P <0.05).②F or the group of neonatal macrosomia, the maternal age、gestational weeks、motherhood times、the end stage of weight, gestational diabetes, are higher than that ofthe control group, the difference was statistically significant (P <0.05).③For the group of macrosomia, cesarean section rate, persistent occipitotransverseposition or occiput posterior position, cephalopelvic disproportion, the prolongation ofthe incubation period, active period of stagnation, shoulder dystocia, uterine atony,perineal laceration, premature rupture of membranes, fetal distress in uterus, postpartumhemorrhage, neonatal asphyxia rate are higher than the control group, the difference wasstatistically significant (P <0.05).④The group of neonatal macrosomia primipara cesarean section rate is higher than the the group of multipara, the difference was statistically significant (P <0.05).⑤For the LGA group in the placental tissue, the VEGF expression is higher than that ofAGA group, the expression level of sFlt-1is lower than AGA group, the difference werestatistical significant (x2=21.17, P <0.01). The expression level of VEGF in placentaltissues and fetal birth weight were positively correlated (r=0.427, P <0.01), theexpression level of sFlt-1m in placental tissues and fetal birth weight were negativelycorrelated (r=-0.569, P <0.01).Conclusion:①The occurrence of macrosomia is not only related to mother’s age、gestational weeks、Motherhood times、the end stage of pregnancy weight, but also related to gestationaldiabetes.②The changing of expression level of VEGF and sFlt-1changes in placenta tissue maybe associated with fetal birth weight. The expression level of VEGF in placental tissuesand fetal birth weight were positively correlated, the expression level of sFlt-1m inplacental tissues and fetal birth weight were negatively correlated.③The fetal macrosomia, cesarean section rate, persistent occipitotransverse position orocciput posterior position, cephalopelvic disproportion, the prolongation of theincubation period, active period of stagnation, shoulder dystocia, uterine atony, perineallaceration, premature rupture of membranes, fetal distress in uterus, postpartumhemorrhage, neonatal asphyxia rate are higher than the normal birth weight infants. Theneonatal macrosomia primipara cesarean section rate is higher than the multipara.④The mode of fetal macrosomia delivery should be evaluated by the fetal bodyweight,gestational age and maternal pregnancy and other comprehensive factors.Weshould conduct regular prenatal examination to pregnant women, guide rational diet andexercise, select the appropriate mode of delivery, delivery time, correct processing ofthe delivery process, conduct treatment for intrapartum abnormal condition of vaginaldelivery in due course, appropriate to relax cesarean operation indications, try to avoiddifficult vaginal delivery,reduce the complications of mothers and infants and effectivemeasures.