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口服补液盐(ORS)进行口服补液治疗与不进行补液治疗对足月孤立性羊水过少孕妇母婴结局的比较研究。

A Comparative Study on Maternal and Perinatal Outcomes in Oral Hydration Therapy With Oral Rehydration Solution (ORS) Versus No Hydration Therapy in Term Pregnancies With Isolated Oligohydramnios.

作者信息

Hadalageri Annapurna S, Yaliwal Rajasri G, Patil Mallanagouda, Shirgur Shobha, Kori Shreedevi

机构信息

Obstetrics, BLDE (Deemed to be University) Shri B. M. Patil Hospital, Medical College and Research Center, Vijayapura, IND.

Obstetrics and Gynaecology, BLDE (Deemed to be University) Shri B. M. Patil Hospital, Medical College and Research Center, Vijayapura, IND.

出版信息

Cureus. 2025 Apr 10;17(4):e82016. doi: 10.7759/cureus.82016. eCollection 2025 Apr.

Abstract

Introduction Oligohydramnios, a condition characterized by reduced amniotic fluid volume, is associated with adverse maternal and perinatal outcomes, including increased rates of cesarean section, fetal distress, and neonatal intensive care unit (NICU) admissions. Maternal hydration therapy, particularly oral rehydration solution (ORS), has been proposed as a simple and cost-effective intervention to improve the amniotic fluid index (AFI) and perinatal outcomes in pregnancies complicated by isolated oligohydramnios. This study aimed to evaluate the effectiveness of ORS therapy compared to no hydration in term pregnancies with isolated oligohydramnios. Materials and methods A randomized controlled trial was conducted at Shri B.M. Patil Medical College and Hospital, India. A total of 60 pregnant women with singleton term pregnancies (37-40 weeks) diagnosed with isolated oligohydramnios (AFI 5-8 cm) were randomized into two groups: Group 1 (ORS Therapy, n=30) received ORS (2 liters/day for 3 days), while Group 2 (no hydration, n=30) followed a routine dietary intake. AFI was measured at baseline and after 72 hours. Secondary outcomes included mode of delivery, birth weight, NICU admissions, Apgar scores, and umbilical artery blood gas analysis. Data were analyzed using IBM SPSS Statistics v. 26 (IBM Corp., Armonk, NY, US), with a p-value < 0.05 considered statistically significant. Results ORS therapy significantly increased AFI after 72 hours (p=0.026). Spontaneous vaginal delivery was higher in the ORS group (50%) compared to the no hydration group (33.3%), while cesarean section rates were lower (23.3% vs. 46.7%). NICU admissions were significantly reduced in the ORS group (23.3% vs. 50%; p=0.0321), and birth weight <2.5 kg was less frequent (13.3% vs. 36.7%; p=0.0368). Umbilical artery blood gas analysis showed better fetal oxygenation in the ORS group (p<0.05). Conclusion ORS therapy is an effective, non-invasive intervention for increasing AFI, reducing cesarean rates, and improving neonatal outcomes in term pregnancies with isolated oligohydramnios. Given its affordability and safety, ORS therapy should be considered a first-line treatment before invasive interventions. Further large-scale trials are needed to establish standardized protocols for its use in obstetric practice.

摘要

引言

羊水过少是一种以羊水量减少为特征的病症,与不良的孕产妇和围产期结局相关,包括剖宫产率增加、胎儿窘迫和新生儿重症监护病房(NICU)收治率上升。孕产妇补液治疗,尤其是口服补液盐(ORS),已被提议作为一种简单且经济有效的干预措施,用于改善单纯性羊水过少妊娠的羊水指数(AFI)和围产期结局。本研究旨在评估与不补液相比,ORS治疗对单纯性羊水过少足月妊娠的有效性。

材料与方法

在印度的什里·B.M. 帕蒂尔医学院及医院进行了一项随机对照试验。共有60名单胎足月妊娠(37 - 40周)且诊断为单纯性羊水过少(AFI 5 - 8 cm)的孕妇被随机分为两组:第1组(ORS治疗组,n = 30)接受ORS(2升/天,共3天),而第2组(不补液组,n = 30)维持常规饮食摄入。在基线和72小时后测量AFI。次要结局包括分娩方式、出生体重、NICU收治情况、阿氏评分和脐动脉血气分析。使用IBM SPSS Statistics v. 26(IBM公司,美国纽约州阿蒙克)进行数据分析,p值<0.05被认为具有统计学意义。

结果

ORS治疗在72小时后显著增加了AFI(p = 0.026)。ORS组的自然阴道分娩率(50%)高于不补液组(33.3%),而剖宫产率较低(23.3%对46.7%)。ORS组的NICU收治率显著降低(23.3%对50%;p = 0.0321),出生体重<2.5 kg的情况也较少见(13.3%对36.7%;p = 0.0368)。脐动脉血气分析显示ORS组的胎儿氧合情况更好(p<0.05)。

结论

ORS治疗是一种有效的、非侵入性的干预措施,可增加AFI、降低剖宫产率并改善单纯性羊水过少足月妊娠的新生儿结局。鉴于其可承受性和安全性,ORS治疗在进行侵入性干预之前应被视为一线治疗方法。需要进一步开展大规模试验以建立其在产科实践中的标准化使用方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8d/12065506/5923fa2e595a/cureus-0017-00000082016-i01.jpg

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