晚期妊娠羊水过少与围产儿缺氧现象临床观察.doc

晚期妊娠羊水过少与围产儿缺氧现象临床观察 【摘要】目的探讨羊水过少与围产儿缺氧现象的关系，并寻找正确的处理方法，以降低围产儿病死率。方法回顾性分析我院2004年1月至12月115例临床羊水过少病例(样本组)。羊水过少诊断标准：临床估算实际羊水量300ml；超声波检查羊水指数AFI≤5cm，超声波检查结果与临床有异时以临床为准。结果样本组围产儿死亡、窒息及难产婴儿率均高于同期羊水正常组。所以羊水过少确诊后，严密监测产程，适时及合理方式终止妊娠，提高围产儿出生质量。 【关键词】 羊水过少；胎儿窘迫；围产儿；新生儿窒息；羊水指数 The effect of oligohydramnios in term pregnancies and the clinical observation of perinatal newborn hypoxemiaZHU ai-xia，LIU xue-jun，YUE xiu-fang (Dept. of Obstetircs and Gynecology, the Central Hospital of TAIAN, Shandong Taian 271000, China) Abstract：Objective: To explore the relationship of the effect of oligohydramnios in term pregnancies and perinatal newborn hypoxemia, and find a suitable resolution in order to reduce the mortality. Methods: One hundred and fifteen patients oligohydramnios in term pregnancies from January to December in 2004 were restrospectively analysed. The diagnosis standard of oligohydramnios in term pregnancies: The actually amount of amniotic fluid by clinical obvervation 300ml；amniotic fluid index (AFI) le;5cm. If the result is different by ultrasonic and clinical observation, the result is according to the clinical observation. Results: The mortality , asphyxiation and prolonged pregnancy rates of perinatal newborn in patient group were significantly higher than the control group. So after oligohydramnios in term pregnancies have been diagnosed, inspect the stages of labor rigorous, terminate the pregnancy timely, improve the birth quality in term pregnancies. Key words： oligohydramnios; neonatal distress; perinatal newborn; newborns asphyxia; amniotic fluid index 羊水过少是产科常见并发症之一，可严重影响围产儿预后。随着围产医学研究的进展及超声技术的不断发展，羊水过少的检出率逐年增高。羊水过少常引起宫缩不协调使产程延长，增加胎儿窘迫和新生儿窒息的机会，增加了难产的机会。因此加强产前检查、产时监测，及时发现和处理异常，是降低围产儿病死率的关键。本文对115例羊水过少进行临床分析，有助于今后的临床处理。 1 资料与方法 1.1 临床资料 我院2004年1月至12月住院分娩总数4125为例，羊水过少115例，发生率为2.54 %为观察组，产妇年龄21～39岁，平均30岁。妊娠小于37周7例，占6.08%；37～41周30例，占26.82%；41周及42周以上78例，占67.82%。另在每例产妇羊水过少的同期随机取1例羊水正常的孕妇作对照组，以便比较两组在妊娠并发症、围生儿情况及分娩方式的区别。 1.2 诊断依据 (1)B超羊水指数［AFI］le;5.0 cm或B超示羊