羊水过少和羊水偏少对分娩方式及妊娠结局的影响  

Effects of oligohydramnios and oligohydramnios on delivery mode and pregnancy outcome

作　　者：金继华 吴燕婷 艾玲[1] 孙丹丹[1] 吴寒冰[1] JIN Jihua;WU Yanting;AI lin;SUN Dandan;WU Hanbing

机构地区：[1]嘉兴市妇幼保健院,浙江嘉兴314000

出　　处：《浙江实用医学》2021年第5期387-389,共3页Zhejiang Practical Medicine

摘　　要：目的探讨孕足月发生的单纯性羊水过少和羊水偏少对妊娠结局及分娩方式的影响。方法选择2019年6月-2021年3月浙江省嘉兴市妇幼保健院收治的孕足月单纯性羊水过少[羊水指数(AFI)≤5cm]和羊水偏少(AFI 5-8cm)的孕妇共641例,其中羊水过少组282例,羊水偏少组359例;另选取同时期AFI正常的孕妇373例作为对照组。比较三组孕妇的分娩方式及妊娠结局。结果(1)分娩方式。与羊水偏少组比较,羊水过少组顺产率较低,阴道助产和剖宫产率较高,差异均有统计学意义(P<0.05);与对照组比较,羊水偏少组顺产率较低,剖宫产率较高(P<0.05);羊水过少组与羊水偏少组阴道助产率均较对照组高(P<0.05),但两组之间差异无统计学意义(P>0.05)。(2)妊娠结局。与羊水过少组比较,羊水偏少组羊水重度污染率低、FHRD低、新生儿体质量大、胎儿生长受限发生率低,差异均有统计学意义(P<0.05);两组在1分钟Apgar评分<8分、胎儿宫内窘迫、新生儿重症监护发生率差异均无统计学意义(P>0.05)。结论无论是单纯性羊水过少还是羊水偏少的孕妇,如产程进展顺利,短时间阴道试产安全可行;如出现胎儿宫内窘迫等征象,应尽早行剖宫产终止妊娠。Objective To investigate the effects of simple oligohydramnios and oligohydramnios on pregnancy outcome and delivery mode.Methods A total of 641 pregnant women with pure oligohydramnios(AFI≤5cm)and oligohydramnios(AFI 5-8cm)were treated in Jiaxing maternal and Child Health Hospital of Zhejiang Province from June 2019 to March 2021,including 282 cases in oligohydramnios group and 359 Cases in oligohydramnios group;Another 373 pregnant women with normal amniotic fluid index in the same period were selected as the control group.The delivery methods and pregnancy outcomes of the three groups were compared.Results(1)Mode of delivery.Compared with oligohydramnios group,oligohydramnios group had lower spontaneous labor rate and higher rates of vaginal midwifery and cesarean section(P<0.05);Compared with the control group,the spontaneous labor rate and cesarean section rate of oligohydramnios group were lower and higher(P<0.05);The rate of vaginal midwifery in oligohydramnios group and oligohydramnios group was higher than that in the control group(P<0.05),but there was no significant difference between the two groups(P>0.05).(2)Pregnancy outcome.Compared with oligohydramnios group,oligohydramnios group had lower severe amniotic fluid pollution rate,lower fhrd,higher neonatal body mass and lower incidence of fetal growth restriction(P<0.05);There was no significant difference between the two groups in the incidence of apgar1 minute score<8,the incidence of fetal functional distress and the incidence of fetal intensive care(P>0.05).Conclusion Whether it is simple oligohydramnios or oligohydramnios,if the labor process goes smoothly,the short-term vaginal trial is safe and feasible;If there are signs of fetal distress etc,cesarean section should be performed as early as possible to terminate pregnancy.

关 键 词：足月妊娠 羊水过少 羊水偏少 分娩方式 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]