羊水过少：多严重才算严重？
Oligohydramnios: how severe is severe?
机构信息
Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), Zerifin, Israel (affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel).
Department of Obstetrics and Gynecology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
J Matern Fetal Neonatal Med. 2022 Dec;35(25):5754-5760. doi: 10.1080/14767058.2021.1892068. Epub 2021 Feb 28.
OBJECTIVE
To investigate whether the severity of isolated oligohydramnios at term is associated with increased rates of adverse perinatal outcome.
STUDY DESIGN
A retrospective study conducted in a single medical center from 2017 to 2019. All low-risk pregnancies with incidental isolated oligohydramnios at term were included. The degree of oligohydramnios was arbitrarily classified into mild (AFI = 41-50 mm), moderate (AFI = 21-40 mm) and severe (AFI = 0-20 mm).
RESULT
A total of 610 women were included: 202 with a mild (33.1%), 287 moderate (47.0%), and 121 severe oligohydramnios (19.8%). Non-reassuring monitor requiring immediate delivery and worse composite neonatal outcome were more common among severe than mild or moderate oligohydramnios (14.0% and 6.4%, 7.3% respectively; = .039 and 19.8%, 10.9% and 11.8%, respectively; = .048).
CONCLUSION
Low-risk pregnancies with isolated severe oligohydramnios at term have a higher tendency toward non-reassuring fetal monitoring requiring prompt delivery and adverse neonatal outcomes, this calls for close intrapartum surveillance.
目的
探讨足月时单纯羊水过少的严重程度是否与不良围产结局发生率增加有关。
研究设计
这是一项于 2017 年至 2019 年在一家医疗中心进行的回顾性研究。所有低危妊娠且足月时偶然出现单纯羊水过少的患者均被纳入研究。将羊水过少的程度任意分为轻度（AFI = 41-50 mm）、中度（AFI = 21-40 mm）和重度（AFI = 0-20 mm）。
结果
共纳入 610 例患者：轻度 202 例（33.1%），中度 287 例（47.0%），重度 121 例（19.8%）。重度羊水过少组需要立即分娩且复合新生儿结局较差的非可靠监测更为常见（14.0%和 6.4%，分别为 = .039 和 19.8%，10.9%和 11.8%，分别为 = .048）。
结论
足月时单纯重度羊水过少的低危妊娠胎儿监测结果更不可靠，需要立即分娩，新生儿结局较差，因此需要密切产时监测。
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