羊水过少84例临床分析

本文对我院 1 997年 1月～ 1 999年 6月收治的 84例羊水过少患者进行分析 ,现报告如下。1　临床资料1 997年 1月～ 1 999年 6月分娩总数 2 0 36例 ,羊水过少 84例 ,发生率 4 1 3% ,其中羊水指数 (ＡＦＩ) 5 0～ 8 0ｃｍ者 53例 ,占 63 1 % ;≤5 0ｃｍ者 31例 ,占 36 9%。2 0 36例早产 1 0 4例 ,发生羊水过少 4例 ,发生率 3 85%。足月妊娠分娩 1 859例 ,发生羊水过少 54例 ,发生率 74 % ,过期妊娠分娩 73例 ,发生羊水过少 2 6例 ,发生率 35 6%。足月妊娠、早产的羊不过少发生率低与过期妊娠相比有显著性差异 (Ｐ <0 0 1 )。84例中导致羊水过…     

羊水过少122例分析

羊水过少严重影响围产儿的预后，易发生小儿宫内窘迫及新生儿窒息。为降低围产儿的死亡率，寻找正确的处理方法，本文对122例羊水过少病例进行分析，报告如下。     

妊娠晚期羊水过少112例临床分析

目的:探讨羊水过少的相关因素及围产儿的预后。方法:采用回顾性分析方法,对妊娠晚期羊水过少112例与羊水正常100例进行对比分析。结果:羊水过少多发生在孕40周后,与胎儿宫内发育迟缓(IUGR)和延期、过期妊娠有关;羊水过少组围产儿不良预后明显高于羊水正常组(P<0.01)。结论:妊娠晚期羊水过少是胎儿宫内慢性缺氧的标志,对围产儿预后有严重影响,应加强产前监测。剖宫产是处理妊娠晚期羊水过少及降低围产儿死亡率的重要措施。     

妊娠晚期羊水过少82例临床分析

目的探讨羊水过少的相关因素及围产儿的预后,寻求羊水过少较好的处理方法以降低围产儿死亡率。方法对我院2006年9月至2009年4月82例羊水过少患者进行综合分析。结果 82例羊水过少者行剖宫产术72例,剖宫产率87.80%。羊水过少组发生胎儿窘迫、新生儿窒息、羊水粪染、低体质量儿及新生儿死亡率均高于对照组,差异有统计学意义（P〈0.05）。结论妊娠晚期羊水过少是胎儿宫内慢性缺氧的标志,严重影响围产儿预后。加强产前监测,及时剖宫产是处理妊娠晚期羊水过少及降低围产儿死亡率的重要措施。     

羊水过少90例临床分析

目的：探讨羊水过少的主要妊娠合并症及与围产儿预后的关系。方法：对90例羊水过少病例进行回顾性分析，将同期分娩的羊水过少组与羊水正常组作对照，分析羊水过少的主要妊娠合并症及与围产儿预后的关系。结果：羊水过少的主要妊娠合并症为过期妊娠，羊水量的多少与胎盘的成熟情况及羊水污染程度存在高度相关。结论：加强产前监护对于羊水过少要适当放宽剖宫产指征。     

162例羊水过少的临床分析

目的：探讨羊水过少的相关因素及对围产儿的影响。方法：对我院2004年1月至2005年12月收治羊水过少162例的临床资料进行回顾分析。结果：羊水过少的发生与过期妊娠、延期妊娠、胎儿生长受限（FGR）、妊娠期高血压疾病、胎儿畸形有显著相关性。羊水过少容易出现脐带受压，导致胎儿窘迫、新生儿窒息的发生率、围产儿死亡率及因胎儿宫内窘迫而行剖宫产率明显增高。结论：羊水过少是判断胎盘功能不全最敏感的指标，一旦确诊应尽快终止妊娠，根据具体情况恰当选择分娩方式，减少围产儿不良预后。     

严重羊水过少83例临床分析

羊水过少对胎儿、新生儿危害极大 ,严重羊水过少尤然。随着产前B超检查的普及 ,羊水过少受到较多的关注 ;及早发现、及早处理降低了围产儿死亡率。现对本院住院分娩严重羊水过少孕妇83例进行回顾性分析 ,报道如下。1资料与方法1.1一般资料本院2002年1～12月住院分娩总数为2499例 ,其中严重羊水过少83例。年龄在20～43岁 ,平均25.8岁 ;初产妇69例 ,经产妇14例 ,孕周分布为36周 +2d1例 ,37周～41 +6d79例 ,孕42周以上3例。有并发症者11例 ,其中妊高征9例 ,IUGR1例 ,前置胎盘1例。合并脐带因素23例。随机抽取同期羊水正常的产妇83例为对照组…     

