未足月胎膜早破患者残余羊水指数与妊娠结局和新生儿预后的关系

摘要

目的 探究未足月胎膜早破(PPROM)患者残余羊水指数(AFI)与妊娠结局、新生儿预后的临床关系.方法 对该院收治的327例PPROM患者的临床资料进行回顾性分析,统计所有患者妊娠结局和新生儿预后,依据B超检测AFI结果将其分为羊水正常组(60例)、羊水偏少组(170例)和羊水过少组(97例),比较3组妊娠结局和新生儿预后,并采用R×C诊断试验确定AFI与妊娠结局和新生儿预后的临床关系.结果 羊水正常组剖宫产、羊膜腔感染构成比均较羊水过少组、羊水偏少组明显降低,差异有统计学意义(P<0.05);羊水偏少组羊膜腔感染和胎儿宫内窘迫构成比均较羊水过少组明显降低,差异有统计学意义(P<0.05);羊水正常组胎儿宫内窘迫构成比较羊水过少组明显降低,差异有统计学意义(P<0.05);羊水偏少组新生儿败血症和死亡构成比均较羊水过少组明显降低,差异有统计学意义(P<0.05);羊水正常组新生儿败血症和感染均较羊水过少组和羊水偏少组明显降低,差异有统计学意义(P<0.05);羊水偏少组和羊水正常组不良妊娠结局和不良新生儿预后构成比均明显低于羊水过少组,差异有统计学意义(P<0.05),且羊水正常组数据明显低于羊水偏少组,差异有统计学意义(P<0.05);羊水过少和不良妊娠结局、不良新生儿预后均呈明显正相关(r=0.427、0.364,P<0.05).结论 PPROM患者AFI和不良妊娠结局、新生儿预后呈明显正相关,推测可用于妊娠结局和新生儿预后评估.%Objective To explore the relationships between residual amniotic fluid index(AFI) and pregnancy outcomes and neonatal prognosis in patients with preterm premature rupture of membranes(PPROM).Methods The clinical data of 327 cases of patients with PPROM treated in the hospital were retrospective analyzed,and the pregnancy outcomes and neonatal prognosis of all of the patients were recorded.All of the patients were divided into normal amniotic fluid group(n=60),amniotic fluid partial group(n=170) and hypamnion group(n=97) according to the AFI level by the detection of B ultrasound.The pregnancy outcomes and neonatal prognosis were compared among the three groups,then the clinical relationships between the AFI and the pregnancy outcomes and neonatal prognosis were analyzed by the R×C diagnostic test.Results The rates of cesarean section,amniotic cavity infection in the normal amniotic fluid group were significantly lower than those in the hypamnion group and amniotic fluid partial group(P<0.05),the rates of amniotic cavity infection and fetal distress in the amniotic fluid partial group were significantly lower than those in the hypamnion group(P<0.05),and the rate of fetal distress in the normal amniotic fluid group was significantly lower than that in the hypamnion group(P<0.05).The rates of neonatal sepsis and death in the amniotic fluid partial group were significantly lower than those in the hypamnion group(P<0.05),and the rates of neonatal sepsis and infection in the normal amniotic fluid group were significantly lower than those in the hypamnion group and the amniotic fluid partial group(P<0.05).The rates of adverse pregnancy outcomes and adverse neonatal prognosis in the amniotic fluid partial group and the normal amniotic fluid group were significantly lower than those in the hypamnion group(P<0.05),which in the normal amniotic fluid group were significantly lower than those in the amniotic fluid partial group(P<0.05).The hypamnion was positively related to the adverse pregnancy outcomes and adverse neonatal prognosis(r=0.427,0.364,P<0.05).Conclusion The AFI is positively related to the adverse pregnancy outcomes and adverse neonatal prognosis in patients with PPROM,and it is supposed to be used to evaluate the outcome of pregnancy and neonatal prognosis.