羊水过少与妊娠并发症的关系及对围生儿的影响

目的:探讨羊水过少与妊娠并发症的关系及对围生儿的影响。方法:收集我院2005年12月至2007年6月住院治疗的羊水过少孕妇106例,随机抽取同期我院分娩的羊水量正常孕妇120例作为对照组,两组病例就妊娠并发症、围生儿情况进行比较。结果:羊水过少组中胎儿生长受限(IUGR)、妊娠高血压综合征(简称妊高征,PIH)、过期妊娠及胎儿畸形的发生率均较对照组高,差异具有非常显著性(P<0.01),羊水过少组中同时合并两种、三种妊娠并发症的发生率均较对照组高,差异具有显著性或非常显著性(P<0.05,P<0.01),胎儿宫内窘迫、新生儿窒息及羊水粪染的发生率也明显升高(P<0.05,P<0.01)。伴有妊娠并发症的羊水过少孕妇,其胎儿宫内窘迫及羊水Ⅱ、Ⅲ度粪染率远较无妊娠并发症孕妇高(P<0.01)。结论:羊水过少与妊娠并发症密切相关,它严重威胁围生儿生命,如果同时合并妊娠并发症则风险更大,羊水过少可视为诸多妊娠并发症的危险信号。     

滋阴活血法结合补液治疗晚期妊娠羊水过少对羊水量及围生期结局的影响

目的：探讨滋阴活血法结合补液对羊水过少患者羊水量及围生期结局的影响。方法：收集羊水过少患者42例随机分入滋阴活血法结合补液治疗组与补液治疗组,并取13例饮水治疗作为对照,观察各组治疗前、治疗1周后、4周后羊水指数（AFI）及围生期胎儿窘迫、胎儿生长受限、剖宫产、新生儿窒息、死亡情况。结果：滋阴活血结合补液组治疗前、治疗1周、4周后AFI分别为（4.67±0.26）、（7.51±0.87）、（6.69±0.70）;补液组为（4.65±0.22）、（6.75±0.88）、（5.64±0.71）;对照组为（4.68±0.27）、（5.18±0.58）、（5.02±0.42）,两治疗组治疗1周、4周后AFI均较治疗前增加（P〈0.05）,对照组治疗前后无差异;滋阴活血结合补液组与补液组治疗1周后AFI增加量无差异,但4周后滋阴活血法结合补液组AFI增加量优于补液组。滋阴活血结合补液组胎儿窘迫、剖宫产构成比分别为14.3%、38%,低于补液组的42.8%、71.4%（P〈0.05）和对照组的61.5%、76.9%（P〈0.05）;三组胎儿生长受限、新生儿窒息、死亡构成比无显著性差异。结论：滋阴活血法结合补液治疗晚期妊娠羊水过少可增加其羊水量并减少胎儿窘迫发生、降低剖宫产率,其机理可能与中医滋阴活血法可改善胎盘功能有关。     

羊水过少174例分析

目的探讨妊娠晚期羊水过少对围生期结局的影响。方法对2008年9月～2009年9月我院超声测定羊水指数（AFI）≤8cm的174例孕妇临床情况及围生期结局进行分析。结果羊水过少高发于孕40～41＋6周,占6.16%（62/1007）;胎儿窘迫占23.256%,胎儿宫内发育迟缓占8.62%,妊高征占14.36%,其他合并症占53.45%。剖宫产率67.24%,新生儿窒息率8.62%。结论妊娠晚期诊断羊水过少的孕妇,应根据临床检查结果,选择最佳分娩方式及时终止妊娠。     

丹参注射液对妊娠晚期羊水过少孕妇凝血功能的影响

目的探讨丹参注射液对晚期妊娠单纯羊水过少孕妇治疗前后羊水量和凝血功能的影响。方法选择妊娠晚期单纯羊水过少者47例,以丹参注射液30ml＋5％葡萄糖500ml,另加林格氏液1000ml＋VitC20静脉滴注,1次／d,连续治疗2周。治疗前后24h内测量羊水指数（AFI）,抽取孕妇静脉血检测凝血功能,包括凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fbg）.结果治疗后患者AFI有显著提高,PT、APTT延长,Fbg下降,差异有显著统计学意义（均P〈0.01）。TT无影响,差异无统计学意义（P〉0．05）。结论丹参注射液可改善妊娠晚期凝血功能,降低血栓形成倾向,对治疗羊水过少有确切疗效。     

产科中羊水过少58例临床诊断及处理

目的探讨晚期妊娠羊水过少对新生儿结局的影响。方法选取我院羊水过少孕妇58例,随机抽取同期住院分娩羊水正常孕妇58例为对照组,对其临床资料进行对比分析。结果羊水过少出现的胎儿宫内窘迫率、胎粪污染率、新生儿窒息率、胎儿宫内发育受限（IUGR）明显高于对照组,差异有统计学意义（P〈0．01）。结论诊断为羊水过少的孕妇,选择合理方式终止妊娠对降低围生儿病死率、提高围生儿生存质量有很大意义。     

