McEvoy C, Sardesai S, Macri C, Paul R, Durand M
University of Southern California Medical Center, Women's Hospital, Los Angeles 90033, USA.
Pediatrics. 1995 May;95(5):688-92.
Amnioinfusion has been reported to improve the perinatal outcome of pregnancies complicated by decreased amniotic fluid volume, but detailed information on its possible adverse effects on neonatal pulmonary mechanics and oxygenation is not available.
We evaluated 42 infants with birth weights of 2600 to 4320 g and gestational ages of 36 to 44 weeks, who were born to mothers enrolled in a prospective, randomized trial of amnioinfusion for oligohydramnios in labor. Maternal entry criteria were gestational age 36 weeks or older, estimated fetal weight more than 2500 g, oligohydramnios defined as an amniotic fluid index of 5 cm or less, and a normal fetal heart rate pattern. Evaluation of pulmonary mechanics and oxygen saturation (SaO2) was done with the infants breathing room air between birth and day 3 of life. Transpulmonary pressure, flow, and tidal volume were recorded simultaneously, and pulmonary resistance and lung compliance were calculated. SaO2 was measured for 30 minutes with the Nellcor N-200 oximeter and IBM computer oximetry software.
Evaluation of the data revealed no significant difference between the two groups for tidal volume, lung compliance, pulmonary resistance, or work of breathing. There were no differences between the two groups in the number of desaturation episodes or in percent of desaturations to less than 90%, 85%, or 80% SaO2.
Prior studies have shown amnioinfusion to improve perinatal outcome. Our findings demonstrate that amnioinfusion for oligohydramnios in labor does not adversely affect neonatal pulmonary mechanics or oxygenation.
据报道，羊膜腔灌注可改善羊水过少合并妊娠的围产期结局，但关于其对新生儿肺力学和氧合可能产生的不良影响的详细信息尚不可得。
我们评估了42例出生体重为2600至4320克、胎龄为36至44周的婴儿，这些婴儿的母亲参与了一项关于产时羊水过少的羊膜腔灌注前瞻性随机试验。母亲的入选标准为胎龄36周或以上、估计胎儿体重超过2500克、羊水过少定义为羊水指数5厘米或以下，以及正常的胎儿心率模式。在出生至出生后第3天期间，让婴儿呼吸室内空气，对其肺力学和氧饱和度（SaO2）进行评估。同时记录跨肺压、流量和潮气量，并计算肺阻力和肺顺应性。使用Nellcor N - 200脉搏血氧仪和IBM计算机血氧测定软件测量SaO2 30分钟。
数据评估显示，两组在潮气量、肺顺应性、肺阻力或呼吸功方面无显著差异。两组在血氧饱和度下降发作次数或血氧饱和度降至低于90%、85%或80% SaO2的百分比方面无差异。
先前的研究表明羊膜腔灌注可改善围产期结局。我们的研究结果表明，产时羊水过少的羊膜腔灌注对新生儿肺力学或氧合无不良影响。
