Shipp T D, Bromley B, Pauker S, Frigoletto F D, Benacerraf B R
Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA.
Ultrasound Obstet Gynecol. 1996 Feb;7(2):108-13. doi: 10.1046/j.1469-0705.1996.07020108.x.
We evaluated the significance of severe oligohydramnios, or anhydramnios, in the second and third trimesters, by determining the range of etiologies as well as the differences in fetal and neonatal outcome. All prenatal ultrasound results on pregnancies found to have severe oligohydramnios over a 7.5-year period at 13-42 weeks' gestation were retrospectively collected. Follow-up results were obtained from review of medical records, autopsies and pathology reports. A total of 250 singleton pregnancies met the criteria of having severe oligohydramnios. A bimodal distribution in gestational age at diagnosis was seen, with more cases diagnosed at 13-21 weeks and at 34-42 weeks. Fetal abnormalities were present in 50.7% of those diagnosed with severe oligohydramnios in the second trimester and in 22.1% of those in the third trimester. There were 10.2% and 85.3% survivors when severe oligohydramnios was diagnosed in the second and third trimesters, respectively. The rate of aneuploidy was at least 4.4% for the entire singleton population. A bimodal distribution of pregnancies presenting with severe oligohydramnios represents two different naturally occurring populations in terms of both etiology and prognosis.
我们通过确定病因范围以及胎儿和新生儿结局的差异，评估了孕中期和孕晚期严重羊水过少或羊水过少的意义。回顾性收集了在13 - 42周妊娠期间7.5年内发现有严重羊水过少的所有产前超声检查结果。通过查阅病历、尸检和病理报告获得随访结果。共有250例单胎妊娠符合严重羊水过少的标准。诊断时的孕周呈双峰分布，更多病例在13 - 21周和34 - 42周被诊断。孕中期诊断为严重羊水过少的患者中，50.7%存在胎儿异常，孕晚期诊断为严重羊水过少的患者中，22.1%存在胎儿异常。孕中期和孕晚期诊断为严重羊水过少时，存活率分别为10.2%和85.3%。整个单胎人群的非整倍体率至少为4.4%。就病因和预后而言，出现严重羊水过少的妊娠双峰分布代表了两个不同的自然发生人群。
