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羊水过少的临床考量

[Clinical considerations on oligohydramnios].

作者信息

Corosu R, Moretti S, Lucchini C, Vizzaccaro F

机构信息

I Istituto di Clinica Ostetrica e Ginecologica IV Divisione, Università degli Studi di Roma, La Sapienza.

出版信息

Minerva Ginecol. 1999 Jun;51(6):219-22.

Abstract

BACKGROUND

Oligohydramnios represents a physiopathologic process, associated to a high rate of pregnancy complications and increased fetal morbidity and mortality. The purpose of this study is to determine whether amniotic fluid ultrasound evaluation is a useful parameter to identify pregnancies at risk for fetal distress.

METHODS

91 pregnant women with oligohydramnios were followed, and fetal conditions monitored with cardiotocography and ultrasounds. Delivery way and new-born conditions at birth were considered too.

RESULTS

Cardiotocograms appeared abnormal in 61 cases (67%). Intrauterine growth restriction (IUGR) observed in 36 cases (39.56%). Cesarean section was performed in 60 cases (66%) for fetal distress, identified with cardiotocography. Also significant was the correlation with oligohydramnios, IUGR and cardiotocographic anomalies. From the results, it may be inferred that oligohydramnios is an index of affected fetal good health, because frequently is related with pregnancy anomalies and fetal health involvement.

CONCLUSIONS

We can then affirm that the ultrasound evaluation of amniotic fluid represents a useful means to identify pregnancies at risk for fetal distress. In case of oligohydramnios, it is important to increase the surveillance on fetus, with the different means at our disposal (ultrasonography, velocimetry, cardiotocography).

摘要

背景

羊水过少是一种病理生理过程,与高妊娠并发症发生率以及胎儿发病率和死亡率增加相关。本研究的目的是确定羊水超声评估是否是识别有胎儿窘迫风险妊娠的有用参数。

方法

对91例羊水过少的孕妇进行随访,并用胎心监护和超声监测胎儿状况。同时也考虑分娩方式和出生时新生儿状况。

结果

61例(67%)胎心监护结果异常。36例(39.56%)观察到胎儿宫内生长受限(IUGR)。因胎心监护确定为胎儿窘迫,60例(66%)进行了剖宫产。羊水过少、IUGR与胎心监护异常之间的相关性也很显著。从结果可以推断,羊水过少是胎儿健康受影响的一个指标,因为它经常与妊娠异常和胎儿健康问题相关。

结论

我们可以确定,羊水的超声评估是识别有胎儿窘迫风险妊娠的有用手段。在羊水过少的情况下,利用我们所掌握的不同手段(超声检查、血流速度测定、胎心监护)加强对胎儿的监测很重要。

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