催产素引产前羊膜腔内灌注对羊水过少母儿结局的影响

The effect of oxytocin induction after transabdominal amnioinfusion on perinatal outcome in term pregnancy oligohydramnios

目的研究经腹羊膜腔内灌注(antepartum transabdominal amnioinfusion,APTA)后再行催产素引产对足月妊娠羊水过少母儿围产结局的影响。方法选择产前经B超检查诊断为羊水过少,孕周≥37周,有阴道分娩适应证,未临产患者96例,将其随机分为观察组和对照组,每组48例。观察组予APTA后再行催产素引产,对照组48例常规静脉滴注催产素引产。观察APTA并发症的发生、两组的分娩方式及新生儿结局。结果观察组APTA术均顺利完成,术中术后无并发症发生。观察组的缩宫素激惹试验(oxytocin challenge test,OCT)阳性率、剖宫产率、羊水Ⅲ度污染率均小于对照组,差异有显著性(P<0.05);新生儿重度窒息率比较,两组间无显著性差异(P>0.05)。结论产前羊膜腔内灌注可以有效扩充羊水,联合催产素引产可以有效地提高足月妊娠羊水过少患者阴道分娩率,降低剖宫产率,改善新生儿结局;APTA安全、经济,值得临床推广使用。

Objective To study the effect of oxytocin induction after antepartum transabdominal amnio-infusion（APTA） on perinatal outcome in term pregnancy oligohydramnios. Methods There were 96 cases with term pregnancy and oligohydramnios found by B-ultrasound that were divided into two groups. Forty-eight cases in experiment group were given Sodium Chloride through the amnioinfusion and the oxytocin intravenously guttae 2-hour later for induced labor. Another 48 cases in control group were carried out the oxytocin intravenously guttae for induced labor. The complications of APTA,delivery modes and perinatal outcome were observed and compared. Results All APTA of cases in experiment group were fulfilled successfully and there was no complications. The positive rate of oxytocin challenge test（OCT）,cesarean section rate and amniotic fluid Ⅲ°pollution rate in experiment group were lower than that in control group and there was significant difference（P〈0.05）. There was no significant difference in severe asphyxia in newborn（P〉0.05）. Conclusion It could increase vaginal delivery rate of cases with oligo-hydramnios,decrease the incidence of cesarean section and improve perinatal outcome of the APTA and oxytocin induction. It was worth spreading that APTA was safe and economic.