临界羊水过少与羊水正常孕妇行阴道试产对围产期结局的比较观察

Peripartum results of pregnant women with borderline oligoamnios undergoing vaginal trial labor

目的观察足月妊娠妇女临界羊水过少时,阴道试产对围产期结局的影响。方法应用B超羊水指数(AFI)法估测羊水量,并测定脐动脉S/D值、生物物理评分、胎监及24 h尿雌三醇与肌酐的比值,比较观察250例B超诊断临界羊水过少者(观察组)和250例羊水量正常的足月妊娠妇女(对照组)阴道试产后的分娩结局。结果观察组产时催产素激惹试验或宫缩应激试验变异减速者54例,晚期减速者26例,明显高于对照组的22、6例(P<0.01),观察组羊水轻度粪染的发生率及急诊剖宫产率均明显高于对照组(29.2%vs12.8%、34.0%vs18.8,P<0.01)。两组新生儿窒息发生率则差异无统计学意义(P>0.05)。结论B超诊断临界羊水过少的足月妊娠妇女,若无胎儿窘迫,可在严密监护下行阴道试产。

Objective To observe the effect of vaginal trial labor on the peripartum results in full-term pregnant women with borderline ollgoamnios. Methods Clinical data of 250 pregnant wonlen with borderline ollgoamnios （observation group） and 250 with normal amount of amn：otlc fluid （control group） were collected, and t：leir peripartum results of vaginal trial labor were com- pared. Borderline oligoamnios was assessed by arnniotic fluid index （AWl）. S/I） ratio in umbilical artery, biophysical score, fetal monitoring and of 24 h urine E/C ratio were detected in both groups. Results The variable deceleration and late deceleration in oxy/ocin challenge test or contraction stress test, and the incidence of mild meconium-stained arnnioSc fluid and emergent cesarean section were significantly higher in observation group than those in control group （ P 〈 0.01 ）. There was no remarkable difference in the incidence of neonatal asphyxia between two groups （P〉0.05）. Conelmion The full-term pregnant women with borderline oligoarnnios may undergo vaginal trial labor under reasonable monitoring, if there is a lack of fetal distress.