Many A, Hill L M, Lazebnik N, Martin J G
Department of Obstetrics and Gynecology, Magee-Womens Research Institute, Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA.
Obstet Gynecol. 1995 Sep;86(3):389-91. doi: 10.1016/0029-7844(95)00179-U.
To determine whether an association exists between the severity of polyhydramnios and the frequency of preterm delivery.
The study group consisted of 275 singleton pregnancies with polyhydramnios as defined by an amniotic fluid index (AFI) of at least 25 cm. Polyhydramnios was arbitrarily categorized into three groups by severity: mild (AFI 25-30 cm), moderate (AFI 30.1-35 cm), and severe (AFI greater than 35.1 cm). A delivery was considered preterm if it occurred before 37 weeks' gestation.
Fifty-two of 275 (18.9%) women delivered before 37 weeks' gestation. Preterm delivery occurred in 37 of 199 (18.5%) cases with mild polyhydramnios, 12 of 55 (21.8%) with moderate polyhydramnios, and three of 21 (14.3%) with severe polyhydramnios (no statistically significant difference). Fetuses with congenital malformations (16 of 41, 39%) and those of diabetic mothers (ten of 45, 22.2%) had a significantly higher incidence of preterm delivery than did cases with unexplained polyhydramnios (24 of 190, 12.6%; P < .001). The prematurity rate in cases with idiopathic polyhydramnios was no higher than the overall rate for our hospital.
The underlying cause of polyhydramnios, rather than the relative excess of amniotic fluid as defined by this study, appears to determine when preterm labor will occur.
确定羊水过多的严重程度与早产频率之间是否存在关联。
研究组由275例单胎妊娠且羊水过多的孕妇组成，羊水过多定义为羊水指数（AFI）至少为25厘米。根据严重程度将羊水过多任意分为三组：轻度（AFI 25 - 30厘米）、中度（AFI 30.1 - 35厘米）和重度（AFI大于35.1厘米）。如果分娩发生在妊娠37周之前，则视为早产。
275例孕妇中有52例（18.9%）在妊娠37周前分娩。轻度羊水过多的199例中有37例（18.5%）早产，中度羊水过多的55例中有12例（21.8%）早产，重度羊水过多的21例中有3例（14.3%）早产（无统计学显著差异）。患有先天性畸形的胎儿（41例中的16例，39%）和糖尿病母亲的胎儿（45例中的10例，22.2%）早产发生率明显高于不明原因羊水过多的病例（190例中的24例，12.6%；P <.001）。特发性羊水过多病例的早产率不高于我院的总体早产率。
羊水过多的潜在原因，而非本研究定义的相对过多的羊水，似乎决定了早产何时会发生。
