Effect of amnioinfusion on delivery outcomes of parturients with isolated oligohydramnios at term
LIU Liheng, WANG Qing, HOU Lei, WANG Xin
Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Beijing Maternal Child Health Care Hospital,Capital Medical University,Beijing 100026,China
摘要目的 探究羊膜腔灌注对足月孤立羊水过少产妇分娩结局的影响。方法 本研究为回顾性研究,选择2017-01至2019-01北京妇产医院产科93例足月孤立羊水过少经腹羊膜腔灌注后引产患者作为灌注组,取同期135例足月孤立羊水过少产妇未接受羊膜腔灌注而直接引产为对照组,比较两组分娩结局。结果 灌注组与对照组一般情况如年龄、孕次、产次、分娩孕周及羊水指数等方面比较,差异无统计学意义(均P>0.05)。灌注组中14例中转剖宫产手术, 剖宫产率15.0%;对照组中40例中转剖宫产,剖宫产率29.6%,灌注组剖宫产率低于对照组,差异有统计学意义(P<0.01)。灌注组与对照组比较,产后出血量[(352.58±163.05)ml vs. (353.78±99.09)ml]、胎儿窘迫发生率(25.8% vs. 34.1%)、羊水Ⅲ度粪染发生率(19.4% vs. 24.4%)、新生儿窒息率(1.1% vs. 4.4%)均无统计学差异。结论 羊膜腔灌注可降低足月羊水过少产妇剖宫产率,不增加并发症发生率,提高产科质量。
Abstract：Objective To investigate the effect of amnioinfusion on the delivery outcome of pregnant women with isolated oligohydramnios at term. Methods Ninety-three cases of induced labor with isolated hydramnios at term treated in the Department of Obstetrics of Beijing Obstetrics and Gynecology Hospital after amnioinfusion between 2017 to 2019 were selected as the perfusion group, while another 135 cases of isolated hydramnios at term without amnioinfusion were selected as the control group. The delivery outcomes were compared between the two groups. Results There was no statistically significant difference(P＞0.05)in age,numbers of pregnancies and deliveries, gestational age or amniotic fluid indexes between the two groups.In the perfusion group, 14 cases were transferred to cesarean section, and the cesarean section rate was 15.0%, compared with 40 and 29.6% in the control group. In addition, the incidence of postpartum hemorrhage [(352.58±163.05) ml], fetal distress (25.8%), amniotic fluid fecal contamination (19.4%) and neonatal asphyxia (1.1%) in the perfusion group was not significantly different from(353.78±99.09) ml, 34.1%, 24.4% and 4.4% in the control group (P＞0.05). Conclusions Amnioinfusion can reduce the cesarean section rate among full-term women with oligohydramnios and improve the quality of obstetrics without increasing the incidence of complications.
刘丽恒, 王青, 侯磊, 王欣. 羊膜腔灌注对足月孤立羊水过少产妇分娩结局的影响[J]. 武警医学, 2022, 33(3): 231-233.
LIU Liheng, WANG Qing, HOU Lei, WANG Xin. Effect of amnioinfusion on delivery outcomes of parturients with isolated oligohydramnios at term. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(3): 231-233.
Dad N, Abushama M, Konje J C,et al. What is the role of amnioinfusion in modern day obstetrics?[J]. J Matern Fetal Neonatal Med, 2016, 29(17): 2823-2827.
[2]
Contro E, Jauniaux E. Amnioinfusion: from termination of pregnancy to therapy[J]. BJOG, 2021, 128(2): 303.
[3]
Chamberlain P F, Manning F A, Morrison I,et al. Ultrasound evaluation of amniotic fluid volume. I. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome[J]. Am J Obstet Gynecol, 1984, 150(3): 245-249.
[4]
Esaki M, Maseki Y, Tezuka A,et al. Continuous amnioinfusion in women with PPROM at periviable gestational ages [J]. J Matern Fetal Neonatal Med, 2020, 33(7): 1151-1156.
[5]
Panda S, Jayalakshmi M,Shashi K G, et al. Oligoamnios and perinatal outcome[J]. J Obstet Gynaecol India, 2017, 67(2): 104-108.
[6]
Ono T, Tsumura K, Kawasaki I,et al. Continuous amnioinfusion for treatment of mid-trimester preterm premature rupture of membranes with oligoamnios[J]. Obstet Gynaecol Res, 2020, 46(1): 79-86.
[7]
Sterpu I, Anfelter P, Wray S,et al. The association of second trimester biomarkers in amniotic fluid and fetal outcome [J].J Matern Fetal Neonatal Med, 2019, 32(21): 3627-3632.
[8]
Sekhon S, Rosenbloom J I, Doering M, et al. Diagnostic utility of maximum vertical pocket versus amniotic fluid index in assessing amniotic fluid volume for the prediction of adverse maternal and fetal outcomes: a systematic review and meta-analysis [J]. J Matern Fetal Neonatal Med, 2019, 72(15): 1-10.
Miyazaki F S, Taylor N A. Saline amnioinfusion for relief of variable or prolonged decelerations. A preliminary reports[J]. Am J Obstet Gynecol, 1983, 146(12): 670-678.
[14]
李笑天,杨慧霞.胎儿学诊断与治疗[M]. 北京:人民卫生出版社,2012:820-827.
[15]
曹泽毅. 中华妇产科学[M]. 北京:人民卫生出版社,2008:440-450.
[16]
Mokhtari N, Wang T, DiSciullo A, et al. Intraamniotic infection rates after intrauterine pressure catheter with and without amnioinfusion[J]. Am J Perinatol, 2021, 38(2): 212-217.
2022, Vol. 33 
