残余羊水量对未足月胎膜早破产妇及胎儿结局的影响

Effect of residual amniotic fluid volume on maternal and fetal outcomes of preterm premature rupture of membranes

目的研究残余羊水量对未足月胎膜早破(PPROM)产妇及胎儿结局的影响。方法选择2014年10月~2017年11月我院收治的PPROM孕妇160例,根据羊水指数(amniotic fluid index,AFI)将患者分为两组:羊水正常组(AFI>50 mm)和羊水量不足组(AFI≤50 mm)。比较两组一般资料、分娩情况、产妇及胎儿妊娠结局。结果羊水正常组孕妇正常分娩的比例(72.17%)明显高于羊水不足组(35.56%)(P<0.01),羊水不足组剖宫产(62.22%)的比例明显高于羊水正常组(27.83%),且差异有统计学意义(P<0.01);羊水不足组发生绒毛膜羊膜炎、子宫内膜炎、产褥感染和羊水污染的比例明显高于羊水正常组(P<0.01);羊水不足组发生胎儿窘迫、胎儿窒息、低体重出生儿和新生儿呼吸窘迫综合征的比例高于羊水正常组(P<0.05);羊水不足组的新生儿Apgar评分明显低于羊水正常组(P<0.01)。结论残余羊水量可影响PPROM产妇及胎儿结局,应关注并监测残余羊水量,及时终止妊娠,减少不良妊娠结局。

Objective To study the effect of residual amniotic fluid on the outcome of puerpera and fetus with pretermpremature rupture of membranes（PPROM）. Methods 160 pregnant women with PPROM who were admitted to our hospital from October 2014 to November 2017 were selected. Patients were divided into two groups according to the amniotic fluid index（AFI）： normal aminotic fluid group（AFI〉50 mm）and amniotic fluid deficiency group （AFI〉50 mm）.The general information, delivery, maternal and fetal pregnancy outcomes were compared between the two groups. ResultsThe proportion of normal delivery in pregnant women in the normal amniotic fluid group（72.17%） was significantlyhigher than that in amniotic fluid deficiency group（35.56%）（P〈0.01）. The proportion of Cesarean section（62.22%）in the amniotic fluid deficiency group was significantly higher than that in the normal amniotic fluid group（27.83%）, andthe difference was statistically significant（P〈0.01）; the proportion of chorioamnionitis, endometritis, puerperal infection and amniotic fluid contamination in the amniotic fluid deficiency group was significantly higher than that in thenormal amniotic fluid group（P〈0.01）; the proportion of fetal distress, fetal asphyxia, low birth weight infant and neonatalrespiratory distress syndrome in the amniotic fluid deficiency group was higher than that in the normal amniotic fluidgroup（P〈0.05）; the Apgar score of neonates in the amniotic fluid deficiency group was significantly lower than that inthe normal amniotic fluid group（P〈0.01）. Conclusion The residual amniotic fluid volume can affect the pregnancy outcome of PPROM puerpera and fetuses. Attention should be paid to and monitor the amount of residual amniotic fluid,terminate pregnancy in time, and reduce adverse pregnancy outcomes.