Ouzounian J G, Miller D A, Paul R H
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Los Angeles County-University of Southern California Medical Center, Los Angeles 90033, USA.
Am J Obstet Gynecol. 1996 Feb;174(2):783-6. doi: 10.1016/s0002-9378(96)70465-9.
Our purpose was to evaluate the use of intrapartum amnioinfusion in women undergoing a trial of labor after a previous cesarean delivery.
Labor and delivery records of women undergoing intrapartum amnioinfusion over a 1-year period were reviewed retrospectively. Neonatal data were obtained by chart review.
During the study period 936 women underwent intrapartum amnioinfusion for the following indications: oligohydramnios (76.6%), meconium-stained amniotic fluid (12.8%),and variable decelerations (7.5%). Among these, 122 (13%) had previous cesarean births. Seventy-one (58.2%) women were delivered vaginally; the remaining 51 (41.8%) were delivered by repeat cesarean. Among women undergoing intrapartum amnioinfusion there were no statistically significant differences (p<0.05) between those with previous cesarean births and those with unscarred uteri with respect to the following: cesarean section for fetal distress (1.6% vs 1.4%), meconium aspiration (0% vs 0.9%), or low 5-minute Apgar scores (2.5% vs 0.9%). There were no perinatal or maternal deaths in either group. One uterine rupture occurred in a woman with one previous cesarean birth.
Amnioinfusion appears to be an acceptable procedure in women with previous cesarean births. The incidence of uterine rupture (0.8%) noted was similar to the 10-year institutional rate at Los Angeles County-University of Southern California Women's Hospital (0.7%).
我们的目的是评估在既往剖宫产术后进行引产的女性中使用产时羊膜腔灌注的情况。
回顾性分析了在1年期间接受产时羊膜腔灌注的女性的分娩记录。通过查阅病历获取新生儿数据。
在研究期间，936名女性因以下指征接受了产时羊膜腔灌注：羊水过少（76.6%）、羊水粪染（12.8%）和变异减速（7.5%）。其中，122名（13%）有既往剖宫产史。71名（58.2%）女性经阴道分娩；其余51名（41.8%）通过再次剖宫产分娩。在接受产时羊膜腔灌注的女性中，有既往剖宫产史的女性与子宫无瘢痕的女性在以下方面无统计学显著差异（p<0.05）：因胎儿窘迫行剖宫产（1.6%对1.4%）、胎粪吸入（0%对0.9%）或5分钟Apgar评分低（2.5%对0.9%）。两组均无围产期或孕产妇死亡。1名有1次既往剖宫产史的女性发生了子宫破裂。
羊膜腔灌注似乎是既往剖宫产史女性可接受的操作。所观察到的子宫破裂发生率（0.8%）与洛杉矶县南加州大学妇女医院的10年机构发生率（0.7%）相似。
