Hankins G D, Rowe J, Quirk J G, Trubey R, Strickland D M
Obstet Gynecol. 1984 Sep;64(3):353-8.
During a two-year period, 83 discolored fluids (77 green, six brown) were obtained during genetic amniocenteses of 1227 patients. When compared with case-matched control subjects, those patients with discolored fluid had no differences in the incidence of spontaneous abortions, abnormal fetal karyotypes, infant abnormalities, occurrence of preterm labor, or requirement for delivery by cesarean section. The only statistically significant difference between control and test patients was that one in 83 versus 32 of 83 reported bleeding before amniocentesis (P less than .001). Both green and brown fluids had spectrophotometric peaks at 400 to 408 nm, similar to that reported for meconium. However, discolored fluid had measurable free hemoglobin, whereas meconium-stained fluid from term gestations did not, suggestive of an in utero hemorrhage. Further, when fetal blood, in concentrations calculated to yield a hemoglobin content similar to those measured in the discolored fluids, was incubated in amniotic fluid the spectrophotometric peak and absorbance units at 400 to 408 nm were similar to those for the discolored fluids. These observations are supportive of the hypothesis that blood breakdown products from an episode of intrauterine bleeding are responsible for the discolored fluid. Discolored amniotic fluid during second trimester, as an isolated finding, does not prognosticate a poor pregnancy outcome.
在两年时间里，1227例患者进行遗传羊膜穿刺术时获取了83份变色羊水样本（77份绿色，6份棕色）。与病例匹配的对照受试者相比，羊水变色的患者在自然流产、胎儿核型异常、婴儿异常、早产发生率或剖宫产分娩需求方面没有差异。对照患者和受试患者之间唯一具有统计学意义的差异是，83例受试患者中有1例在羊膜穿刺术前报告有出血，而83例对照患者中有32例（P<0.001）。绿色和棕色羊水在400至408nm处均有分光光度峰，与胎粪报告的情况相似。然而，变色羊水含有可测量的游离血红蛋白，而足月妊娠的胎粪污染羊水则没有，这提示存在宫内出血。此外，当将计算得出的血红蛋白含量与变色羊水中测得的含量相似的胎儿血液浓度在羊水中孵育时，400至408nm处的分光光度峰和吸光度单位与变色羊水相似。这些观察结果支持以下假设：宫内出血事件产生的血液分解产物是导致羊水变色的原因。孕中期出现的变色羊水，作为一个独立发现，并不预示着不良妊娠结局。
