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肾性羊水过少和无羊水:病因、病程及结局——一项单中心研究

Renal oligo- and anhydramnios: cause, course and outcome--a single-center study.

作者信息

Spiro Judith Eva, Konrad Martin, Rieger-Fackeldey Esther, Masjosthusmann Katja, Amler Susanne, Klockenbusch Walter, Schmitz Ralf

机构信息

Department of Gynecology and Obstetrics, University of Muenster, Muenster, Germany,

出版信息

Arch Gynecol Obstet. 2015 Aug;292(2):327-36. doi: 10.1007/s00404-015-3648-7. Epub 2015 Feb 13.

Abstract

PURPOSE

To evaluate the outcome of patients with renal oligohydramnios and explore the impact of patient variables on outcome and prognosis.

METHODS

A retrospective single-center study was conducted analyzing 104 pregnancies complicated by oligohydramnios of renal origin from 2001 to 2011. Statistical analysis was performed to assess the influence of pre- and postnatal data on pregnancy outcome, morbidity and mortality.

RESULTS

Prenatal renal diagnoses were as follows: hydronephrosis/megaureter: n = 21 (20.2 %), aberrance in renal form or location: n = 7 (6.7 %), cystic renal disease: n = 28 (26.9 %), renal dysplasia: n = 24 (23.1 %), renal agenesis: n = 42 (30.4 %), posterior urethral valves: n = 11 (10.6 %). Hydronephrosis/megaureter and late onset of oligohydramnios were prognostic factors for fetal survival, whereas renal agenesis and associated anomalies had a negative impact on pregnancy outcome. Prenatal interventions did not improve prognosis.

CONCLUSIONS

Pregnancies complicated by renal oligohydramnios still have a poor outcome. Careful weighing of prognostic factors is necessary to decide about further therapeutic measures.

摘要

目的

评估肾性羊水过少患者的结局,并探讨患者变量对结局及预后的影响。

方法

进行一项回顾性单中心研究,分析2001年至2011年期间104例合并肾源性羊水过少的妊娠病例。进行统计分析以评估产前和产后数据对妊娠结局、发病率和死亡率的影响。

结果

产前肾脏诊断如下:肾积水/巨输尿管:n = 21(20.2%),肾脏形态或位置异常:n = 7(6.7%),囊性肾病:n = 28(26.9%),肾发育不良:n = 24(23.1%),肾缺如:n = 42(30.4%),后尿道瓣膜:n = 11(10.6%)。肾积水/巨输尿管和羊水过少的晚发是胎儿存活的预后因素,而肾缺如及相关畸形对妊娠结局有负面影响。产前干预并未改善预后。

结论

合并肾性羊水过少的妊娠结局仍然较差。在决定进一步治疗措施时,有必要仔细权衡预后因素。

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