晚发性羊水过少的临床对策研究

Clinical methods for delayed-occurence by pamnion

目的探讨晚发性羊水过少的因素及临床对策。方法收集该院2004年6月～2005年1月住院分娩的羊水过少的产妇105例,随机抽取同期住院分娩的羊水量正常的产妇103例作为对照组,两组病例就妊娠并发症,围产儿及母体情况进行比较。结果羊水过少组中延期过期妊娠、胎儿宫内发育受限(FGR)、妊娠高血压疾病(PIH)、妊娠期肝内胆汁瘀积症(ICP)及脐带异常、胎膜早破发生率均高于对照组,差异有显著性(P<0.05),羊水过少组中同时合并两种或两种以上并发症者高于对照组(P<0.01)差异有显著性。胎儿窘迫,新生儿窒息及羊水Ⅱ、Ⅲ度粪染发生率也明显升高(P<0.05),且羊水量越少,羊水粪染及胎儿窘迫、新生儿窒息发生率越高;剖宫产及产后出血发生率较对照组高,两组比较差异有显著性(P<0.05)。结论羊水过少与妊娠并发症关系密切,它严重威胁围产儿生命,造成不良妊娠结局。但及时发现羊水过少后,及时采取了相应对策,确保了母婴安全,降低了母婴死亡率。

[Objective] To approach the causes and methods for delayed-occurence hypamnion. [Method] 105 cases of wonen with hypamnion in our hospital from June, 2004 to Jan, 2005 were collected and 103 cases with normal amniotic fluid were also chosen. Their complications and related indexes were studied, [Result] In the group with too little arrmiofic fluid, happening rates of some diseases such as postponing or overdue parturition, fetus＇s limited growth in the uterus （FGR）, hypertension of parturition 0aIH）, disease of bile＇s depositing in the liver （ICP）, strange umbilical cord, fetal membrane break early are all higher than the contrastivo group. The difference was obvious （P 〈0.05）. In the group with too little amniotic fluid, the quantity of women who have two or more than two complications at the same time was also higher than the other group. And the difference was remarkable （P〈0.01）. The rates of fetus in the predicament, rebirth stifling and wate affection on amniotic fluid Ⅱ, Ⅲ[ were all obviously rising. The less alrmiotie fluid was, the more those diseases would happen. The rates of uterine-incision delivery and hemorrhage after parturition are also higher than the eonstraetive group. The defferenee was obvious （P 〈0.05）. [Conclusion] Too little alrmiotie fluid has close relationship with complications of parturition. It seriously threatens the life of perinatal-son, and causes harmful of parturition. But early diagosis and right measures can secure the mothers and infants and effectively depress the mortality.