完全足月妊娠可疑羊水过少不同处理方法的临床研究
Clinical study of different treatment methods for full term suspected oligohydramnios
田星月 1翟建军 1冯碧波1
作者信息
- 1. 100176 北京,首都医科大学附属北京同仁医院妇产科
- 折叠
摘要
目的 回顾性探究完全足月(39～40+6周)妊娠可疑羊水过少不同治疗方法的有效性和安全性.方法 选取2019年1月至2020年12月在首都医科大学附属北京同仁医院产科住院的孕39～40+6周、无阴道分娩禁忌症、有阴道试产意愿、可疑羊水过少的孕妇160例作为研究对象,按照治疗方法将孕妇分为期待治疗组78例和终止妊娠组82例.期待治疗组孕妇年龄(30.0±2.9)岁,分娩孕周(40.0±1.2)周.终止妊娠组孕妇年龄(30.8±2.7)岁,分娩孕周(39.1±1.2)周.比较不同处理方式的两组妊娠结局及新生儿情况.结果 期待治疗组的分娩孕周大于终止妊娠组(P＜0.05),但两组的剖宫产率差异无显著性.期待治疗组胎儿窘迫率、羊水胎粪污染率、绒毛膜羊膜炎发生率均高于终止妊娠组(P＜0.05),新生儿转入儿科率高于终止妊娠组(P＜0.05).本研究中新生儿窒息发生率为3.1％.新生儿体重、新生儿窒息、新生儿脐动脉PH＜7、新生儿1 minApgar评分＜7分组间差异无显著性.结论 若发现可疑羊水过少且孕周大于39周、无阴道分娩禁忌症,可考虑促宫颈成熟后积极引产.
Abstract
Objective To retrospectively investigate the efficacy and safety of different treatment modalities for suspected oligohydramnios in full-term(39-40+6 weeks)pregnancies.Methods A total of 160 pregnant women with suspected oligohydramnios,admitted to the Department of Obstetrics at Beijing Tongren Hospital,Capital Medical University from January 2019 to December 2020,were included as study participants.Based on the treatment methods,the pregnant women were categorized into two groups:expectant management group(n=78)and termination pregnancy group(n=82).The expectant management group had a mean age of 30.0±2.9 years and a mean gestational age of 40.0±1.2 weeks,while the termination pregnancy group had a mean age of 30.8±2.7 years and a mean gestational age of 39.1±1.2 weeks.The pregnancy outcomes and neonatal conditions of the two groups with different treatment methods were compared.Results The gestational age of expectant management group was significantly longer than that of termination pregnancy group,and there was no significant difference in the cesarean section rate between the two groups.The rate of fetal distress,amniotic fluid meconium contamination and chorioamnionitis in expectant management group were significantly higher than those in termination pregnancy group(P＜0.05).The rate of neonatal transfer to the pediatric department in expectant management group was significantly higher than that in termination pregnancy group(P＜0.05).The incidence of neonatal asphyxia in this study was 3.1％.There was no significant difference in neonatal weight,neonatal asphyxia,umbilical artery pH＜7 and neonatal Apgar score＜7 in 1 minute between the two groups.Conclusion For suspicious oligohydramnios pregnancies with gestational age is greater than 39 weeks and without contraindication for vaginal delivery,active labor induction after cervical ripening can be considered.
关键词
可疑羊水过少/完全足月妊娠/期待治疗/终止妊娠Key words
suspected oligohydramnios/full term pregnancy/expectant treatment/terminate pregnancy引用本文复制引用
基金项目
吴阶平医学基金会临床科研专项资助基金(320.6750.2021-04-46)
出版年
2024
NETL
NSTL
万方数据