羊水过少与围产儿预后关系的探讨.DOCVIP

临床医学论文-羊水过少与围产儿预后关系的探讨 【摘要】? 目的 探讨羊水过少与围产儿预后的关系。方法 收集我院2005年1月~2006年4月住院治疗的羊水过少孕妇136例，随机抽取同期我院分娩的羊水量正常孕妇136例作为对照组，两组病例就妊娠并发症、围产儿情况进行比较。结果 羊水过少组胎儿生长受限（FGR）、妊娠高血压综合征（简称妊高征，PIH）、过期妊娠、胎儿畸形的发生率均较对照组高，差异有显著统计学意义（P＜0.01），胎儿窘迫、羊水粪染、新生儿窒息、剖宫产率也明显升高（P＜0.01)。结论 羊水过少与妊娠并发症密切相关，严重威胁围产儿预后，剖宫产是重度羊水过少孕妇分娩方式的最佳选择。 【关键词】? 羊水过少；妊娠期并发症；围产儿预后；剖宫产 ??? ［Abstract］? Objective? To study the relationship between the oligohydramnios and the? prognosis of? neonates.Methods? The clinical date of 136 patients with oligohydramnios in our hospital from January 2005 to April 2006 were collected.136 patients with normal amniotic fluid volume were selected randomly as control group. The complications of pregnancy and adverse perinatal outcomes were analyzed.Results? Compared to control group，incidences of intrauterine growth retardation，pregnancy-induced hypertension syndrome，postterm pregnancy，and fetal anomalies in oligohydramnios group was obviously high and had significant difference（P＜0.01）.Occurrence of fetal distress，meconium-stained fluid，newborn asphyxia，and caesarean section rate increased in this group （P＜0.01）too.Conclusion? Intimate association of oligohydramnios with pregnancy complications is identified. Oligohydramnios severly threatens perinatal life. The caesarean section is the best way to treat severe oligohydramnios. ??? ［Key words］? oligohydramnios;pregnancy complications;prognosis of neonate;caesarean section ??? 羊水过少是妊娠期常见的并发症，是胎儿生命危险的重要信号，随着围产医学的发展及超声诊断技术的提高，羊水过少的诊断率明显提高，发生率亦明显增加。由于围产儿发病率及死亡率较高，其危害逐渐被产科医务人员所重视。为探讨羊水过少对妊娠、围产结局、分娩经过的影响，本文就我院2005年1月~2006年4月住院治疗的羊水过少孕妇136例及136例正常孕妇的临床资料进行回顾性分析。 ??? 1? 资料与方法 ??? 1.1? 一般资料? 我院2005年1月~2006年4月住院分娩总数4560例，产后确诊为羊水过少136例，发生率2.98%，年龄22~44岁，平均27.5岁，孕周 ??? 31~41周，平均37.5周，初产妇129例，经产妇7例，平均产次（1.1±0.15）次。136例正常孕妇设为对照组，年龄23~40岁，平均27.1岁，孕周33~42周，平均孕周38.7周，平均产次（1.08±0.1）次，两组孕妇在年龄、孕周、产次上差异无统计学意义（P＞0.05）。 ??? 1.2? 诊断标准? （1）阴道分娩时置盛器与产妇臀下持续收集或剖宫产术中以吸引器吸尽羊水，估算羊水量＜300 ml即可诊断。（2）超声显示羊水指数（AFI）＜5 cm诊断为羊水过少，5~8 cm诊断为羊水偏少。 ??? 1.3? 统计学方法? 采用χ2检验。 ??? 2? 结果