高原地区超声诊断羊水过少对围产儿的影响

目的：分析高原地区超声对羊水过少的诊断价值。方法：采用最大羊水池深度(AFD)及羊水指数(AFI)指标，对120例妊娠晚期拟诊羊水过少患者，经腹部扫查，分娩后核实羊水量，评估超声对羊水过少的诊断价值。选择年龄相近羊水正常孕妇120例作对照组，比较其胎儿窘迫、新生儿窒息、新生儿体重等指标的差异。结果：①应用AFD和AFI在妊娠晚期超声对羊水过少的诊断准确率为99％。②妊娠晚期经超声诊断的羊水过少孕妇发生胎儿窘迫、新生儿窒息、低体重儿的机会明显增加，与对照组相比，各指标间差异均有极显著性(P＜0.01)。结论：超声诊断羊水过少准确率高，高原地区羊水过少是围产儿危险的征兆，须给予重视及治疗。     

超声诊断羊水过少与母子预后的临床分析

目的分析超声诊断晚期妊娠羊水过少对母子预后的影响。方法应用最大羊水暗区深度(AFD)和羊水指数(AFI)指标测定法，对诊断为羊水过少110例临床资料进行分析。结果绝对羊水过少组胎儿窘迫、低体重儿、新生儿窒息、羊水Ⅱ～Ⅲ度污染、过期妊娠、剖宫产发生率明显高于临界羊水过少组和正常羊水组。结论B超以AFD AFI方法结合诊断羊水过少准确率高，晚期妊娠羊水过少是引起围产儿预后不良的根本原因，以剖宫产终止妊娠是绝对羊水过少的必要措施。     

晚期妊娠羊水过少的临床分析

目的探讨晚期妊娠羊水过少的并发症与围产不良结局的关系。方法采用回顾性分析方法，对晚期妊娠羊水过少的216例病例和羊水正常对照组216例孕妇就羊水过少的并发症及妊娠结局进行对比分析。结果超声羊水指数（AFI）法估测羊水量比单一的羊水池深度测量更客观、更准确。羊水过少组胎儿生长受限、妊娠高血压疾病、胎儿畸形、胎儿窘迫、新生儿窒息发生率较对照组高（P〈O．05）。羊水过少组中AFI≤3．0cm孕妇，其胎儿窘迫、新生儿窒息发生率较AFI3．1～5．0cm组高（P〈O．05）。结论羊水过少孕妇妊娠和分娩并发症发生率高是造成不良围产结局的高危因素。对于AFI≤3．0cm有并发症者应于孕36周前适时终止妊娠。剖宫产是此类孕妇分娩方式的最佳选择。     

晚期妊娠合并羊水过少对围产儿的影响

目的:探讨晚期妊娠合并羊水过少对围产儿预后的影响.方法:采用B超检查诊断羊水过少或分娩时收集羊水量＜300mL的175例晚期妊娠住院待产患者,并选择年龄相近羊水正常的175例孕妇作为对照组,比较其分娩方式、胎儿窘迫、新生儿窒息、新生儿体重等指标的差异.结果:晚期妊娠合并羊水过少的孕妇发生胎儿窘迫、新生儿窒息、低体重儿的机会明显增高,与对照组相比,各项指标差异均有显著性(P＜0.05).结论:晚期妊娠合并羊水过少是围产儿危险的征兆,加强国产保健非常重要,剖腹产是羊水过少的孕妇分娩方式的最佳选择.     

