Hotta M, Ishimatsu J, Manabe A, Hamada T, Yakushiji M
Department of Obstetrics and Gynecology, Kurume University School of Medicine, Japan.
Kurume Med J. 1994;41(1):31-6. doi: 10.2739/kurumemedj.41.31.
Estimation of amniotic fluid volume is an important part of routine obstetric sonography. A relationship between polyhydramnios and poor perinatal outcome has been reported. This study correlates the severity of polyhydramnios with perinatal morbidity and mortality. Among 67 cases of polyhydramnios detected in singleton pregnancies, 8 were associated with maternal conditions including noninsulin-dependent diabetes (5 cases), insulin-dependent diabetes (1 case) and gestational diabetes (2 cases). Forty-four were associated with fetal conditions, including fetal anomalies (31 cases), fetal chromosomal disorders (10 cases) and fetal functional disorders (3 cases). Fifteen of the 67 cases had no apparent underlying fetal or maternal cause. Perinatal death occurred in 19 cases (28%) and was associated with fetal anomalies (12 cases), chromosome disorders (6 cases) and a functional fetal abnormality (1 case). Severe polyhydramnios with amniotic pocket dimensions > or = 120 mm (91%) or with a need for amniocentesis (91%) were associated with fetal abnormalities in most cases. The rate of perinatal death was not increased, indicating that severe polyhydramnios does not always result in lethal abnormalities.
羊水体积的评估是常规产科超声检查的重要组成部分。已有报道称羊水过多与围产期不良结局之间存在关联。本研究将羊水过多的严重程度与围产期发病率和死亡率进行关联。在单胎妊娠中检测出的67例羊水过多病例中，8例与母体情况相关，包括非胰岛素依赖型糖尿病（5例）、胰岛素依赖型糖尿病（1例）和妊娠期糖尿病（2例）。44例与胎儿情况相关，包括胎儿畸形（31例）、胎儿染色体疾病（10例）和胎儿功能障碍（3例）。67例病例中有15例没有明显的潜在胎儿或母体病因。围产期死亡发生在19例（28%），与胎儿畸形（12例）、染色体疾病（6例）和胎儿功能异常（1例）相关。大多数情况下，羊水池深度≥120mm的重度羊水过多（91%）或需要进行羊膜穿刺术的重度羊水过多（91%）与胎儿异常相关。围产期死亡率并未增加，表明重度羊水过多并不总是导致致命异常。
