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足月妊娠时羊水指数异常对孕产妇及围产儿结局的影响。

Impact of abnormal amniotic fluid index on maternal and perinatal outcomes in term pregnancies.

作者信息

Meet Dinesh Kumar, Yadav Birendra Kumar, Khan Sajjad Ahmed, Bhandari Bibisa, Pradhan Tarun, Thapa Prajwol, Karki Sanjay, Uprety Anisha

机构信息

Department of Obstetrics and Gynecology, Paropkar Maternity and Women's Hospital, Kathmandu, Nepal.

Department of Obstetrics and Gynecology, Bir Hospital, Kathmandu, Nepal.

出版信息

Medicine (Baltimore). 2025 Oct 24;104(43):e45320. doi: 10.1097/MD.0000000000045320.

Abstract

Amniotic fluid, the protective medium within the amniotic sac, plays a vital role in fetal development and maternal well-being during pregnancy. Abnormal amniotic fluid index (AFI), including oligohydramnios (AFI ≤ 2 cm) and polyhydramnios (AFI ≥ 8 cm), is associated with various maternal and fetal complications such as preeclampsia (6.6%), antepartum hemorrhage (3.1%), gestational diabetes (3.5%), prematurity, and intrauterine growth restriction. The objective of this study was to evaluate fetomaternal outcomes in full-term pregnancies with abnormal AFI, with the aim of informing delivery timing and improving both maternal and neonatal outcomes. Furthermore, the study explores the utility of ultrasonography and Doppler imaging in identifying and managing high-risk cases. A prospective observational study was conducted on 60 term pregnancies meeting the inclusion criteria after obtaining informed consent. The incidence of oligohydramnios was 5.33%, and polyhydramnios was 2%. Most cases were observed in women aged 20 to 24 years, with a higher prevalence among primigravida. Oligohydramnios was frequently associated with postdated pregnancy, whereas polyhydramnios was predominantly linked to maternal diabetes. Both conditions were significantly associated with increased rates of cesarean delivery, fetal distress, and neonatal intensive care unit admissions. The findings emphasize the clinical significance of regular AFI monitoring, particularly beyond 37 weeks of gestation. Ultrasonography, coupled with Doppler studies, proved valuable in early detection and informed decision-making, ultimately contributing to better perinatal outcomes. Early identification and timely intervention in pregnancies complicated by abnormal AFI can reduce adverse fetomaternal outcomes and guide clinicians in optimizing delivery management strategies.

摘要

羊水是羊膜囊内的保护介质,在孕期胎儿发育和母体健康方面发挥着至关重要的作用。羊水指数(AFI)异常,包括羊水过少(AFI≤2cm)和羊水过多(AFI≥8cm),与各种母体和胎儿并发症相关,如子痫前期(6.6%)、产前出血(3.1%)、妊娠期糖尿病(3.5%)、早产和宫内生长受限。本研究的目的是评估AFI异常的足月妊娠的母儿结局,旨在为分娩时机提供依据并改善母体和新生儿结局。此外,该研究探讨了超声检查和多普勒成像在识别和管理高危病例中的作用。在获得知情同意后,对60例符合纳入标准的足月妊娠进行了前瞻性观察研究。羊水过少的发生率为5.33%,羊水过多的发生率为2%。大多数病例见于20至24岁的女性,初产妇中患病率更高。羊水过少常与过期妊娠相关,而羊水过多主要与母体糖尿病有关。这两种情况均与剖宫产率、胎儿窘迫和新生儿重症监护病房入院率增加显著相关。研究结果强调了定期监测AFI的临床意义,尤其是在妊娠37周以后。超声检查结合多普勒研究在早期检测和明智决策方面被证明是有价值的,最终有助于改善围产期结局。对合并AFI异常的妊娠进行早期识别和及时干预可以减少不良母儿结局,并指导临床医生优化分娩管理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93dd/12558317/230c410b7920/medi-104-e45320-g001.jpg

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