探讨胎死宫内(intrauterine fetal death, IUFD)的母体因素及治疗方法。

选择2004年3月至2010年3月本院收治的40例胎死宫内患者为研究对象，年龄为20~38岁，平均为30岁；初产妇为32例(80.0%)，经产妇为8例(20.0%)；孕龄为22~39孕周，平均为34孕周(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准和受试对象本人的知情同意，并与之签署临床研究知情同意书)。采用回顾性分析法分析胎死宫内的母体相关因素及诊治方法。

合并产科并发症患者占胎死宫内比例最大，包括妊娠期高血压疾病12例(30.0%)，前置胎盘9例(22.5%)和胎盘早剥7例(17.5%)。脐带因素所占比例次之。治疗措施应根据患者病情、产道条件和胎儿死亡时间综合制定，同时积极防治胎死宫内并发弥散性血管内凝血(disseminated intravascular coagulation，DIC)。

胎儿缺氧缺血死亡是胎死宫内的主要病因。早期诊断、适时终止妊娠、正确治疗胎死宫内所致并发症至关重要。

To study the maternal factors and treatment of intrauterine fetal death (IUFD).

From March 2004 to March 2010, a total of 40 cases with intrauterine fetal death were recruited into this study. They were at the age of 20~38 with the average age of 30. Among them, primipara were 32 cases (80.0%) and multipara were 8 cases (20.0%). The gestational age was 22~39 weeks with the average gestational week of 34. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Second People's Hospital of Yunnan Province. Informed consent was obtained from all participants. Maternal factors and treatment of intrauterine fetal death were analyzed retrospectively.

The main cause of intruterine fetal death was obstetric complications, including hypertensive disorder complicating pregnancy (12/40, 30.0%), placenta previa (9/40, 22.5%), and placental abruption (7/22, 17.5%). Cord factors were the second main cause. Meanwhile, positive prevention the complication of disseminated intravascular coagulation (DIC).

Fetal hypoxic-ischemic death plays the most important role in intrauterine fetal death. The key to deal with intrauterine fetal death lies in diagnosing as early as possible, stopping pregnancy in time and treating complication being induced by fetal deaths.