Reduction of perinatal morbidity and mortality is a priority task of medical obstetrics in the world. A significant role in the structure of perinatal mortality and morbidity has a clinically narrow pelvis. The incidence of clinically narrow pelvis in the world according to some authors is 1,4-8,5%, fetal-pelvic disproportion during labor of large fetus is 5,8-60 %. High rates of birth trauma (24-60%) as a result of fetal-pelvic disproportion determine the relevance of the study. The aim of the study was to define possibilities of diagnosis and prognosis fetal-pelvic disproportion at present stage.Materials. Literary data of foreign and domestic authors in the period from 1959 to 2016.Methods. Systematic review and synthesis of the literature data.Conclusion. It is necessary to determine an optimal algorithm for the diagnosis and prognosis fetal-pelvic disproportion, which will optimize the tactics of pregnancy and childbirth.
In spite of large number of studies on the issue of delivery pregnant with large fetus, avowed tactics of pregnancy and delivery does not exist. High rates of mother’s birth trauma and adverse perinatal outcomes during delivery large fetus are great medical and social problem.The aim of the study was to investigate the course of pregnancy and delivery, and perinatal outcomes during delivery large fetus.Materials: literary data of foreign and domestic authors in the period from 1991 to 2016.Methods: a systematic review and synthesis of the literature data.Conclusion: It is necessary to determine an optimum tactics of pregnancy and delivery large fetus that will reduce significantly perinatal morbidity and mortality.
1 ФГБОУ ВО «Читинская государственная медицинская академия» Минздрава РФ, Чита; 2 ФГБОУ ВО «Московский государственный медико-стоматологический университет имени А.И. Евдокимова» Минздрава РФ, Москва Поступила в редакцию: 12.09.2016 Принята к печати: 18.10.2016 ■ В настоящее время снижение перинатальной заболеваемости и смертности является приоритетной задачей родовспоможения во всем мире. Важную роль в структуре перинатальной патологии отводят родам крупным плодом. Высокие показатели асфиксии (9,2-34,2 %), родового травматизма (10,9-24 %) при родах крупным плодом имеют большое медицинское и, несомненно, социальное значение. Целью исследования явилось изучение возможностей диагностики макросомии плода на современном этапе развития науки. Материалы: литературные данные зарубежных и отечественных авторов за период с 1992 по 2016 год. Методы: систематический анализ и обобщение литературных данных. Заключение. Необходимо определить оптимальный алгоритм диагностики макросомии плода, который позволит оптимизировать тактику ведения беременности и родов. ■ Ключевые слова: крупный плод; макросомия; гиперсомия; пахисомия; крупный к сроку гестации.
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