羊膜腔灌注术治疗妊娠28～34周羊水过少的价值

摘要

Objective To evaluate the prenatal outcomes and obstetric risk assessment of transabdominal amnioinfusion in 28-34 weeks' gestation with oligohydramnios without prerupture of membranes.Methods Sixty five cases complicated with oligohydramnios without rupture of membranes with 28-34 weeks' gestation were divided into two groups.The amnioinfusion group including 35 cases received transabdominal amnioinfusion and the control group including 30 cases received maternal hydration.Results There was 1 case diagnosed fetal unilateral renal agenesis by ultrasound after received transabdominal amnioinfusion.In treatment group,the average birth age was 36.93 ± 1.29 weeks,and average birth weight was 2852.00 ± 649.02g.Both the average birth age and average birth weight were higher than the control group (P ＜ 0.05).Compared with the control group,the cesarean section rate in transabdominal amnioinfusion group was decreased (P ＜ 0.05).There was no statistically significant difference in prerupture of membranes,neonatal pneumonia and neonatal jaundice(P ＞ 0.05).Placental abruption,amniotic fluid embolism and puncture complications such as infection did not happen in two groups.Conclusion Transabdominal amnioinfusion can improve the prenatal outcomes,increase AFI effectively,prolong the duration of gravidity,decrease cesarean section rate and detect timely the fetal anomaly.%目的 探讨经腹羊膜腔灌注术治疗妊娠28 ～ 34周未破膜羊水过少的妊娠结局及安全性评估.方法 选择2012～2015年在笔者医院诊治,孕周28 ～34周,B超提示羊水过少的孕妇共65例,按自愿原则进行分组,其中接受经腹羊膜腔灌注术35例(治疗组),补液组30例(对照组),观察妊娠结局及相关并发症.结果 治疗组35例,有1例在灌注后B超诊断胎儿左肾缺如.治疗组的新生儿平均出生孕周为36.93±1.29周,出生体重为2852.00±649.02g,均高于对照组,差异有统计学意义(P＜0.05);而剖宫产率低于对照组,差异有统计学意义(P＜0.05).两组在胎膜早破、新生儿肺炎、新生儿黄疸的差异无统计学意义(P＞0.05).两组均无胎盘早剥、羊水栓塞、穿刺感染等并发症发生.结论 经腹羊膜腔灌注术能改善妊娠28 ～34周未破膜羊水过少妊娠结局,增加羊水量、延长孕周、降低剖宫产率、及时排除胎儿畸形,操作安全性高.