223例羊水过少孕妇的临床分析

对羊水过少223例临床资料进行分析。羊水过少确诊后要联合B超及电子胎心监护来检测胎儿宫内缺氧状况,短期内不能经阴道分娩者以剖宫产为宜。     

羊水过少78例临床分析

羊水过少严重影响围产儿的预后，随着医学的发展，对足月及过期妊娠的羊水过少的诊断、处理、分娩方式等研究越来越受到重视。我院自1994--1999年收治的羊水过少78例，综合分析如下：     

羊水过少216例临床分析

目的 :探讨羊水过少患者的宫颈Bishop评分与分娩方式、围产儿预后的关系。比较B超羊水指数法 (AFI法 )与最大羊水池测定法 (AFD法 )在临床诊断羊水过少中的准确率。方法 :对 2 16例羊水过少患者的临床资料进行回顾性分析。结果 :①胎儿宫内窘迫、新生儿窒息发生率随羊水量减少而升高 (P <0 .0 5 ) ;②宫颈Bishop评分 >6分者剖宫产率明显低于≤ 6分者 (P <0 .0 5 ) ,其新生儿窒息发生率无显著性差异 (P >0 .0 5 ) ;③AFI法检测羊水过少的准确率高于AFD法 (P <0 .0 5 )。结论 :羊水过少严重影响围产儿预后。产前B超监测羊水AFI法优于AFD法。羊水过少不是剖宫产的绝对指针 ,临床中可结合宫颈Bishop评分、催产素激惹试验及胎心监护无反应激实验及AFI值选择相应分娩方式     

Amniotic fluid and the clinical relevance of the sonographically estimated amniotic fluid volume: oligohydramnios

The amniotic fluid volume (AFV) is regulated by several systems, including the in-tramembranous pathway, fetal production (fetal urine and lung fluid) and uptake (fetal swallowing), and the balance of fluid movement via osmotic gradients. The normal AFV across gestation has not been clearly defined; consequently, abnormal volumes are also poorly defined. Actual AFVs can be measured by dye dilution techniques and directly measured at cesarean delivery; however, these techniques are time-consuming, are invasive, and require laboratory support, and direct measurement can only be done at cesarean delivery. As a result of these limitations, the AFV is estimated by the amniotic fluid index (AFI), the single deepest pocket, and subjective assessment of the AFV. Unfortunately, sonographic estimates of the AFV correlate poorly with dye-determined or directly measured amniotic fluid. The recent use of color Doppler sonography has not improved the diagnostic accuracy of sonographic estimates of the AFV but instead has led to overdiagnosis of oligohydramnios. The relationship between the fixed cutoffs of an AFI of 5 cm or less and a single deepest pocket of 2 cm or less for identifying adverse pregnancy outcomes is uncertain. The use of the single deepest pocket compared to the AFI to identify oligohydramnios in at-risk pregnancies seems to be a better choice because the use of the AFI leads to an increase in the diagnosis of oligohydramnios, resulting in more labor inductions and cesarean deliveries without any improvement in peripartum outcomes.     

Effect of fetal movement on the amniotic fluid index in diamniotic twin gestations

Fetal movement changes the size and location of amniotic fluid pockets during measurement of the amniotic fluid index. In singleton gestations, the effect of redistributing the fixed intrauterine fluid volume on the amniotic fluid index is clinically insignificant. In this study, we tested the hypothesis that the index in twin pregnancies is unaffected by fetal movement. A single examiner prospectively determined the amniotic fluid index before and after three discrete episodes of movement by both fetuses of 82 diamniotic twin pregnancies referred for obstetric sonograms between 20 and 38 weeks' menstrual age. A reliable blinded examiner provided a second post-movement measurement as a control. Data were analyzed by the paired t-test. The mean change in the amniotic fluid index after fetal movement was 2.1 ± 0.2 cm and 3.7 ± 0.3 cm for post-movement determinations by the same and blinded examiners, respectively (p < .001). Interobserver variation was 3.5 cm. Intraobserver variation was 1.8 cm for the first examiner and 2.2 cm for the second examiner. Therefore, interobserved and intraobserver variation can account for the observed change in the amniotic fluid index following movement of both diamniotic twins. © 1997 John Wiley & Sons, Inc. J Clin Ultrasound 25:255–257, 1997     

