经腹羊膜腔灌注术后胎儿的妊娠结局及相关影响因素分析  

Perinatal outcome of pregnancies presenting with oligo-and anhydramnion after amnioinfusion

作　　者：赵媛[1] 韩娟 牛翠茹 马小花 韩鑫[1] 李惠琴 孙庆梅[1] ZHAO Yuan;HAN Juan;NIU Cuiru;MA Xiaohua;HAN Xin;LI Huiqin;SUN Qingmei(Prenatal Diagnosis Center,Gansu Provincial Maternity and Child-care Hospital,Lanzhou,Gansu 730050,China)

机构地区：[1]甘肃省妇幼保健院产前诊断中心,甘肃兰州730050

出　　处：《中国优生与遗传杂志》2021年第6期852-855,共4页Chinese Journal of Birth Health & Heredity

基　　金：甘肃省重点实验室(18JR2JA018);甘肃省自然基金(18JR3RA013);兰州市科技发展指导性科技项目(2019-ZD-129)。

摘　　要：目的探讨经腹羊膜腔羊水灌注术治疗的胎儿的预后及相关的影响因素分析。方法选取甘肃省妇幼保健院2013年1月—2019年1月间诊断为羊水过少的101例病例进行回顾性研究,分析羊膜腔灌注术治疗妊娠中、晚期羊水过少对妊娠结局的影响。探讨羊膜腔灌注术后胎儿的健康存活率及相关的影响因素。结果在可随访的72例接受羊水灌注术的病例中,手术平均孕周24(22~34)周,术前羊水AFV平均约12(0~20)mm,术后羊水AFV平均约39(35~50)mm。羊膜腔灌注术胎儿的总体健康存活率为58.3%。研究发现,在接受1次羊水灌注术后羊水恢复正常且染色体及结构未见明显异常的胎儿,其术后胎儿健康存活率达90%。多次灌注不能明确改善胎儿的总体预后。28周前拒绝和接受羊水灌注的胎儿健康存活率分别为0和50.0%,而28周后拒绝和接受羊水灌注的胎儿出生后健康存活率分别为81.2%和70.0%。结论经腹羊膜腔灌注术能提高胎儿结构畸形诊断率,降低围生儿死亡率,改善妊娠结局,具有一定的临床应用价值。Objective To investigate the prenatal and postnatal outcome of pregnancies presented with oligo-and anhydramnion after amnioinfusion.Methods Amnioinfusion were conducted in 72 pregnancies with oligo-or anhydramnion from 2013.1 to 2019.1.The details of all the cases were collected and analyzed.Factors which could affect the pre-and postnatal outcome of fetuses were investigated.Results In 72 cases,amnioinfusion was done at median age of 24(22-34)weeks.The amniotic fluid verticel pocket(AFV)increased from 12(0-20)mm to 39(35-50)mm after amnioinfusion.The overall survival rate of amnioinfusion is 58.3%.In our study,it showed that the survival rate increased to 90%when the amniotic fluid recovered by one time amnioinfusion and there is no structural abnormality detected.Multiple amnioinfusion could not improve the outcome of pregnancies remarkably.Compared to those pregnancies who refused amnioinfusion before 28 weeks,the survival rate increased to 50%when the pregnant women accepted amnioinfusion.There is no difference of survival rate between cases performed by the procedure and not(70%vs 81.2%).Conclusions Amnioinfusion could improve the prenatal and postnatal outcome of pregnancies presenting with severe oligo-and anhydramnios.

关 键 词：经腹羊膜腔灌注术 羊水过少 妊娠结局 

分 类 号：R714.5[医药卫生—妇产科学]