Chen Kuang-Chao, Liou Jui-Der, Hung Tai-Ho, Kuo Dong-Ming, Hsu Jenn-Jeih, Hsieh Ching-Chang, Hsieh Tsang-Tang
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital. 199, Duenhua N. Road, Sungshan Chiu, Taipei, Taiwan 105, ROC.
Chang Gung Med J. 2005 Apr;28(4):222-8.
Polyhydramnios carries a high rate of complications during pregnancy and adverse perinatal outcomes. We could find no studies of this condition in a large Asian population. The aim of this investigation was to evaluate the risks of adverse perinatal outcomes in a large study population with polyhydramnios without associated fetal anomalies after the gestational age of 20 weeks in Taiwan.
We retrospectively reviewed the computerized records of women who had babies without associated fetal anomalies after the gestational age of 20 weeks at Chang Gung Memorial Hospital from July 1990 to December 2001. Possible confounding factors that could affect the occurrence of polyhydramnios were analyzed. We then investigated the relative risks of these events to adverse perinatal outcome by adjusting the variants.
Significantly higher incidences of preeclampsia, placental abruption, placenta accreta, past history of fetal death or preterm delivery, multiple pregnancy, bodyweight gain > or = 20kg during pregnancy and primiparity were noted in patients with polyhydramnios than in patients without this condition. The presence of polyhydramnios significantly increased the rate of preterm delivery, low birth weight or very low birth weight, low one- and five-minute Apgar scores, fetal death, large for gestational age babies, meconium-stained amniotic fluid, Cesarean section, fetal distress in labor, NICU transfer and neonatal death.
Polyhydramnios carried a higher incidence of adverse perinatal outcomes, such as low Apgar scores, fetal death, fetal distress in labor, NICU transfer and neonatal death, despite exclusion of congenital anomalies from the study population. Detailed antepartum fetal well-being surveillance, intensive intrapartum monitoring and further attention postpartum are warranted in patients with this condition.
羊水过多在孕期并发症发生率高，围产期不良结局风险大。我们未在大型亚洲人群中找到关于此病症的研究。本调查旨在评估台湾地区孕20周后羊水过多且无相关胎儿异常的大型研究人群中围产期不良结局的风险。
我们回顾性分析了1990年7月至2001年12月在长庚纪念医院分娩且孕20周后胎儿无相关异常的产妇的计算机化记录。分析了可能影响羊水过多发生的混杂因素。然后通过调整变量研究这些事件与围产期不良结局的相对风险。
羊水过多患者的子痫前期、胎盘早剥、胎盘植入、既往胎儿死亡或早产史、多胎妊娠、孕期体重增加≥20kg及初产的发生率显著高于无此情况的患者。羊水过多显著增加了早产、低出生体重或极低出生体重、1分钟和5分钟阿氏评分低、胎儿死亡、大于胎龄儿、羊水粪染、剖宫产、产时胎儿窘迫、转入新生儿重症监护病房（NICU）及新生儿死亡的发生率。
尽管研究人群排除了先天性异常，但羊水过多仍有较高的围产期不良结局发生率，如阿氏评分低、胎儿死亡、产时胎儿窘迫、转入NICU及新生儿死亡。对于患有此病症的患者，产前应进行详细的胎儿健康监测，产时应加强监护，产后也需进一步关注。
