张掖地区羊水过少对母婴结局的影响

Effect of oligohydramnios on maternal and infantile outcomes in Zhangye area

目的调查分析张掖地区羊水过少对母婴结局的影响。方法选取2014年6月-2016年6月在该院分娩的168例孕妇为研究对象,其中孕晚期羊水过少58例(观察组),羊水正常110例(对照组),对两组孕妇的临床资料及母婴结局进行回顾性分析。结果观察组的延期妊娠率、剖宫产率、产后出血率及产后感染率分别为24.14%、82.76%、6.90%和8.62%,均显著高于对照组的10.00%、68.18%、0.91%和0.91%,差异均有统计学意义(P<0.05);观察组的新生儿窒息率、胎儿窘迫发生率、Ⅱ~Ⅲ度羊水粪染发生率、围产儿死亡率分别为24.14%、25.86%、13.79%、5.17%,均显著高于对照组(4.55%、7.27%、4.55%、0),差异均有统计学意义(P<0.05)。观察组的平均产后出血量(320.4±61.5)ml显著高于对照组(202.1±50.4)ml,差异有统计学意义(P<0.05)。结论妊娠晚期羊水过少会增加剖宫产率及羊水粪染、胎儿窘迫、新生儿窒息发生风险,对母婴结局造成不利影响,临床应对孕妇加强围生期监测与保健,积极处理羊水过少,以改善母婴结局。

Objective To investigate and analyze the effect of oligohydramnios on maternal and infantile outcomes in Zhangye area.Methods A total of 168 pregnant women who gave birth to their babies in the hospital from June 2014 to June 2016 were selected and divided into observation group（ including 58 cases with oligohydramnios during the third triemster of pregnancy） and control group（ including110 cases with normal amniotic fluid）. The clinical data of pregnant women,maternal and infantile outcomes were retrospectively analyzed.Results The delayed pregnancy rate,cesarean section rate,postpartum hemorrhage rate and puerperal infection rate in observation group were 24. 14%,82. 76%,6. 90%,and 8. 62%,respectively,which were statistically significantly higher than those in control group（ 10. 00%,68. 18%,0. 91%,and 0. 91%,respectively）（ P〈0. 05）. The incidence rates of neonatal asphyxia,fetal distress,meconium-staining amniotic fluid of degree Ⅱ-Ⅲ,and perinatal mortality in observation group were 24. 14%,25. 86%,13. 79%,and 5. 17%,respectively,which were statistically significantly higher than those in control group（ 4. 55%,7. 27%,4. 55%,and 0. 00%,respectively）（ P〈0. 05）. The average volume of postpartum hemorrhage in observation group was（ 320. 4±61. 5） ml,which was statistically significantly higher than that in control group [（ 202. 1±50. 4） ml]（ P〈0. 05）. Conclusion Oligohydramnios during the third triemster of pregnancy will increase cesarean section rate and the risk of meconium-staining amniotic fluid,fetal distress,and neonatal asphyxia,which has adverse impact on maternal and infantile outcomes. Perinatal monitoring and health care should be strengthened,oligohydramnios should be treated actively to improve maternal and infantile outcomes.