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当继续妊娠伴随的母胎风险高于终止妊娠所带来的母婴风险时,就具有终止妊娠的指征,即分娩时机正合适。当母胎出现合并症和并发症时,大多数未能自然临产,临床中需要引产,因此,在决定引产前,确定最佳的分娩时机不仅是关乎围产结局的关键因素,也是产科精准医疗的临床再现。分娩时机不是一成不变的,也不是机械刻板的,遵循母婴安全为第一要务的宗旨,采取个体化医疗的原则,最适宜的才是最好的。文章从胎儿因素(胎儿生长受限、双胎妊娠)、母体及产科因素(妊娠期高血压疾病、妊娠合并糖尿病、胎膜早破、曾有不明原因的死胎或死产)、胎盘及子宫因素(前置胎盘、胎盘植入、瘢痕子宫、子宫破裂)三方面总结伴有母胎合并症及并发症妊娠的分娩时机。
When the risk of maternal birth with subsequent pregnancy is higher than the risk of maternal death from termination of pregnancy, there is an indication of termination of pregnancy, ie the timing of childbirth is appropriate. When maternal morbidity and complications occur, most of them fail to spontaneous birth and require induction of labor in clinical practice. Therefore, determining the optimal timing of maternity is not only a critical factor in the outcome of perinatal labor but also a prerequisite for obstetric care Clinical Reproduction. The timing of childbirth is not immutable, nor is it mechanical rigid, follow the principle of maternal and child safety as the most important task, the principle of individualized medical treatment, the most appropriate is the best. Articles from the fetal factors (fetal growth restriction, twin pregnancy), maternal and obstetric factors (gestational hypertension, pregnancy complicated with diabetes, premature rupture of membranes, unexplained stillbirth or stillbirth), placenta and uterine factors (Placenta previa, placenta accreta, scar uterus, uterine rupture) were summarized in three aspects with maternal complications and complications of pregnancy timing of childbirth.