Hesson Ashley, Langen Elizabeth
University of Michigan Obstetrics and Gynecology, Ann Arbor, MI, USA.
J Perinat Med. 2018 Oct 25;46(8):948-950. doi: 10.1515/jpm-2017-0281.
Objective Early-onset oligohydramnios is typically secondary to renal-urinary anomalies (RUA) or preterm premature rupture of membranes (PPROM). We compared neonatal pulmonary outcomes between these etiologies. Methods We conducted a retrospective cohort study of women with oligohydramnios identified before 24 completed weeks of gestation attributed to either PPROM or RUA. Patients were excluded if other fetal anomalies were noted. Respiratory morbidity was assessed by the need for oxygen at 36 corrected weeks or at hospital discharge. Results Of 116 eligible patients, 54 chose elective pregnancy termination. A total of 39.5% of PPROM (n=17/43) and 36.8% of RUA (n=7/19) pregnancies experienced pre-viable loss (P=1.00). Significantly fewer PPROM live births resulted in neonatal mortality (26.9% vs. 75.0%, P<0.01). There was no difference in respiratory morbidity (57.9% vs. 66.6%, P=1.00). The collective incidence of respiratory mortality and morbidity was not different between etiologies (P=0.06). Conclusion This analysis suggests that the prognoses for oligohydramnios due to pre-viable PPROM vs. renal anomalies are similarly grave, though RUA infants experienced a higher rate of neonatal respiratory mortality.
目的 早发型羊水过少通常继发于肾泌尿异常（RUA）或胎膜早破（PPROM）。我们比较了这些病因导致的新生儿肺部结局。方法 我们对妊娠24周前确诊为羊水过少且病因是PPROM或RUA的女性进行了一项回顾性队列研究。如果发现其他胎儿异常则将患者排除。通过矫正孕周36周时或出院时对氧气的需求来评估呼吸疾病发生率。结果 在116例符合条件的患者中，54例选择了选择性终止妊娠。PPROM妊娠中有39.5%（n = 17/43）、RUA妊娠中有36.8%（n = 7/19）发生了未存活前的流产（P = 1.00）。PPROM活产儿导致新生儿死亡的比例显著更低（26.9% 对 75.0%，P < 0.01）。呼吸疾病发生率无差异（57.9% 对 66.6%，P = 1.00）。不同病因之间呼吸死亡率和发病率的总体发生率无差异（P = 0.06）。结论 该分析表明，未存活前PPROM与肾异常导致的羊水过少的预后同样严重，尽管RUA婴儿的新生儿呼吸死亡率更高。