足月妊娠孕妇羊水过少的超声诊断及妊娠结局分析

目的：探讨足月妊娠孕妇羊水过少的超声诊断,并对妊娠结局进行分析。方法选取250例羊水过少的足月妊娠孕妇为观察组,另选取同期250例羊水正常的足月妊娠孕妇为对照组,比较2组孕妇的分娩方式、胎儿情况（宫内窘迫及羊水浑浊）及妊娠结局（新生儿窒息）的发生情况。结果231例羊水量小于300 mL,超声诊断正确诊断率达92.4%。观察组孕妇的剖宫产率为82.8%,高于对照组孕妇的28.8%（P＜0.05）。观察组发生宫内窘迫以及羊水浑浊的情况高于对照组患者（均P＜0.05）。观察组新生儿窒息发生率为20.8%,高于对照组的6.4%（P＜0.05）。结论羊水过少严重影响胎儿宫内的发育以及预后,对妊娠方式的选择也会产生很大的影响,尤其会使剖宫产率增加;超声是目前诊断孕妇羊水过少最主要的方式。     

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     

羊水过少107例临床分析

目的：探讨晚期妊娠羊水过少者的分娩方式。方法：对107例羊水过少孕妇的分娩方式及新生儿结局进行回顾性分析。结果：不同孕周羊水过少孕妇引产后,新生儿结局不同,羊水过少者中羊水粪染、胎儿窘迫、新生儿窒息率显著增加。结论：孕周≥40周羊水过少者应积极终止妊娠,分娩方式以剖宫产为主。     

妊娠晚期羊水指数临界产妇的妊娠结局

目的：探讨妊娠晚期羊水指数（AFI）临界对妊娠结局的影响。方法：对照研究1973例孕37-42周单产活胎孕产妇的临床资料,并进行分析,比较羊水指数临界组（A组）（5〈AFI≤8,n=367）和AFI正常组（B组）（AFI〉8,n=1606）的分娩方式、羊水过少发生率、分娩时羊水粪染发生率、产妇分娩时间及产时出血、新生儿出生时体重、阿氏评分、新生儿畸形。结果：A组剖宫产率、羊水过少发生率、分娩时羊水粪染发生率、新生儿窒息率、新生儿畸形率明显大于B组,差异有显著性（P〈0．05）;A组分娩时间及产时出血、新生儿出生体重与B组相比差异无统计学意义（P〉0．05）。结论：妊娠晚期AFI临界是胎盘功能减退的早期信号,产前应定期监测AFI,重视AFI临界的产妇,可改善围产儿的不良结局。     

妊娠晚期超声计量低羊水指数产妇的围生期结局指标观察

目的 观察妊娠晚期超声计量低羊水指数(AFI)产妇的各项围生期结局指标变化.方法 选择近期住院的83例低AFI产妇,观察她们的围生期结局各项指标,并与175例同期住院分娩的正常AFI产妇(对照组)比较.结果 低AFI组的剖宫产、胎儿窘迫、羊水污染、新生儿窒息和围产期儿死亡发生例数均明显多于对照组(P均<0.01～0.05).结论 超声计量低AFI是预示产妇围生期结局不良的理想指标.     

羊水过少115例分析

目的探讨妊娠晚期羊水过少对围生期结局的影响。方法 2008-01-2010-12我院分娩2 485例,通过超声测定羊水指数(AFI)诊断为羊水过少115例妊娠妇女临床情况及围生期结局进行分析。结果羊水过少高发于妊娠≥41周,羊水过少的孕妇常合并有一定的高危因素,当AFI≤5.0cm时,胎儿宫内窘迫发生率明显增高。结论加强围产期检查及早发现羊水过少,选择最佳分娩方式及时终止妊娠,改善围生儿预后。     

羊水指数≤5 cm与羊水池最大切面≤2 cm×2 cm围产结局的比较

目的为超声诊断羊水过少寻求更为适宜的诊断标准。方法分别以羊水指数(AFI)≤5cm和羊水池最大切面≤2cm×2cm为诊断标准超声诊断羊水过少，采用χ2检验分析两组围产结局。结果AFI≤5cm组中有45.2％的孕妇羊水池最大切面>2cm×2cm。羊水池最大切面≤2cm×2cm组的胎心率异常，羊水II度以上粪染率均高于AFI≤5cm组(P<0.05)，新生儿5min低Apgar评分(≤7分)率和剖宫产率两组差异无显著性意义(P>0.05)。结论以羊水池最大切面≤2cm×2cm为标准超声诊断羊水过少更为准确。     

