妊娠晚期超声对羊水量评估的临床价值及其影响因素

The clinical value of ultrasonography and the influential factors in assessing amniotic fluid volume during late gestation

目的探讨妊娠晚期超声对羊水量评估的临床价值及其影响因素。方法彩色多普勒超声仪测量羊水指数(AFI),并与产后测得的实际羊水量(AAFV)进行比较,探讨其对AAFV的评估价值。同时记录孕妇的一般情况、产前7天内的超声参数及胎儿附属物等情况,研究影响羊水量(AFV)测量的相关因素,并对影响测量的各参数进行回归分析,预测羊水量。结果羊水过少(AFI≤50mm和AFI:51～79mm)、羊水量正常及羊水过多组的阳性预测值分别为82.6%、40.0%、93.1%、7.1%。AFI、胎儿腹围(AC)对羊水量测量有影响,且具有显著性差异(P<0.01)。进行回归分析得到回归方程,该方程与羊水过少的阳性预测有很好的相关性。结论超声对羊水过少(AFI≤50mm)和正常羊水量具有较高的评估价值,回归方程可以更加精确地估计羊水量。

Objective To study the clinical value of uhrasonography and the influential factors in the assessment of amniotie fluid volume daring the last pregnancy term. Methods Color Doppler ultrasound measurement of amniotic fluid index （AFI） was subsequently compared with postpartum actual amniotic fluid volume （AAFV） to investigate the clinical value of uhrasonography in assessing AAFV. Meanwhile, the general health status of the pregnant women, ultrasonic parameters during the last 7 prenatal days and fetal appendage were recorded to make a study of the influential factors. A regression analysis was conducted on the contributing parameters of uhrosonographic measurements to prognosticate AFV. Results The coincidence rates of postpartum oligohydramnios （ AFI ≤ 50 mm; AFI ： 51 - 79 mm）, normal amniotic fluid volume and polyhydramnios with uhrasonographic results were 82.6%, 40.0% , 93.1% and 7.1% , respectively. AFI and AC may affect uhrasonographic diagnoses, with significant differences. A regression equation y^ = 3.5 AFI ＋ 123 obtained by regression analysis was positively correlated with the prognostication of oligohydramnios. Conclusion Uhrasonography has considerable clinical value in assessing oligohydramnios （AFI ≤50 mm） and normal amniotic fluid volume, and regression equation serves to speculate AAFV with higher precision.