经腹羊膜腔穿刺羊水减量术治疗妊娠合并羊水过多的效果及胎儿死亡率分析

Effect of Transabdominal Amniocentesis Amniotic Fluid Reduction in the Treatment of Pregnancy with Polyhydramnios and Analysis of Fetal Mortality

目的:分析经腹羊膜腔穿刺羊水减量术治疗妊娠合并羊水过多的效果及胎儿死亡率。方法:回顾性分析本院收治的62例妊娠合并明显羊水过多孕产妇,按照治疗方法分为手术组(n=29,使用经腹羊膜腔穿刺羊水减量术治疗)与药物组(n=33,经常规药物治疗)。比较治疗前及治疗1周后两组孕产妇羊水指数(AFI)水平,记录手术组孕产妇术后1周内并发症发生情况,比较两组分娩方式、围产期并发症、围生儿结局、胎儿娩出后1 min窒息情况(Apgar评分)。结果:治疗1周后,两组孕产妇AFI水平均明显降低,且手术组明显低于药物组(P<0.05);手术组术后并发症经处理后均可自行缓解;手术组孕产妇经阴道分娩率、胎儿娩出后1 min Apgar评分均明显高于药物组(P<0.05);手术组孕产妇围产期并发症发生率、围生儿宫内窘迫、窒息、脐带脱垂及死亡率均明显低于药物组(P<0.05)。结论:经腹腔穿刺羊水减量术治疗妊娠合并羊水过多可明显降低孕产妇孕晚期AFI水平、围产期并发症发生率及围生儿死亡率,具有较高临床应用价值。

Objective:To analyze the effect and fetal mortality of transabdominal amniocentesis in the treatment of pregnancy complicated with polyhydramnios.Method:A total of 62 pregnant women with obvious polyhydramnios in our hospital were retrospectively analyzed and divided into the operation group(n=29,treated with transabdominal amniocentesis amniotic fluid reduction)and the drug group(n=33,treated with regular drug)by treatment method.The amniotic fluid index(AFI)levels of the two groups were compared before and after 1 week of treatment.The incidence of complications within 1 week after operation in the operation group was recorded.The delivery mode,perinatal complications,perinatal outcome and asphyxia 1 min after delivery(Apgar score)of the two groups were compared.Result:After 1 week of treatment,the AFI levels of the two groups were significantly decreased,and the operation group was significantly lower than that of the drug group(P<0.05);the postoperative complications of the operation group could be alleviated by themselves after treatment;the vaginal delivery rate of the operation group,1 min after the delivery of the fetus Apgar scores were significantly higher than those in the drug group(P<0.05);the incidence of perinatal complications,perinatal distress,asphyxia,umbilical cord prolapse and mortality in the operation group were significantly lower than those in the drug group(P<0.05).Conclusion:Transabdominal amniocentesis in the treatment of pregnancy with polyhydramnios can significantly reduce the level of AFI in late pregnancy,the incidence of perinatal complications and perinatal mortality.