Chauhan Suneet P, Taylor Michelle, Shields Dawn, Parker Donna, Scardo James A, Magann Everett F
Maternal-Fetal Medicine, Aurora Health Care, West Allis, Wisconsin 53227, USA.
Am J Perinatol. 2007 Apr;24(4):215-21. doi: 10.1055/s-2007-972926.
The purposes of this study were (1) to determine the prevalence of oligohydramnios (amniotic fluid index < 5.0 cm) among fetuses with intrauterine growth restriction (IUGR) and newborns identified as small for gestational age (SGA), and (2) among fetuses with IUGR, to determine the predictive accuracy of amniotic fluid index (AFI) < or = versus > 5.0 cm for adverse peripartum outcomes. This was a retrospective review of high-risk pregnancy that had reliable gestational age (GA) and needed weekly biophysical profile (BPP). Along with 95% confidence intervals (CIs), we calculated the likelihood ratios (LRs) and used guidelines promulgated by Evidence-Based Medicine Working Group. Among the 1859 singletons undergoing BPP, IUGR (estimated fetal weight < 10% for GA) was suspected in 22% (n = 410) and the prevalence of oligohydramnios was 6% (95% CI, 4 to 8%). SGA (birthweight < or = 10%) occurred among 28% (n = 517) of newborns and oligohydramnios was noted in 6% (95% CI, 4 to 8%). Among fetuses with IUGR, the LR of oligohydramnios to predict cesarean delivery for nonreassuring fetal heart tracing was 2.0 (range, 0.8 to 5.0); for newborns small for gestational age, 1.9 (range, 1.2 to 3.1), and for neonatal intensive care unit admission, 1.4 (range, 0.6 to 2.3) More than 90% of patients with IUGR or SGA have AFI > 5.0 cm, and oligohydramnios with IUGR is a poor predictor of peripartum complications.
（1）确定宫内生长受限（IUGR）胎儿及出生时确定为小于胎龄儿（SGA）的新生儿中羊水过少（羊水指数<5.0 cm）的患病率；（2）在IUGR胎儿中，确定羊水指数（AFI）≤5.0 cm与>5.0 cm对围产期不良结局的预测准确性。这是一项对具有可靠孕周（GA）且需要每周进行生物物理评分（BPP）的高危妊娠的回顾性研究。我们计算了95%置信区间（CIs），似然比（LRs），并采用循证医学工作组发布的指南。在接受BPP的1859例单胎妊娠中，22%（n = 410）怀疑有IUGR（估计胎儿体重<GA的第10百分位数），羊水过少的患病率为6%（95%CI，4%至8%）。28%（n = 517）的新生儿为SGA（出生体重≤第10百分位数），其中6%（95%CI，4%至8%）有羊水过少。在IUGR胎儿中，羊水过少预测因胎儿心率异常而行剖宫产的LR为2.0（范围0.8至5.0）；对于小于胎龄儿，LR为1.9（范围1.2至3.1），对于入住新生儿重症监护病房，LR为1.4（范围0.6至2.3）。超过90%的IUGR或SGA患者AFI>5.0 cm，IUGR合并羊水过少对围产期并发症的预测价值较差。
