足月妊娠可疑羊水过少孕妇阴道试产的探讨

The effects of suspected oligohydramnios in full-term pregnancy women to be deliveried

目的 分析足月妊娠妇女超声检查提示可疑羊水过少时，阴道试产对围生期结局的影响。方法应用羊水指数（AFI）估测羊水量，并测定脐动脉收缩期最大血流速度（S）和舒张末期血流速度（D）比值（S／D），测定血雌三醇（E3），结合胎无应激试验（NST）和缩宫素激惹试验（OCT）或宫缩应激试验（CST）进行综合评价无异常，分析比较320例超声诊断可疑羊水过少的足月妊娠妇女（观察组）和320例羊水量正常无高危因素的足月妊娠妇女（对照组）阴道试产的分娩结局。结果两组新生儿窒息的发生率（9．1％与11．8％）和新生儿死亡率差异无统计学意义（P〉0．05），观察组急诊剖宫产率（30．0％）升高（P〈0．05）。结论超声诊断可疑羊水过少的足月妊娠妇女，在严密监护下可行阴道试产。

Objective To study the effects of oligohydramnios in full-term pregnancy women deliveried on the perinatal outcomes. Methods 320 suspected otigohydramnios cases from January 2008 to June 2009 were taken as observation group, and compared with 320 cases full-term pregnant women with normal amniotic fluid and without any high-risk factors as control group. B-type ultras onography was used to determine the volume and index of amniotic fluid and fetal umbilical blood flow index （S/D）. Blood estriol was determined combining with non-stress test（NST） and oxytocin challenge test（OCT） or contraction stress test（CST） examination to evaluate maternal and fetal situation. The perinatal outcomes of the two groups was analyzed and compared. Result The neonatal asphyxiation and mortality rate between the two groups had no significant difference（ P 〉 0.05 ）. The rate of cesarean section in the observation group was increased （ P 〈 0.05 ）. Conclusion The term pregnancy women with oligohydramnion during labour diagnosed by B-type ultrasonography should select vaginal delivery based on comprehensive examination.