羊水过少与妊娠并发症的关系及对围生儿的影响

The Association of Oligohydramnios with Pregnancy Complications and Effect on Perineonate

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 2 0 0 2年 1月至 2 0 0 3年 4月住院治疗的羊水过少孕妇 10 6例 ,随机抽取同期我院分娩的羊水量正常孕妇 12 0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 (FGR)、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 .0 1) ,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 .0 5 ,P <0 .0 1) ,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 .0 5 ,P <0 .0 1)。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 .0 1)。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 ,羊水过少可作为许多妊娠并发症的危险信号。

Objective: To explore the association of oligohydramnios with pregnancy complications and effect on perineonate. Methods: The clinical data of 106 patients with oligohydramnios in our hospital from January 2002 to April 2003 were collected. 120 patients with normal amniotic fluid volume were selected randomly as control group. The complications of pregnancy and adverse perinatal outcomes were analyzed. Results:Compared to control group, incidences of intrauterine growth retardation, pregnancy-induced hypertension syndrome, postterm pregnancy, and fetal anomalies in oligohydramnios group was obviously high and had significant difference ( P <0.01). The incidences of two or three kinds of pregnancy complications in oligohydramnios group were significant higher than that of control group( P <0.05, P <0.01). Occurrence of fetal distress, newborn asphyxia, and meconium-stained fluid increased in this group ( P <0.05, P <0.01) too. The rate of fetal distress, Ⅱ or Ⅲ meconium-stained fluid in patients with oligohydramnios complicated with pregnancy complications was higher than that of oligohydramnios patients without pregnancy complications ( P <0.01). Conclusions: Intimate association of oligohydramnios with pregnancy complications is identified. Oligohydramnios severely threaten perinatal life and the risk will increase if oligohydramnios patients complicated with pregnancy complications. Moreover, oligohydramnios can be seen as a risk signal of many pregnancy complications.