深圳地区羊水过少226例临床分析

目的探讨羊水过少与妊娠并发症的关系及其分娩方式的选择与围生儿预后关系。方法收集我院2005年6月至2006年5月住院分娩的羊水过少孕妇226例,随机抽取我院同期分娩的羊水量正常孕妇220例为对照组,两组病例就妊娠并发症、分娩方式及围生儿情况进行比较。结果羊水过少组中过期妊娠、妊娠期高血压疾病、胎儿生长受限（FGR）及胎儿畸形的发生率均高于对照组（P〈0.01）。羊水过少组羊水粪染、胎儿窘迫、胎粪吸入综合征（MAS）的发生率明显高于对照组（P〈0.05,P〈0.01）。羊水过少伴妊娠并发症组羊水粪染、胎儿窘迫、新生儿窒息的发生率明显高于无并发症组,（P〈0.01,P〈0.05）,剖宫产率明显增加（P〈0.01）,而胎粪吸入综合征（MAS）与围生儿死亡率无显著差异（P〉0.05）。单纯羊水过少者围生儿结局与对照组无显著差异（P〉0.05）。结论羊水过少与妊娠并发症密切相关,羊水过少伴有妊娠并发症者围生儿结局不良,应放宽手术指征,单纯羊水过少者可以阴道试产。

Clinical analysis of 226 cases of oligohydramnios

Objective:To explore the association of oligohydramnios with pregnancy complications and the mode of delivery and its effect on perinatal outcome.Methods: The clinical data of 226 patients with oligohydramnios in our hospital from June 2005 to May 2006 were collected.220 patients with normal amniotic fluid volume were selected randomly as control group.The complications of pregnancy,the mode of delivery and adverse perinatal outcomes were analyzed.Results: Compared to control group,incidences of post-term pregnancy,hypertensive disorder complicating pregnancy,fetal growth restriction(FGR) and fetal anomalies in oligohydramnios group were obviously high(P<0.01).Occurrence of meconium-stained fluid,fetal distress,and meconium aspiration syndrome(MAS) increased in oligohydramnios group(P<0.05).The rate of meconium-stained fluid,fetal distress,and newborn asphyxia in patients with oligohydramnios complicated with pregnancy complications was higher than that of oligohydramnios patients without pregnancy complications(P<0.01,P<0.05).And the cesarean section rate was obviously high(P<0.01).But there was not a statistically significant difference between the two groups regarding meconium aspiration syndrome(MAS) and perinatal die rate(P>0.05).Pregnancies with isolated oligohydramnios had perinatal outcomes similar to pregnancies with a normal amniotic fluid index(P>0.05).Conclusion: There is an intimate association of oligohydramnios with pregnancy complications.Patients with oligohydramnios complicated with pregnancy complications associated with an increased risk of adverse perinatal outcomes,so we need not control the cesarean section rate.Isolated oligohydramnios is not associated with adverse perinatal outcomes, so a trial of labor is indicated.