经腹羊膜腔内灌注术扩充羊水后母儿围产结局观察  

The perinatal outcome of mothers and fetuses with transabdominal amnioinfusion

作　　者：张秀兰[1] 谢文娟[1] 周夫群[1] 金社红[1] 赵黎敏[1] 王菊仙[1] 喻秀美[1] 

机构地区：[1]绍兴市妇幼保健院,312000

出　　处：《浙江医学》2003年第7期405-406,414,共3页Zhejiang Medical Journal

摘　　要：目的 观察经腹羊膜腔内灌注扩充羊水的安全性、有效性、可行性。 方法 选择经B超检查提示羊水过少或偏少、有阴道分娩适应证 ,要求阴道分娩并愿意接受经腹羊膜腔内灌注的头位妊娠孕妇 ,腹部B超穿刺探头定位 ,经穿刺孔1次注入预热至37℃左右的灭菌生理盐水200～380ml。结果 33例中穿刺灌注成功32例(96.97% ) ;发生胎膜早破1例 (3.03 % ) ,无胎盘早剥、羊水栓塞、穿刺感染等其它并发症发生 ;阴道分娩25例(75.76% ) ;在纠正头盆不称、脐带脱垂、胎儿宫内窘迫后作剖宫产8例 (24.24% );无一例新生儿发生重度或轻度窒息。结论 经腹羊膜腔内灌注可有效扩充羊水 ,为羊水过少的晚期妊娠孕妇创造阴道分娩的条件。能有效降低剖宫产率 ,进一步提高围产质量。Objective To study the safety,efficiency and feasibility of enlarging amniotic fluid volume by transabdominal amnioinfusion(AI).Methods Thirty three parturients were included in the study,who had oligoamnios or borderline oligoamnios detected by B ultrasound examination,and had indication of vaginal deˉlivery with cephalic presentation.During the procedure200～380ml saline solution at37℃were infused into the amniotic cavity.Results AI was accomplished in32of33cases(96.97%).Premature rupture of membrane occurred in one case(3.03%).No placental abruption and infection or other complications happened.Twenty-five patients(75.76%)succeeded in vaginal delivery.Eight cases(24.24%)had the indication of cesarean sections,but after correction of cephalopelvic disproportion,prolapse of umbilical cord and fetal distress,the rate of cesarean section decreased to3.03%.No neonatal asphyxia occured.Conclusion Amnioinfusion can effecˉtively enlarge amniotic fluid volume,create favorable conditions of vaginal delivery for oligoamnios and decrease the incidence of cesarean section as well as improve perinatal outcome.

关 键 词：经腹羊膜腔内灌注术 母儿围产结局 观察 阴道分娩 羊水扩充 羊水过少 

分 类 号：R714.7[医药卫生—妇产科学]