Barrilleaux P Scott, Magann Everett F, Chauhan Suneet P, York Brian M, Philibert Lisa, Lewis David F
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
J Reprod Med. 2007 Apr;52(4):293-8.
To evaluate the prognostic value of an amniotic fluid index (AFI) < or = 5 cm for an adverse perinatal outcome in pregnancies with the syndrome of hemolysis, elevated liver enzymes and low platelets (HELLP syndrome).
A prospective, observational study of patients with the HELLP syndrome. An ultrasound estimate of amniotic fluid volume was obtained on admission. Adverse intrapartum outcomes included amnioinfusion for variable decelerations and/or indicated abdominal/vaginal operative delivery for nonreassuring fetal heart rate changes. Maternal characteristics and perinatal outcome parameters were compared AFI < or = vs. > 5 cm. Statistical analysis was performed using chi2 analysis, Student's t test and receiver-operator characteristic curve (ROC) analysis.
Between January 1996 and February 1999, 120 patients were enrolled. Twenty-six (22%) had an AFI < or = 5 cm. This group did not differ from that with AFI > 5 cm regarding the severity of the HELLP syndrome, admission-to-delivery interval (p = 0.354), variable decelerations in labor (p = 0.06), Apgar score of < 7 at 5 minutes (p = 0.361), cesarean delivery for nonreassuring fetal status (p = 1.0) or significant fetal acidosis (pH < 7.0 [p = 0.2101). ROC analysis revealed no AFI measurement between 0 and 16 cm that was useful for identifying the compromised fetus.
Antepartum/intrapartum performance of AFI in patients with the HELLP syndrome is a poor prognostic test for subsequent fetal compromise.
评估羊水指数（AFI）≤5cm对溶血、肝酶升高及血小板减少综合征（HELLP综合征）孕妇围产期不良结局的预后价值。
对HELLP综合征患者进行一项前瞻性观察研究。入院时通过超声估计羊水量。分娩期不良结局包括因变异减速行羊水灌注和/或因胎儿心率变化异常而行剖宫产或阴道助产。比较AFI≤5cm和＞5cm的孕妇的母体特征及围产期结局参数。采用卡方分析、学生t检验和受试者工作特征曲线（ROC）分析进行统计学分析。
1996年1月至1999年2月，共纳入120例患者。26例（22%）AFI≤5cm。该组与AFI＞5cm组在HELLP综合征严重程度、入院至分娩间隔时间（p = 0.354）、产程中变异减速（p = 0.06）、5分钟时Apgar评分＜7分（p = 0.361）、因胎儿状况异常行剖宫产（p = 1.0）或显著胎儿酸中毒（pH＜7.0 [p = 0.2101]）方面无差异。ROC分析显示，0至16cm之间没有AFI测量值可用于识别受损胎儿。
HELLP综合征患者产前/产时的AFI表现对随后胎儿受损情况的预后判断价值不大。
