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羊水过少的诊断处理与围产儿预后 |
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梁梅英 呼松月 王山米
摘要 目的 探讨羊水过少的早期诊断及适当的产科处理与围产儿预后的关系。方法 对1994～1996年我院101例羊水过少病例进行分析，并与正常分娩者进行对比。结果 我院羊水过少发生率为2.98%，其胎儿宫内窘迫、胎儿宫内发育迟缓、新生儿窒息及吸入性肺炎发生率明显高于正常分娩组(P＜0.05)。产前以B超羊水指数(AFI)≤8为诊断标准，其诊断率为38.39%，符合率为95%；另有22.2%AFI在8.1～12.0间，有39.4% AFI＞12。妊娠合并症伴发羊水过少易发生在37周后，正常妊娠在40周后。结论 应重视对妊娠合并症在37周后及正常妊娠在40周后B超对羊水的动态监测，但因其局限性，需结合临床胎心监护以提高对羊水过少的诊断率。在分娩方式上，羊水过少不是剖宫产的绝对手术指征，应结合有无高危因素、胎心监护情况及宫颈条件综合选择适当的分娩方式。阴道分娩中强调严密监护，控制产程，作好新生儿复苏。
关键词 羊水过少 羊水指数 围产儿预后
Diagnosis and treatment of oligohydramnios and it's effect on fetal outcome
Liang Meiying，Hu Songyue，Wang Shanmi
(Department of Obstetrics and Gynecology,People's Hospital,
Beijing Medical University,Beijing 100044)
Abstract Objective To assess the relationship between the early diagnosis and properly treatment of oligohydramnios and fetal outcome.Methods A total of 101 cases of oligohydramnios from 1994 to 1996 were analyzed and compared with normal parturition.Results The incidence of oligohydramnios was 2.98%.The rate of fetal distress,IUGR,neonatal asphyxia and pneumonia in oligohydramnios group were statistically higher than in the control group respectively.The B-model ultrasound measured amniotic fluid index(AFI)≤8 was taken as the diagnostic standard for oligohydramnios.With this standard,38.39% of patients were diagnosed with oligohydramnios,and the AFI between 8.1 to 12.0 were seen in 22.2%,AFI＞12 in 39.4%.Conclusions Oligohydramnios resulted from pregnant complications was usually happened after the 37th week of pregnancy,and in normal pregnant women usually after the 40th week of pregnancy.
Key words Oligohydramnios Amniotic fluid index Fetal outcome
羊水过少是产科需要重视的合并症，因其围产儿窒息率、死亡率明显增高，及早诊断、恰当处理直接影响到围产儿预后。我们通过对我院2年中产后确诊为羊水过少的101例进行分析，对其诊断与处理进行探讨，以更好地改善围产儿预后。
资料与方法
一、一般资料
我院1994年1月至1996年7月分娩总数3 386例，产后确诊为羊水过少101例，发生率为2.98%。孕妇年龄23～41岁。孕周33+4～42+1周，其中＜37周4例，37～41+6周96例，＞42周1例。头位83例，[1] [2] 下一页
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