70例羊水过少患者的围产结局分析

目的 探讨羊水过少患者对围产儿结局影响.方法 对2005年9月～2009年12月收治的70例羊水过少患者作观察组和80例正常孕妇作对照组对比;另70例羊水过少中NST有反应型42例作为A组和NST异常的患者28例作为B组对比.对二组剖宫产、羊水粪染、新生儿窒息作统计学分析.结果 羊水过少的剖宫产、新生儿窒息,羊水粪染明显高于对照组,差异有统计学意义（P〈0.05）.NST和AFI均异常的患者的剖宫产、新生儿窒息、羊水污染明显高于NST有反应型和AFI异常组,差异有统计学意义（P〈0.05）.结论 羊水过少者若胎儿已成熟,尽早终止妊娠,根据胎心监护情况,选择合理分娩方式.     

羊水过少对围产儿的影响及处理分析

目的探讨羊水过少的相关因素及其对围产儿的影响,寻找正确的处理方法。方法对2008年2月至2009年4月就诊于我院的140例羊水过少病例（观察者）与同期羊水量正常的100例病例（对照组）进行对比分析。结果B超诊断的符合率高达94.3%。羊水过少的发生与妊娠高血压、过期妊娠、胎儿宫内发育迟缓和胎儿畸形密切相关。观察组的孕妇选择阴道产的几率明显小于对照组的孕妇。观察组羊水污染、胎盘钙化、胎儿窘迫、新生儿窒息、脐带绕颈和低体质量儿发生率明显高于对照组。结论羊水过少严重威胁着围生儿的健康,做好产前严密的检测和适时地选择其他生产方式是提高出生质量的重要方法。     

Objective method of diagnosing oligohydramnios in postterm pregnancies

Oligohydramnios is an important factor influencing the management of postterm pregnancies. However, sonographic assessment of oligohydramnios has been based largely on the subjective judgement of the sonologist. From January 1982 to December 1984, 54 patients had articulated-arm B-scan ultrasound examinations and were identified as postterm. Of these patients, 25 were subjectively diagnosed as having oligohydramnios. Five patients were considered to have low normal amounts of amniotic fluid. The remainder were considered to have normal or greater than normal quantities of amniotic fluid. From this population, an amniotic fluid index was determined for each patient by finding the product of the length, width, and depth of the largest amniotic fluid pocket. Patients with a fluid index less than 60 showed a strong association with the postmaturity syndrome. Indeed, all but one postmature infant was born of a pregnancy with a fluid index less than 60. No other fetal or perinatal complications were statistically correlated with oligohydramnios in this small patient series.     

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。     

The accuracy of ultrasound evaluation of amniotic fluid volume in singleton pregnancies: The effect of operator experience and ultrasound interpretative technique

The objective of this study was to evaluate the effect of operator experience and ultrasound interpretation technique on the accuracy of ultrasound estimates of amniotic fluid volume. Ultrasound evaluation was carried out by an obstetric resident, a nurse sonographer, a maternal-fetal medicine fellow, and a maternal-fetal medicine staff member to subjectively estimate (visual interpretation without sonographic measurements) amniotic fluid volume in 63 pregnancies. Amniotic fluid volume was also evaluated using ultrasound measurements based on the largest vertical pocket technique, the amniotic fluid index, and the two-diameter pocket method. The accuracy of these ultrasound estimates was assessed by comparing the ultrasound results to actual amniotic fluid volume as determined by a dye-dilution technique. For analysis, amniotic fluid volumes were classified as oligohydramnios, normal, or hydramnios using established volumetric criteria for singleton pregnancies. Subjective estimates ranged from 65% to 70% correct and did not differ by operator experience except for the more accurate diagnosis of hydramnios by the maternal-fetal medicine staff. The three sonographic measurements were similar in overall accuracy (59–67%). The two-diameter pocket method was, however, significantly more accurate in identifying oligohydramnios. It appears that neither operator experience nor sonographic technique greatly affects the accuracy of ultrasound estimates of amniotic fluid volume. © 1997 John Wiley & Sons, Inc. J Clin Ultrasound 25:249–253, 1997     

