增液汤治疗羊水过少的疗效观察

目的探讨增液汤治疗羊水过少的疗效。方法将60例患者随机分为增液汤治疗组和饮水治疗对照组,观察AFI、剖宫产率、Apgar评分等指标。结果治疗后两组间AFI、Apgar评分及剖宫产率差异均有统计学意义(P<0.05,P<0.01)。结论增液汤治疗羊水过少的疗效明显优于单纯饮水,是一种安全、经济、有效的治疗方法。     

自拟参葛安胎汤治疗羊水过少的临床研究

目的探讨采用自拟参葛安胎汤治疗妊娠晚期羊水过少的临床疗效。方法本研究选择本院妇产科门诊2011年1月～2012年7月确诊为羊水过少孕妇120例,随机分为3组：饮水组、静脉输液组、中药组（参葛安胎汤）,每组40例,观察治疗10d后,B超测羊水指数（AFI）及脐血流S/D值,并统计妊娠结局。结果中药组治疗10d后AFI较治疗前增加、脐血流S/D值下降（P〈0.05）,饮水组及静脉输液组治疗前后差异无统计学意义。中药组较饮水组、静脉输液组经阴分娩率高、新生儿并发症少,且差异有统计学意义（P〈0.05）。结论中药治疗（参葛安胎汤）不仅可增加羊水过少者的羊水量,同时可降低胎儿脐血流阻力、改善围产结局。     

Low Amniotic Fluid Index at Term as a Predictor of Adverse Perinatal Outcome

Aim

To determine whether an antepartum low amniotic fluid index (AFI) is a predictor of adverse perinatal outcome in normal pregnancy and to determine a threshold level of AFI that could predict an adverse outcome.

Methods

This was a prospective study conducted among 180 pregnant women at 37–40 weeks of gestation with no known obstetric or medical complications with an AFI ≤ 5th percentile. The results were statistically analyzed and compared.

Results

In the control group, the mean AFI was 10.14 cm and in the study group, it was 4.14 cm. 65 % patients in the study group and 24 % in the control group had a non-reactive non-stress Test. In the control group, 53 % of patients were induced for reasons other than oligohydramnios, while in the study group, 86 % of patients were induced for oligohydramnios. Among the control group, 33 % had a LSCS, while 67 % delivered vaginally; and in the study group, 34 % delivered vaginally and 66 % had a LSCS. In our study, a 5-min APGAR < 7 was seen in 34 % in the study group and 11 % in the control group. 33 % neonates in the control group and 64 % in the study group had birth weights <2.5 kg.

Conclusions

In the presence of oligohydramnios, perinatal morbidity and mortality are high. Determination of AFI is a valuable screening test for predicting fetal distress.     

Clinical features of polyhydramnios associated with fetal anomalies

The purpose of this study was to examine the clinical features of pregnancy complicated by polyhydramnios associated with fetal anomalies. Sixty-nine patients with a singleton pregnancy complicated by polyhydramnios were retrospectively analyzed. Based on prenatal ultrasonographic findings, 13 cases were considered to have idiopathic polyhydramnios and the remaining 56 cases were associated with fetal anomalies. Between these two groups, no significant difference was found in the gestational weeks when polyhydramnios developed. However, significant difference was noted in the maximum amniotic fluid index (AFI) values during the pregnancy period; 25.4 +/- 2.7 cm in the former, and 30.6 +/- 8.9 cm in the latter (P = 0.0004). In all of 13 cases with idiopathic polyhydramnios, AFI values remained less than 30 cm until delivery. Twenty-two patients (39%) with fetal anomalies required a prenatal treatment such as amnioreduction and tocolysis, whereas only one patient (7.7%) with idiopathic polyhydramnios needed tocolysis therapy (P = 0.03). There was a significant risk of premature delivery with fetal anomalies (35.6 +/- 3.9 weeks' gestation vs. 38.8 +/- 1.5 weeks' gestation, P = 0.004) because of refractory polyhydramnios, rupture of membranes, non-reassuring fetal status, and intrauterine fetal death, and although most infants with idiopathic polyhydramnios were appropriate-for-dates, many of the infants with congenital anomalies were small-for-dates. Significant risk of fetal anomalies should be considered in pregnant women with severe polyhydramnios (AFI > or = 30 cm), an increased trend of amniotic fluid during the pregnancy period, polyhydramnios requiring a prenatal treatment, or fetal growth restriction. On the other hand, based on our experience, a fetus without these conditions seems to have a low risk of congenital anomalies even if polyhydramnios is noted.     

The umbilical coiling index and adverse perinatal outcome.

OBJECTIVE: Evaluation of the relationship between umbilical coiling index (UCI) and adverse perinatal outcome. METHOD: A prospective study was performed on 699 pregnant women who were 37-40 weeks. UCI was determined by dividing the total number of the complete vascular coiling by the total umbilical cord length in centimeters. Then the relationship between UCI and neonatal weight, amniotic fluid index, meconium, Apgar score, and fetal distress were evaluated. RESULTS: There was a significant difference between normo- and hypocoiled groups according to the Apgar score less than 7 in minute 5, AFIAFIAFI相似文献