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Obstet Gynecol:孤立性羊水过多危害多

2015-03-11 Mechront MedSci原创

近期Aviram A等人进行了一项回顾性队列研究,以探究羊水过多孕妇在≥34周孕时阴道试产的妊娠结局。 研究纳入了2007-2012年间伴孤立的羊水过多(羊水指数AFI超过25cm,没有妊娠前糖尿病或糖尿病合并妊娠,没有胎儿大体结构或染色体异常等)的孕妇和羊水量正常(AFI 5-25cm)的孕妇,共计31,376人。其中215名(0.7%)孕妇为羊水过多,余下31,161名孕妇羊水量在正常范

近期Aviram A等人进行了一项回顾性队列研究,以探究羊水过多孕妇在≥34周孕时阴道试产的妊娠结局。

研究纳入了2007-2012年间伴孤立的羊水过多(羊水指数AFI超过25cm,没有妊娠前糖尿病或糖尿病合并妊娠,没有胎儿大体结构或染色体异常等)的孕妇和羊水量正常(AFI 5-25cm)的孕妇,共计31,376人。其中215名(0.7%)孕妇为羊水过多,余下31,161名孕妇羊水量在正常范围。

研究结果显示,羊水过多组比正常组在阴道试产过程中有更高的引产率(7.9% vs. 4.8%,P=0.04);更高的剖宫产率(12.1% vs.
5.1%, P<0.001);更多的胎盘早剥(0.9% vs.
0.2%, P=.02);更多的异常的胎心率FHR(7.0% vs. 3.2%, P=.002);更多的第一产程延长(6.0% vs. 1.4%, P<.001);更高的肩难产发生率(1.9% vs. 0.3%, P<.001);更多的新生儿呼吸窘迫综合征RDS(0.5% compared with 0.03%, P=.001)。

根据多因素回顾分析得出,孤立性羊水过多是以下情况的独立危险因子:试产时予以引产(诱导分娩)(aOR 1.7, 95% CI 1.01-2.8);剖宫产 (aOR 2.6, 95% CI 1.7-4.0);第一产程延长(aOR 3.6, 95% CI 1.97-6.7);异常的胎心率FHR(aOR 2.6, 95% CI 1.6-4.5);胎盘早剥(aOR 8.4, 95%
CI 2.00-35.4);肩难产(aOR 3.4, 95% CI 1.2-9.7);呼吸窘迫综合征RDS(aOR 38.9, 95% CI 4.6-332.6)。轻度孤立性羊水过多AFI(25.1-30.0cm)是剖宫产、第一产程延长、胎盘早剥、异常FHR和肩难产的独立危险因素。


研究结果表明:孤立性羊水过多的孕妇在≥34周孕时阴道试产与众多不良妊娠结局有关。

原始出处:

Aviram A1, Salzer L, Hiersch L, Ashwal E, Golan G, Pardo J, Wiznitzer A, Yogev Y.Association of Isolated Polyhydramnios at or Beyond 34 Weeks of Gestation and Pregnancy Outcome.Obstet Gynecol. 2015 Mar 5. [Epub ahead of print]

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    2015-09-01 yhy100200
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    2015-12-06 陈吴1243
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    2015-03-13 jxrzshh

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