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不同孕周时,与羊水胎粪污染相关的孕期“胎儿窘迫”的相对风险。

The relative risk of 'fetal distress' in pregnancy associated with meconium-stained liquor at different gestation.

作者信息

Wong S F, Chow K M, Ho L C

机构信息

Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Kowloon, Hong Kong SAR.

出版信息

J Obstet Gynaecol. 2002 Nov;22(6):594-9. doi: 10.1080/0144361021000020333.

Abstract

Pregnancies complicated with meconium-stained liquor are regarded as at risk of fetal distress. Evidence from animal and human studies indicate that passage of meconium may be related to fetal maturity. This retrospective study attempts to quantify the relative risk of non-reassuring cardiotocography or 'fetal distress' in pregnant women complicated by meconium-stained liquor for preterm, term and post-term pregnancies. A total of 9542 singleton pregnancies, delivered in a tertiary obstetric unit in Hong Kong between 1 July 1996 and 31 June 1999, were included in the study. Of these pregnancies, 1946 (20.4%) were identified as having meconium-stained liquor, ranging from thin to thick staining. There was a strong association between incidence of meconium-stained liquor (P < 0.0005) and moderate/thick meconium-stained liquor with advanced gestational age. The incidence of non-reassuring cardiotocography in women presenting with meconium-stained liquor was significantly higher (9.8% vs. 6.4%). The relative risk of non-reassuring cardiotocography in women with meconium-stained liquor increased with more advanced gestation. Close fetal surveillance during labour is required among these pregnancies. Premature labour is associated with higher incidence of fetal distress but the presence of meconium did not pose an additional risk.

摘要

羊水胎粪污染的妊娠被视为有胎儿窘迫风险。动物和人体研究的证据表明,胎粪排出可能与胎儿成熟度有关。这项回顾性研究试图量化早产、足月和过期妊娠中,羊水胎粪污染的孕妇出现胎心监护异常或“胎儿窘迫”的相对风险。该研究纳入了1996年7月1日至1999年6月31日期间在香港一家三级产科单位分娩的9542例单胎妊娠。在这些妊娠中,1946例(20.4%)被确定为羊水胎粪污染,污染程度从稀薄到浓稠不等。羊水胎粪污染的发生率(P < 0.0005)以及中度/浓稠羊水胎粪污染与孕周增加之间存在密切关联。羊水胎粪污染的女性出现胎心监护异常的发生率显著更高(9.8%对6.4%)。羊水胎粪污染女性出现胎心监护异常的相对风险随着孕周增加而升高。这些妊娠在分娩期间需要密切监测胎儿。早产与胎儿窘迫的发生率较高相关,但胎粪的存在并未带来额外风险。

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