Stoll C, Dott B, Alembik Y, Roth M P
Institut de Puériculture, Hospices Civils, Strasbourg.
J Gynecol Obstet Biol Reprod (Paris). 1990;19(8):947-53.
Our registry of congenital anomalies allows us to study systematically pregnancies which ended in the birth of a malformed child. Over 8 years 105,374 births were registered. A control was selected for each malformed baby. Numerous factors are studied. One of them is oligohydramnios. During the study period 199 children carriers of at least one congenital major malformation were born after a pregnancy complicated by oligohydramnios; which represent an incidence of 1.88%. Overall 2,787 malformed children were born during the study period, 7.14% of them were born after oligohydramnios (controls 1.6%, p less than 0.001). The malformations which were more often associated with oligohydramnios involved the urinary system (15.9%), the digestive system (10.2%), the genital system (5.9%) and the limbs (5.7%). A chromosomal aberrations was present in 11 infants (5.5%). Most of the isolated malformations were not associated with oligohydramnios, whereas the pregnancies which ended with the birth of a malformed baby were often complicated by oligohydramnios. Therefore when a fetal malformation is discovered during pregnancy the obstetrician should not be satisfied with the discovery of one anomaly associated with oligohydramnios. He (she) has to look carefully for other associated fetal malformations. The weight, the length and the head circumference at birth of the children born after oligohydramnios were less than those of the controls (p less than 0.001). The length of gestation was shorter (p less than 0.01). The weight of the placenta was smaller. In this study the only maternal factors which favoured the occurrence of oligohydramnios were diabetes and epilepsy.
我们的先天性异常登记系统使我们能够系统地研究那些以畸形儿出生告终的妊娠情况。在8年时间里，共登记了105,374例出生情况。为每例畸形儿选取了一个对照。研究了众多因素。其中之一是羊水过少。在研究期间，199名至少患有一种先天性严重畸形的患儿在妊娠合并羊水过少后出生；发病率为1.88%。在研究期间，总共出生了2,787名畸形儿，其中7.14%在羊水过少后出生（对照组为1.6%，p<0.001）。与羊水过少关联更频繁的畸形涉及泌尿系统（15.9%）、消化系统（10.2%）、生殖系统（5.9%）和四肢（5.7%）。11名婴儿（5.5%）存在染色体畸变。大多数孤立性畸形与羊水过少无关，而以畸形儿出生告终的妊娠往往合并羊水过少。因此，当孕期发现胎儿畸形时，产科医生不应仅满足于发现一种与羊水过少相关的异常。他（她）必须仔细查找其他相关的胎儿畸形。羊水过少后出生的儿童出生时的体重、身长和头围均低于对照组（p<0.001）。妊娠时长较短（p<0.01）。胎盘重量较小。在本研究中，唯一有利于羊水过少发生的母体因素是糖尿病和癫痫。
