Yan-Rosenberg Linli, Burt Borislava, Bombard Allan T, Callado-Khoury Fady, Sharett Loren, Julliard Kell, Weiner Zeev
Department of Obstetrics and Gynecology, Lutheran Medical Center, Brooklyn, NY 11220, USA.
J Matern Fetal Neonatal Med. 2007 Oct;20(10):715-8. doi: 10.1080/14767050701516204.
To compare the treatment of acute intravenous hydration with placebo in term pregnant women manifesting oligohydramnios.
All patients with oligohydramnios who met the inclusion criteria were offered participation in this randomized, double-blind, placebo-controlled study. After ruling out rupture of membranes and maternal and fetal complications, we recruited 44 women with third trimester singleton pregnancies having an amniotic fluid index (AFI) of less than 6. Patients were randomized into treatment or control groups. Patients in the treatment group received a continuous intravenous infusion of (1/2) normal saline (NS) at a rate of 1000 mL/h for two hours. Patients in the placebo group received an intravenous infusion of (1/2) NS at 10 mL/h for two hours. The AFI was re-assessed by the same sonographer one hour after the hydration was completed. Both the patient and the examiner were blinded to the study groups.
Maternal age, parity, gestational age, and birth weight were not significantly different between the two groups. The AFI increased significantly in both treatment (3.8 +/- 1.2 vs. 5.3 +/- 2.5, p < 0.05) and placebo (4 +/- 1.3 vs. 5.5 +/- 2.4, p < 0.05) groups. Moreover, the changes in AFI did not significantly differ between the treatment and the placebo groups (1.2 +/- 2.1 vs. 1.5 +/- 2.1, respectively; p > 0.05).
There are statistically significant short-term increases in the AFI in patients with oligohydramnios whether the patients are treated with intravenous fluids or not. The short-term increase in AFI may reflect physiologic diurnal variations in the amniotic fluid.
比较足月羊水过少孕妇急性静脉补液与安慰剂治疗的效果。
所有符合纳入标准的羊水过少患者均受邀参与这项随机、双盲、安慰剂对照研究。在排除胎膜破裂及母婴并发症后，我们招募了44例孕晚期单胎妊娠且羊水指数（AFI）小于6的女性。患者被随机分为治疗组或对照组。治疗组患者以1000 mL/h的速度持续静脉输注（1/2）生理盐水（NS），共两小时。安慰剂组患者以10 mL/h的速度静脉输注（1/2）NS，共两小时。补液完成一小时后，由同一位超声检查医师重新评估AFI。患者和检查者均对研究分组不知情。
两组孕妇的年龄、产次、孕周和出生体重无显著差异。治疗组（3.8±1.2 vs. 5.3±2.5，p<0.05）和安慰剂组（4±1.3 vs. 5.5±2.4，p<0.05）的AFI均显著增加。此外，治疗组和安慰剂组AFI的变化无显著差异（分别为1.2±2.1和1.5±2.1；p>0.05）。
羊水过少患者无论是否接受静脉补液治疗，AFI在短期内均有统计学意义的增加。AFI的短期增加可能反映了羊水的生理性昼夜变化。