羊水过少孕妇阴道分娩的临床研究

目的 探讨羊水过少孕妇阴道分娩对围产儿的影响,寻找正确的处理方法,降低围产儿病死率.方法 采用回顾性调查方法对100例羊水过少足月妊娠妇女及100例羊水正常足月妊娠妇女阴道试产临床资料进行分析.结果 100例羊水过少组4例围产儿死亡,其中死胎1例、死产2例,新生儿死亡1例.羊水过少组新生儿窒息评分与羊水污染明显高于正常羊水组（P＜0.05）.结论 羊水过少确诊后应积极引产,可适当阴道试产,估计短时间内不能分娩者,以适时剖宫产结束妊娠为宜.     

The natural history of oligohydramnios/polyhydramnios sequence in monochorionic diamniotic twins.

Twelve patients with monochorionic diamniotic twin pregnancies complicated by oligohydramnios/polyhydramnios sequence were evaluated to determine the natural history of this syndrome. Nine patients elected to continue their pregnancies and three underwent elective termination. Six of the nine continuing pregnancies delivered viable fetuses. Four of the nine continuing pregnancies had evidence of a 'stuck' twin at less than 20 weeks' gestation, and only one yielded live newborns (25%). Three patients diagnosed with a mild case of oligohydramnios/polyhydramnios sequence underwent worsening of the syndrome with a 'stuck' twin seen only after 26 weeks: all neonates survived. Five pregnancies initially diagnosed as having a 'stuck' twin showed improvement in amniotic fluid volume, with one actually reversing, so that the previously 'stuck' twin developed polyhydramnios and the co-twin became 'stuck'.In summary, among the nine non-aborted pregnancies managed conservatively, 12 of 18 fetuses (67%) survived. When the diagnosis of 'stuck' twin was made at 相似文献   

羊水过少80例的临床研究

目的了解羊水过少对围产儿的影响,探讨相关因素,并寻找正确的处理方法,降低围产儿病死率。方法选择羊水正常80例为对照组,羊水过少80例为观察组,对两组的临床资料进行回顾性分析。结果观察组并发症发生率明显高于对照组,差异有显著性(P<0.05)。结论羊水过少严重威胁围产儿的生命安全,一旦确诊,宜及早终止妊娠,以剖宫产终止妊娠为宜。     

Accuracy of ultrasonography in evaluating amniotic fluid volume at less than 24 weeks' gestation.

The purpose of this investigation was to evaluate the accuracy of common sonographic techniques in assessing the amniotic fluid volume in pregnancies of less than 24 weeks' gestation. Patients at less than 24 weeks' gestation undergoing an amniocentesis for the placement of prostaglandin F2 alpha for termination (because of genetic or fetal anomalies, or both) were assessed for amniotic fluid volume. All fetuses were alive at the time of prostaglandin instillation. The amniotic fluid index and two-diameter pocket were used to determine the amniotic fluid volume. Prior to the prostaglandin instillation, the amniotic fluid volume was determined with para-aminohippurate using a diazo dye reaction with spectrophotometric analysis. The amniotic fluid volume was determined in 21 pregnancies between 15 and 24 weeks' gestation, yielding volumes ranging from 189 to 1840 ml. Using published standards for amniotic fluid volume in singleton pregnancies, oligohydramnios was present in three gestations, the volume was found to be normal in 15, and hydramnios complicated three pregnancies. The two-diameter pocket identified the amniotic fluid volumes correctly more often (18 of 21 [85.7%]) than the amniotic fluid index (10 of 21 [47.6%]) (P = 0.02). Normal amniotic fluid volume was identified in nine of 15 (60%) pregnancies by the amniotic fluid index and in 14 of 15 (93.3%) by the two-diameter pocket (P = not significant). Abnormal amniotic fluid volumes, oligohydramnios, and hydramnios were recognized more often by the two-diameter pocket (66.7%) than by the amniotic fluid index (1 of 6 [16.7%], P = not significant).