经阴道羊膜腔灌注治疗单胎初产妇临产后羊水过少的母儿结局分析

目的:分析经阴道羊膜腔灌注治疗临产后羊水过少的单胎初产妇分娩结局和新生儿结局。方法:回顾性分析中国人民武装警察部队特色医学中心2015年4月—2018年3月临产后诊断为羊水过少的358例单胎初孕妇,分为行经阴道羊膜腔灌注的治疗组(166例)和未行羊膜腔灌注的对照组(192例),比较2组的分娩结局(顺产率、产钳助产率、剖宫产率、产后出血率和产褥感染率)和新生儿结局新生儿脐动脉血pH值、脐动脉血乳酸值、出生后1 min Apgar评分、胎粪吸入综合征(MAS)发生率、入住新生儿科率]。结果:治疗组的顺产率高于对照组,产钳助产率和剖宫产率低于对照组,差异有统计学意义(P<0.05)。治疗组的产后出血率和产褥感染率与对照组相比差异无统计学意义(P>0.05)。治疗组的新生儿脐动脉血p H值、新生儿1 min Apgar评分高于对照组,而治疗组新生儿脐动脉血乳酸值、MAS发生率和入住新生儿科率低于对照组,差异均具有统计学意义(P<0.05)。结论:经阴道羊膜腔灌注治疗单胎初产妇临产后羊水过少是安全有效的,可以显著改善分娩结局和新生儿结局。

The Delivery Outcomes and Neonatal Outcomes Analysis in the Treatment of Single-Birth Primipara Oligohydramnios in Labor Using Transvaginal Amnioinfusion

Objective：To analyze the delivery outcomes and neonatal outcomes in the treatment of single-birth primipara oligohydramnios in labor using transvaginal amnioinfusion. Methods: 358 patients with single-birth primipara oligohydramnios in labor who were hospitalized in the Characteristic Medicine Center of the Chinese People′s Armed Forces from April 2015 to March 2018 were divided into two groups, including the treatment group (166 women those who accepted the transvaginal amnioinfusion) and the control group (192 women those who did not accept the transvaginal amnioinfusion). The delivery outcomes including spontaneous labor rate, forceps delivery rate, cesarean section rate, postpartum hemorrhage rate and puerperal infection rate, and the neonatal outcomes including umbilical artery PH, umbilical artery lactate, 1 minute Apgar score after birth, incidence of meconium aspiration syndrome (MAS) and admission rate of newborn department, were compared between the two groups. Results: The spontaneous labor ratein the treatment group was higher than that in the control group, while the forceps delivery rate and cesarean section rate were both lower than that in the control group. The difference of these three indexes between the treatment group and the control group were all statistically significant (P＜0.05). The difference of the postpartum hemorrhage rate and puerperal infection rate between the treatment group and the control group were both statistically insignificant (P＞0.05). The umbilical artery pH and 1 minute Apgar score after birth in the treatment group were both higher than that in the control group, while the umbilical artery lactate, incidence of MAS and admission rate of newborn department in the treatment group were all lower than that in the control group, and the difference of the these five indexes between the two groups were all statistically significant (P＜0.05). Conclusions: Transvaginal amnioinfusion is safe and effective in the treatment of single-birth primipara oligohydramnios in labor, which can improve obviously the delivery outcomes and neonatal outcomes.