羊水过少产妇不同分娩方式对临床分娩结局的影响研究

Study on Effect of Different Delivery Methods on the Clinical Delivery Outcome of Delivery Women with Oligohydramnios

目的研究足月妊娠羊水过少产妇不同分娩方式对临床分娩结局的影响。方法方便选取该院在2016年12月—2017年6月期间收治的足月妊娠羊水不足产妇50例,划入观察组,将同期羊水正常产妇50名划入对照组,观察组产妇按照各自分娩方式又划定为两类,即阴道分娩(29例)与剖宫产(21例),记下该两组产妇的剖宫产率与羊水指数、以及分娩之后的羊水量、两组产妇及婴儿的不良反应现象并进行对比。结果观察组剖宫产率为42%(21/50),明显高于对照组,差异有统计学意义(χ~2=7.284,P<0.05)。此外,观察组阴道分娩组新生儿体重、产后羊水量、羊水指数和新生儿评分分别为(3 104.6±283.6)g、(214.1±57.2)mL、(5.3±0.7)和(9.9±0.7)分,阴道分娩组和剖宫产组上述指标对比,差异无统计学意义(P>0.05)。观察组胎儿窘迫、脐带绕颈、新生儿窒息和产后出血发生率分别为16.0%、10.0%、14.0%、12.0%,明显高于对照组(χ~2=5.003、6.921、5.703、6.004),但观察组围生儿死亡率为4.0%,与对照组对比,差异无统计学意义(χ~2=1.903,P>0.05)。结论妊娠产妇及婴儿的结局虽然主要受到羊水总量的影响,但是亦会受到分娩方式的影响。所以需考虑产妇的具体检查状况后,周密研判是否有必要做剖宫产术,以使母婴获得更理想的结局。

Objective To research the effect of different delivery methods on the clinical delivery outcome of delivery women with oligohydramnios. Methods 50 cases of delivery women with full-term gestational oligohydramnios admitted and treated in our hospital from December 2016 to June 2017 were convenient selected as the observation group, 50 cases of delivery women with normal amniotic fluid at the same period were selected as the control group, and the observation group were divided into two groups, the cesarean section rate and amniotic fluid index, amniotic fluid amount after delivery, and adverse reactions of delivery women and infants of the vaginal delivery group（29 cases） and cesarean section group（21 cases）were compared. Results The cesarean section rate in the observation group was 42%（21/50）, which was obviously higher than that in the control group, and the difference was statistically significant（χ~2=7.284,P〈0.05）, besides, the weight of newborns, amniotic fluid amount after delivery, amniotic fluid index and score of newborns were respectively（3 104.6±283.6）g,（214.1±57.2）mL,（5.3±0.7）,（9.9±0.7）points, and there were no obvious differences, without statistical significance（P〈0.05）,and the incidence rates of fetal distress, umbilical cord around the neck, neonatal asphyxia and postpartum bleeding in the observation group were respectively 16.0%,10.0%,14.0%,12.0%, which were obviously higher than those in the control group（χ~2=5.003,6.921,5.703,6.004）, and the perinatal mortality in the observation group was 4.0%, and the difference between the two groups was statistically significant（χ~2=1.903,P〉0.05）. Conclusion The outcome of pregnant women and infants is mainly affected by the total amount of amniotic fluid, however, it is also affected by the delivery method, therefore, we should comprehensively determine whether the cesarean section surgery is necessary after the specific examination of delivery women to obtain a more ideal maternal and infant outcome.