| Objective：Oligohydramnios can occur in the different period of pregnancy stage, but inlate stage of pregnancy is the most occuring, oligohydramnios is an important signalof fetal intrauterine conditions. Oligohydramnios also can lead to contamination ofamniotic fluid, during childbirth dystocia, fetal distress, neonatal asphyxia, aspirationpneumonia and other serious consequences of neonatal such as the increased perinatalmortality, serious impact on perinatal prognosis and increased adverse pregnancyoutcomes. Because of atypical clinical symptoms, the critical point is to treat patientswith oligohydramnios in late pregnancy in obstetric department, thus strengtheningprenatal monitoring and the proper and timely treatment is essential. The purpose ofthis research was to investigate the risk of adverse pregnancy outcome which patientswith full-term pregnancy borderline oligohydramnios, prenatal care throughcomprehensive evaluation, to seek the best time for termination of pregnancy and thebest mode of delivery, so as to reduce the perinatal mortality rate, reduce the cesareansection rate, improve the quality of obstetrics.Methods:Data collection from June2012to June2013in the center hospital ofshenyang medical college with borderline oligohydramnios of full-term (5<amnioticfluid index (AFI)≤8cm), full-term pregnancy (gestational age37weeks), singleton,head position, no placenta previa, cephalopelvic disproportion, no scar uterus andgestational diabetes mellitus, in80cases of pregnant women aged21~35years oldas the observation group, we select80subjects as the control group who delivery withamniotic fluid (8<AFI≤18cm), the other characteristics were same as observationgroup. Analysis of the observation group and the control group on the basis of thebasic information of the pregnant women, we analysised the outcome of the care,placental calcification and amniotic fluid pollution, perinatal outcome and mode of delivery and pregnancy before1weeks of birth. The obtained data were analyzedby SPSS13.0software, using t test and x~2test.Results：1. Compared the basic situation of pregnant women in observation group and thecontrol group. There was no statistical difference between the two groups of pregnantwomen age, weight, gravidity, parity and gestational age (P>0.05). It means pregnantwomen age, weight, gravidity, parity and gestational age had no effect on the amountof amniotic fluid.2The analysis of pregnant women monitoring results before1weeks of birthshowing that:①In observation group, fetal non stress test (non-stress test, NST) respondingrate was17.5%, significantly higher than that of the control group5%(χ~2=6.26, P <0.05), suggesting that the full-term pregnancy borderline oligohydramnios make NSTnon reaction of term pregnancy increase;②The observation group and the control group of umbilical artery systolic andend diastolic velocity ratio (S/D ratio) is similar, it means no significant difference (P>0.05), borderline oligohydramnios and S/D ratio have no relationship independentof full-term pregnancy;③The observation group and the control group of placental function were2degree and3degree, the observation group of2degree level accounted for57.5%,3degree accounted for42.5%, compared with the control group, the difference wasstatistically significant (x~2=7.29, P <0.01), the observation group of3pregnantwomen placental grade higher than the proportion of22.50%in the control group, itsuggests that the full-term pregnancy borderline oligohydramnios have relationshipwith placental function.3The placenta appearance calcification rate of observation group was21.25%,significantly higher than the control group2.5%, the difference was statisticallysignificant (x~2=13.44, P <0.01), Studies suggest that full-term pregnancy borderlineoligohydramnios related to placental calcification. The comparison results of observation group and the control group according to the amniotic fluid contaminationsituation showing that the different levels of pollution of amniotic fluid. Thedifference was statistically significant (x~2=23.84, P <0.01), and the observation groupwith amniotic fluid III level pollution accounts for the proportion is higher than thecontrol group. Studies suggest that full-term pregnancy borderline oligohydramniosassociated with amniotic fluid III level pollution.4The outcome analysis the birth ending of observation group and the controlgroup showing that: the observation group neonatal birth weight was3133.8±279.3g, significantly lower than the control group3411.9±366.3g (P <0.01);Apgarscores of the two groups, the incidence of fetal malformations and neonatalpneumonia incidence rate showed no significant difference (P>0.05). Studies suggestthat borderline oligohydramnios full-term pregnancy reduced birth weight, but onneonatal asphyxia, fetal malformation and neonatal pneumonia had no effect.5We analysis the delivery modes of observation group and the control group(normal vaginal delivery, cesarean section, emergency cesarean section and cesareansection were analyzed transfer). Results showed that two groups to adopt the mode ofdelivery had significant difference (x~2=24.41, P <0.01). The proportion of normaldelivery in the observation group is27.50%, significantly less than the control groupof63.75%, and the proportion of selective cesarean section, emergency cesareansection and cesarean section transfer in observation group (25%,11.25%and36.25%)was higher than that of control group (20%,5%and11.25%), the transfer of cesareansection is obvious. Studies suggest that the critical influence of full-term pregnancyoligohydramnios on child delivery wayConclusion：1Oligohydramnios independent critical have no relationship with the maternalage, maternal weight, times of pregnancy, fetal basic situation and full-termpregnancy2Borderline oligohydramnios of full-term pregnancy will increase the rate ofprenatal care without response to NST, and having the relationship with the placental function, delivery of placenta calcification and amniotic fluid III concentration.3Borderline oligohydramnios of the full-term pregnancy have no relationshipwith the neonatal weight loss, and asphyxia of newborn and fetal malformation.4Borderline oligohydramnios of the full-term pregnancy effect of mode ofdelivery, fetal distress due to take transfer ratio of cesarean section increased.5Patient with oligohydramnios of full-term can select vaginal delivery ifprenatal care is good, monitored intrauterine fetal condition in the trial productionprocess, we will terminate pregnancy if fetal distress, meconium stained amnioticfluid appear, we can obtain a good outcome of pregnancy, can reduce the rate ofcesarean section, and improve the quality of obstetrics. |
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