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羊水过少的母儿结局:孕28至42周妊娠的横断面分析

Maternal and Perinatal Outcomes in Oligohydramnios: A Cross-Sectional Analysis of Pregnancies Between 28 to 42 Weeks of Gestation.

作者信息

Sawant Akash A, Wankhede Sachin, Thakare Sarika, Narayan Gaurang N, Saha Indrakshi, Vernekar Amruta, Wagaskar Bhagyashree D, Khandare Tejaswini S, Hatwar Vidya S, Deshmukh Rajlaxmi L

机构信息

Obstetrics and Gynecology, Indira Gandhi Government Medical College and Hospital, Nagpur, IND.

Obstetrics and Gynaecology, Indira Gandhi Government Medical College and Hospital, Nagpur, IND.

出版信息

Cureus. 2025 Feb 18;17(2):e79232. doi: 10.7759/cureus.79232. eCollection 2025 Feb.

Abstract

Background Oligohydramnios, defined as an amniotic fluid index (AFI) <5 cm or a single deepest pocket <2 cm, is associated with increased risks of intrauterine growth restriction (IUGR), umbilical cord compression, and perinatal morbidity. Despite extensive research, controversy remains regarding the optimal management strategy for pregnancies complicated by oligohydramnios. This study evaluates maternal and perinatal outcomes in oligohydramnios to guide clinical decision-making. Methods A hospital-based cross-sectional study was conducted over two years (October 2022 to September 2024) at a tertiary care center. The study included 188 pregnant women between 28 and 42 weeks of gestation diagnosed with oligohydramnios. Data on maternal demographic characteristics, pregnancy complications, fetal monitoring parameters, mode of delivery, and neonatal outcomes were collected and analyzed using chi-square and t-tests, with a significance level of p<0.05. Results The study revealed significant maternal and perinatal complications in oligohydramnios. The mean maternal age was 25.4 ± 4.2 years, with 61.7% primigravida. Cesarean section was the predominant mode of delivery (69.1%) due to fetal distress. Low birth weight (<2.5 kg) occurred in 53.19% of neonates, with 29.73% having an Apgar score ≤7 at one minute. Neonatal intensive care unit (NICU) admission was required in 14.36% of cases, and perinatal mortality was 8.5%. Non-reactive non-stress tests (NST) (25.53%) and abnormal Doppler findings were strongly associated with adverse outcomes, highlighting the need for close fetal monitoring and timely intervention. Conclusion Oligohydramnios is associated with a high rate of operative deliveries, increased neonatal morbidity, and adverse perinatal outcomes. Early identification and close fetal monitoring using Doppler studies and NSTs play a critical role in optimizing pregnancy outcomes. The findings reinforce the need for individualized management strategies to improve neonatal survival and reduce maternal complications.

摘要

背景 羊水过少定义为羊水指数(AFI)<5 cm或单个最深羊水池<2 cm,与宫内生长受限(IUGR)、脐带受压和围产期发病率增加相关。尽管进行了广泛研究,但对于合并羊水过少的妊娠的最佳管理策略仍存在争议。本研究评估羊水过少孕妇的孕产妇和围产期结局,以指导临床决策。方法 在一家三级医疗中心进行了一项为期两年(2022年10月至2024年9月)的基于医院的横断面研究。该研究纳入了188例妊娠28至42周被诊断为羊水过少的孕妇。收集了孕产妇人口统计学特征、妊娠并发症、胎儿监测参数、分娩方式和新生儿结局的数据,并使用卡方检验和t检验进行分析,显著性水平为p<0.05。结果 该研究揭示了羊水过少孕妇存在显著的孕产妇和围产期并发症。孕产妇平均年龄为25.4±4.2岁,初产妇占61.7%。由于胎儿窘迫,剖宫产是主要的分娩方式(69.1%)。53.19%的新生儿出生体重低(<2.5 kg),29.73%的新生儿1分钟时阿氏评分≤7分。14.36%的病例需要入住新生儿重症监护病房(NICU),围产期死亡率为8.5%。无反应型无应激试验(NST)(25.53%)和异常多普勒检查结果与不良结局密切相关,突出了密切胎儿监测和及时干预的必要性。结论 羊水过少与手术分娩率高、新生儿发病率增加和不良围产期结局相关。使用多普勒检查和NST进行早期识别和密切胎儿监测在优化妊娠结局中起着关键作用。这些发现强化了需要个性化管理策略以提高新生儿存活率并减少孕产妇并发症的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40b8/11925226/67d72ae085eb/cureus-0017-00000079232-i01.jpg

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