妊娠晚期羊水过少对围生期结局的影响

目的分析妊娠晚期羊水过少者对产妇及围生儿的影响。方法应用B型超声测定羊水指数（AFI）,对245例妊娠晚期羊水过少孕妇（观察组）进行分析,同时选择200例羊水量正常者作为对照,比较2组分娩方式及其对产妇及围生儿的影响。结果除新生儿死亡外,羊水过少组中羊水污染率（≥Ⅱ度）、胎儿窘迫发生率、新生儿窒息发生率、剖宫产率、产后出血发生率及平均总产程均高于羊水正常组（P〈0.01）,在羊水过少组中,羊水量越少,羊水污染率（≥Ⅱ度）、胎儿窘迫发生率、新生儿窒息发生率、剖宫产率、产后出血发生率越高（P〈0.05）。结论羊水过少严重威胁围生儿生命,应适时终止妊娠,以选择剖宫产为宜。     

超声测定羊水过少与围生儿预后的价值

目的 :探讨晚期妊娠羊水过少对围生儿的影响。方法 :应用B超测定羊水指数 (AFI)法 ,对 5 12例妊娠妇女的羊水量进行估计 ,并与围生儿结局进行对照分析。结果 :羊水过少高发于孕周 >4 0周的孕妇。AFI≤ 5 .0cm组与AFI >8 0cm组比较 ,两组胎儿宫内发育迟缓 (IUGR)、胎儿宫内窘迫、新生儿评分 5minApgar<7min、胎儿粪染的发生率有显著性差异 ;AFI 5 .0～ 8.0cm组围生儿不良结局的发生率也比AFI>8.0cm组明显增多。结论 :羊水过少易发生不良围生儿结局 ,严重影响围生儿预后。发现AFI≤ 5 .0cm及AFI 5 .0～ 8.0cm者应高度重视 ,加强监护 ,尽可能避免不良围生儿结局的发生。     

Perinatal outcome associated with oligohydramnios in uncomplicated term pregnancies

Purpose In high-risk pregnancies, oligohydramnios is frequently used to identify fetuses at risk of an adverse outcome. The purpose of this study was to evaluate the effect of oligohydramnios on perinatal outcome in uncomplicated pregnancies between 40.0 and 41.6 weeks.Methods From January 1997 to December 2000 all uncomplicated pregnancies reaching 40.0 weeks' gestation with a singleton non-malformed fetus and reliable dating underwent monitoring with serial determination of amniotic fluid index (AFI) and biophysical profile. Labor was induced for AFI 5 cm, biophysical profile score of 6 or less, rise in maternal blood pressure >140/90 mm Hg, or gestational age of 42.0 weeks. Perinatal outcome was compared between cases with AFI 5 cm and those with AFI >5 cm using Chi-square or Fisher's exact test for categorical variables, Student's t-test for continuous variables, and logistic regression analysis. A two-tailed p value <0.05 or an odds ratio (OR) with 95% confidence interval (CI) not inclusive of the unity was considered significant.Results Three thousand and forty-nine women met the inclusion criteria, 341 of which (11%) had an AFI 5 cm. Gestational age at delivery, rates of nulliparity and induction of labor were significantly different between cases with oligohydramnios and those with normal AFI (all p<0.001). Rates of cesarean delivery for non-reassuring fetal testing (8.2% vs. 3.9%, p<0.001) and of neonates with birth weight <10th percentile (13.2% vs. 5.5%, p<0.001) were significantly higher in the AFI 5 cm group compared with the AFI >5 cm. No significant differences were identified between the two groups in rates of meconium-stained amniotic fluid, 5-min Apgar score <7, or umbilical artery pH <7. Logistic regression analysis demonstrated that the association between oligohydramnios and rate of cesarean delivery for non-reassuring fetal testing lost significance after controlling for gestational age at delivery, nulliparity and induction of labor, whereas the association between AFI 5 cm and low birth weight centiles remained statistically significant (OR=2.2, 95% CI 1.5, 3.2).Conclusion In conclusion, in uncomplicated pregnancies at 40.0 to 41.6 weeks, oligohydramnios is independently associated with a higher risk of low birth weight centile.     

妊娠晚期羊水过少采用饮水治疗分析

目的:探讨饮水疗法治疗羊水过少的临床效果。方法:选择孕晚期羊水过少孕妇90例,随机分为两组,治疗组除日常饮食外,每日 24h内饮水≥4000mm,对照组行日常饮食。两组分别于治疗或观察前 1日、第 8日测定 AFI。此后治疗组仍坚持饮水疗法,两组均每2周动态监测AFI 1次,直至分娩。比较两组妊娠结局。结果:治疗组饮水7天后第8日 AFI和分娩前AFI均较饮水前明显增加,P<0.01;对照组观察前 1日,第 8日和分娩前AFI三组间比较,差异无显著性,P>0.05;治疗组与 对照组于第8日、分娩前AFI两组间比较,差异有显著性,均P<0.01。治疗组新生儿体重3150g,Apergar评分≤7分者1例,剖宫产9例,对照组分别为2750g,4例和21例。两组比较,差异有显著性,平均P<0.05。结论:饮水疗法治疗羊水过少简便有效,并能促进胎儿发育,减少新生儿窒息,降低剖宫产率。     

Ultrasonic features of preeclampsia

Preeclampsia, the hypertension of pregnancy, is a high-risk obstetric situation that can be monitored ultrasonically. Ultrasonic features commonly associated with preeclampsia, including decreased total intrauterine volume (TIUV), oligohydramnios, and intrauterine growth retardation (IUGR), are presented and their possible prognostic implications discussed.