| Objective: Oligohydramnios is a common obstetric pathology,and it occurs at different periods of pregnancy,especially at the period of late pregnancy. In recent years, with the development of ultrasound diagnostics, the incidence of oligohydramnios increased gradually, according to statistics, the incidence of oligohydramnios national rate of 0.5% to 4%, foreign incidence rate of 0.5% to 5.5%. The main reason of oligohydramnios was not yet entirely clear, mostly, including prolonged pregnancy, fetal deformity, pulmonary hypoplasia,intrauterine growth restriction, premature rupture of membranes and maternal drug misuse. Oligohydramnios occurred in early pregnancy is often associated with fetal deformity, and most of them end in abortion. However, oligohydramnios ccurred in late pregnancy can lead to fetal deformity such as fetal bones and muscular anomaly,limbs shortage,intrauterine growth restriction, fetal distress, etc. Fetus and umbilical lcord have to face compression in labor due to the lack of buffer action of amniotic fluid,which leads to fetal distress, stained amniotic fluid, neonatal asphyxia and even death of fetus.Amnio fluid plays a role on washing the parturient canal,and oligohydramnios raises the incidence rate of infection.And oligohydramnios also slows the progress of laber,leading to the increasing of cesarean section rate as well as the recent and long-term complications of cesarean section, and eventually an adverse outcome .The purpose of the research was to determine whether oligohydramnios of late pregnancy leads to a significant risk of adverse perinatal outcome.Methods:Since 1987 Phelan recommended us the amnio fluid index (AFI),AFI has been widely used. Amniotic fluid index(AFI) less than 5cm is considered as oligohydramnios.Many patients whose AFI are from 5cm to 8cm request for cesarean section for the reason of social factors.We considered AFI less than 5cm as oligohydramnios in the study. We conducted a retrospective review of 29 patients entering antepartum testing one week before delivery at the Fourth Affiliated Hospital of Heibei Medical University sciences from June to December in 2010.Amniotic fluid index(AFI) less than 5cm is considered as oligohydramnios.We choosed 29 cases whose AFI was less than 5cm as our study group and 29 normal cases as control group. The two groups all undertook antenatal examination including fetal heart monitor ,ultrasonic inspection,and the measurement of amniotic fluid index, systolic peak velocity and diastolic blood flow velocity ratio (ie S / D) of umbilical artery and placental maturity also included .Perinatal outcomes including delivery gestational weeks,neonate birth weight, degree of ripeness of the placenta, delivery mode,stained amniotic fluid ,neonatal asphyxia and even death.The research was to determine whether it had statistical significance between the two groups both at antepartum testing and pregnancy outcome.Result:There was no difference in the time of termination of pre- gnancy or placental calcification(P>0.05).The incidence rate of stained amniotic fluid in the study group was 10%,and it was 0% in the control group. The incidence rate of neonatal asphyxia in two groups both are 3%.There was no statistical significance between two groups at stained amniotic fluid and neonatal asphyxia (P<0.05),and neonatal death was found in neither group.The S/D had statistical significance between the two groups(P<0.05),and one was 24% while the other was 0%.Neonate birth weight in the group of oligohydramnios was obviously different form that of the control group(P<0.05). And there was statistical significance between two groups at cesarean section rate and the incidence rate of cord entanglement(P<0.05).Conclution: Since oligohydramnios can significantly increase the cesarean section rate and the incidence of intrauterine growth restriction,it occurs as a danger signal of perinatal adverse outcomes of pregnancy.More attention should be paid to this in order for a better perinatal outcome.
|
PDF Full Text Request