Naveiro-Fuentes Mariña, Puertas Prieto Alberto, Ruíz Rocío Sánchez, Carrillo Badillo María Paz, Ventoso Francisco Montoya, Gallo Vallejo José Luis
J Perinat Med. 2016 Oct 1;44(7):793-798. doi: 10.1515/jpm-2015-0198.
To compare the outcomes of term gestations with oligohydramnios in the absence of other underlying disorders and term gestations with normal amniotic fluid.
A retrospective analysis of obstetric outcomes in 27,708 term pregnancies. We compared three groups: labor induced because of oligohydramnios, spontaneous onset of labor with normal amniotic fluid, and labor induced because of late term pregnancy with normal amniotic fluid. We excluded pregnancies with maternal or fetal diseases or disorders potentially related with amniotic fluid alterations. The main outcome measures were mode of delivery, neonatal birth weight, umbilical artery blood pH, Apgar scores and neonatal discharge status.
Compared to spontaneous labor, induction of labor because of oligohydramnios was associated with a higher risk of cesarean delivery and small size of the fetus for gestational age (SGA). Compared to induction because of late term pregnancy there were no significant differences in neonatal, although neonates had a higher risk of being SGA.
The only perinatal outcome for which the risk was higher in term pregnancies with isolated oligohydramnios was SGA. The systematic induction of labor in these pregnancies should be questioned.
比较无其他潜在疾病的足月羊水过少妊娠结局与羊水正常的足月妊娠结局。
对27708例足月妊娠的产科结局进行回顾性分析。我们比较了三组:因羊水过少引产、羊水正常自然发动分娩以及因足月妊娠羊水正常引产。我们排除了患有可能与羊水改变相关的母体或胎儿疾病或紊乱的妊娠。主要结局指标为分娩方式、新生儿出生体重、脐动脉血pH值、阿氏评分及新生儿出院状况。
与自然分娩相比,因羊水过少引产剖宫产风险更高,且胎儿小于孕周(SGA)的比例更高。与足月妊娠引产相比,新生儿方面虽无显著差异,但新生儿为SGA的风险更高。
孤立性羊水过少的足月妊娠中,唯一风险较高的围产期结局是SGA。对这些妊娠进行系统性引产应受到质疑。