足月妊娠羊水偏少孕妇阴道试产对妊娠结局的影响

目的分析足月妊娠孕妇羊水偏少进行阴道试产对妊娠结局的影响，探讨胎儿生物物理评分（BPS）、催产素激惹试验（OCT）及宫缩应激试验（CST）在羊水偏少孕妇阴道试产中监测的意义。方法对105例有完整临床资料并行阴道试产的羊水偏少足月妊娠孕妇（研究组）进行回顾性分析，与同期100例羊水正常范围的孕妇（对照组）进行比较，B超羊水指数法（AFI）估测羊水量，进行BPS、OCT、CST和胎儿脐动脉收缩期最大血流速度（S）和舒张末期血流速度（D）的比值（S／D）检测，观察羊水偏少对阴道试产的影响。结果两组患者产前胎儿生物物理评分、胎儿宫内窘迫发生率和新生儿窒息率比较，差异无统计学意义（P〉0．05），研究组中胎心率变异减速（VD）高于对照组，但差异无统计学意义（P〉0．05），研究组社会因素指征剖宫产显著高于对照组，差异有统计学意义（P〈0．05）。结论羊水偏少孕妇在严密产前及产时监护下阴道试产是可行的，可有效降低剖宫产率。

The effect of pregnancy outcome of transvaginal birth in pregnant women at term with less amniotic fluid

Objective To study the effect of pregnancy outcome of transvaginal delivery in term pregnant women with less amniotic fluid, To investigate the significance of fetal biophysic score in antepartum（BPS）, oxytocin challenge test （OCT） and contraction stress test （CST）in the process by transvaginal birth in term pregnant women with less amniot- ic fluid. Methods All of 105 patients （study group） with integrated clinical data of less amniotic fluid in term preg- nancy undergo transvaginal delivery and 100 cases with normal amniotic fluid range in the same period （control group） were analyzed retrospectively. All the patients were estimated the amniotic fluid index （AFI） by B-type uhra- sound, accepted BPS, OCT, CST and color doppler was used to examine the systolic/diastolic （S/D） ratio of the blood flow velocity in fetal umbilical arteries. Results There was no difference in the incidence of BPS, fetal distress in uterus and neonatal asphyxia between two groups , variable deceleration （VD）of fetal heart rate in study group was higher than the control group but without significance （P 〉 0.05）. The rate of uterine-incision delivery because of so- cial factor was higher than the control group（P 〈 0.05 ）. Conclusion Transvaginal delivery under proper intensive care is an effective method to decrease the rate of uterine-incision delivery.