足月妊娠羊水过少306例临床分析(1)
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【摘要】 目的探讨羊水过少的病因及相关因素,观察羊水过少对围生儿的影响,寻找正确的处理方法,防止漏诊,降低围生儿病死率。方法对羊水过少306例临床资料进行回顾性分析。结果 B超对羊水量的估计准确率可达97.71%,羊水过少发生率为2.51%,且多发生于妊娠晚期,尤其是过期妊娠与之关系密切,羊水过少组(观察组)明显高于对照组(P<0.01),差异有非常显著性意义,有胎儿生长受限(FGR)及妊娠期高血压疾病者多发生于孕37～40周。羊水粪染、胎儿宫内窘迫、新生儿窒息及剖宫产率均明显高于对照组,差异有非常显著性意义(P<0.01)。结论 加强孕晚期B超监测,放宽诊断标准,重视羊水局限的提示,可提高羊水过少诊断的检出率,及时剖宫产,可明显改善围生儿结局。
【关键词】 羊水过少;胎儿宫内窘迫;新生儿窒息;剖宫产;围生儿
Full-term pregnancy oligoamnios Clinical analysis of 306 cases
CHEN Li-qun.Maternal and child Health Hospital Renshou County,Sichuan Province,Renshou 620500 China
【Abstract】 Objective To investigate the cause of oligoamnios and related factors,observation of oligoamnios on perinatal effects of children,to find the right approach,to prevent misdiagnosis and reduce perinatal child mortality. Methods 306 cases of oligoamnios were retrospectively analyzed. Results B-ultrasound estimated amniotic fluid volume of up to 97.71% accuracy rate,the incidence of oligoamnios is 2.51%,and mostly occurs in late pregnancy,especially close relationship with prolonged pregnancy,oligoamnios group (observation group) was significantly control group (P<0.01),the difference was statistically significant,there is fetal growth restriction (FGR) and pregnancy-induced hypertension occurred in those over 37 to 40 weeks pregnant. Meconium-stained amniotic fluid,fetal distress,neonatal asphyxia and cesarean section rate was significantly higher than that,the difference was statistically significant (P<0.01). Conclusion Strengthening the third trimester B-monitoring,relaxation of diagnostic criteria and prompt attention to the limitations of amniotic fluid can improve the diagnosis of oligoamnios detection rates,timely cesarean section,children can significantly improve the perinatal outcome.
【Key words】 Oligoamnios;Fetal distress;Asphyxia;Cesarean;Perinatal child
羊水过少是一种妊娠晚期的并发症,妊娠晚期羊水量少于300 ml者,为羊水过少[1]。近年来,随着围产医学的发展,超声诊断技术的不断提高,B超的广泛应用,羊水过少的诊断率也显著提高。羊水过少是胎儿危险的信号,常引起不协调子宫收缩,增加了胎儿窘迫、新生儿窒息和死亡的机率,影响围生儿的预后,增加围生儿病死率。为寻找羊水过少正确的处理方法,降低围生儿病死率,本文对306例羊水过少病例进行回顾性分析,现报告如下。
1 资料与方法
1.1 一般资料 2006年1月至2008年12月在本院住院分娩的足月及过期妊娠12177例,产后确诊为羊水过少306例,发生率2 ......
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