普贝生用于足月羊水偏少引产的临床研究

【目的】观察普贝生用于足月羊水偏少引产的有效性、安全性。【方法】将120例孕37～41周未破膜,合并羊水偏少（B超示羊水指数5．0～8．0cm）单胎头位产妇随机分为普贝生组和缩宫素组各60例。普贝生组阴道后穹隆放置普贝生引产,缩宫素组常规静滴缩宫素引产,比较普贝生和缩宫素两种药物引产的宫颈Bishop评分、临产时间、分娩情况、阴道分娩率、产后出血、新生儿情况以及不良反应。【结果】普贝生组宫颈评分较宫缩素组显著提高（P〈0．01）,普贝生组用药到临产时间明显短于缩宫素组（P〈0．01）,普贝生组引产成功率高于缩宫素组。而产后出血及新生儿窒息率无显著差别。【结论】普贝生用于足月妊娠羊水偏少病例引产安全有效,能显著提高阴道分娩率,降低剖宫产率。     

Use of the amniotic fluid index combined with estimated fetal weight within 10 days of delivery for prediction of macrosomia at birth.

OBJECTIVE: The purpose of this study was to assess the value of combining the sonographically estimated fetal weight (EFW) and amniotic fluid index (AFI) measured within 10 days of term delivery for prediction of macrosomia at birth. METHODS: Prospective sonographic fetal biometric measurements and delivery ward data of a single center, uploaded separately over a 4-year period, were retrospectively linked to yield an unselected sample of nondiabetic pregnancies with live-born term neonates. RESULTS: Of the 1925 pregnancies evaluated, 140 (7.2%) were macrosomic (birth weight > or =4000 g). The AFI was significantly higher in the macrosomic group (P < .001). On receiver operating characteristic curve analysis, the area under the curve was larger for predictions based on the EFW alone than on the AFI. An EFW of 4000 g or higher had a positive predictive value of 46.6% for macrosomia at birth. Use of the previously suggested combined EFW and AFI cutoffs of 3689 g and 119 mm, respectively, yielded a positive predictive value of 30.3%. CONCLUSIONS: Combined use of the EFW and AFI rather than the EFW alone does not improve prediction of macrosomia at birth.     

Association of amniotic fluid index with estimated fetal weight.

OBJECTIVE: The relationship between amniotic fluid volume and gestational age has been described previously. The association of body weight and urine output has been observed in human neonates. Our goal was to assess the correlation of the amniotic fluid index (AFI) with estimated fetal weight (EFW) in the third trimester. METHODS: We conducted a retrospective observational study on 426 pregnant women with singleton gestations who were referred to our unit for sonographic evaluation in the third trimester. The AFI, EFW, and EFW percentile corrected for gestational age were evaluated. The sonographic examinations were stratified into 3 gestational age categories: 28 through 33.9 weeks, 34 through 37.9 weeks, and 38 weeks and later. Maternal and fetal outcome variables were collected from medical records. Linear regression, Mann-Whitney U, and Kruskal-Wallis tests were used for statistical analysis. RESULTS: There was no significant relationship between the AFI and EFW in the entire group of patients (R = 0.08; P = .096). There was a significant relationship between the AFI and EFW after 38 weeks' gestation (R = 0.30; P = .003). In addition, in female fetuses the EFW percentile correlated with higher AFI values at all gestational ages (R = 0.31; P < .001); this, however, was not observed in male fetuses. CONCLUSIONS: There is no relationship between the AFI and EFW during the third trimester, although a positive relationship between the AFI and EFW was noted late in gestation. In pregnancies with female fetuses, the AFI was positively associated with EFW percentile before 38 weeks' gestation.     

羊水过少的处理与治疗

近年来羊水容量监测成为产前监测的重要内容之一。超声检查是诊断羊水过少最简单而准确的方法。羊水过少在不同孕期相应的处理不同。发现羊水过少合并胎儿畸形,应尽早终止妊娠。对于妊娠未足月羊水过少者应行增加羊水量期待治疗,妊娠足月发现羊水过少者应迅速终止妊娠。加强产前监护,及早发现病因是羊水过少临床处理的关键,对降低剖宫产率及改善母婴预后具有重要意义。