足月妊娠不同羊水指数对妊娠结局的影响

Effect of different amniotic fluid index on pregnancy outcome in full-term pregnancy

摘要:

目的：分析足月妊娠孕妇的不同羊水指数对分娩方式的影响。方法：选取2014年至2018年在重庆医科大学附属大学城医院住院分娩的羊水指数（amniotic fluid index，AFI）≤80 mm的足月妊娠孕妇572例作为实验组，以及同时期的81 mm≤AFI≤250 mm的足月妊娠孕妇599例作为对照组。上述两组数据采集样本前均排除易导致剖宫产的产科高危因素，如头盆不称、瘢痕子宫、前置胎盘、胎方位异常、双胎妊娠等。首先按照羊水指数（mm）0~30、31~50、51~65、66~80分组，分别计算各组在住院期间因异常NST或OCT阳性行剖宫产终止妊娠的剖宫产率，并与81~250组的上述数据进行观察分析。结果：0~30、31~50、51~65、66~80及81~250组的剖宫产率分别为79%、55%、47%、44%、44%。上诉各组中的孕妇均顺利分娩，新生儿均未出现窒息、死亡等。经统计软件SPSS 20.0进行行列卡方检验及组间两两比较分析，得出5组之间剖宫产率不全相等（P<0.05）。组间两两比较，0~30组与31~50组差异不具统计学意义（P=0.05），0~30组与51~65组差异有统计学意义（P<0.05），0~30组与66~80组差异有统计学意义（P<0.05），0~30组与81~250组差异有统计学意义（P<0.05）；31~50组与51~65组差异没有统计学意义（P>0.05），31~50组与66~80组差异有统计学意义（P<0.05），31~50组与81~250组差异有统计学意义（P<0.05）；51~65组与66~80组差异没有统计学意义（P>0.05），51~65组与81~250组差异没有统计学意义（P>0.05）；66~80组与81~250组差异没有统计学意义（P>0.05）。结论：羊水指数80 mm及50 mm所区分的羊水偏少及过少对本次研究中的临床工作有明确指导意义，而更细致的羊水量分组对本次研究的临床工作指导意义不明显。

Abstract:

Objective：To study the effect of different amniotic fluid index on pregnancy outcome in full-term pregnancy. Methods：Five hundred and seventy two full-term pregnant women whose amniotic fluid index（AFI） were less than 80mm were selected as the experimental group，and 599 full-term pregnant women whose AFI was more than 81mm but less than 250 mm were selected as the control group. All the experimental subjects were chosen from Chongqing Medical University Affiliated University Town Hospital since 2014 to 2018. The two groups excluded high-risk obstetric factors，such as cephalopelvic disproportion，scarred uterus，previa placenta，abnormal placenta orientation and twin pregnancy，etc.. Groups were divided according to the AFI（mm） of 0-30，31-50，51-65，66-80. Then the cesarean section rates due to abnormal NST or OCT positive in each group were calculated and analyzed combined with the data of the group of 81-250. Results：The cesarean section rates of the group 0-30，31-50，51-65，66-80 and 81-250 were 79%，55%，47%，44%，44%，respectively. All pregnant women in the groups have a smooth delivery，and no newborn baby has been stifled to death. Comparative analyses of the Chi-square test and group to group comparison by using SPSS 20.0 showed that：the cesarean section rate was not all the same among the five groups（P<0.05）；there was no significant difference between 0-30 and 31-50 groups（P=0.05）；there were significant differences between 0-30 and 51-65 groups（P<0.05），0-30 and 66-80 groups（P<0.05），0-30 and 81-250 groups（P<0.05）；there was no significant difference between 31-50 and 51-65 groups（P>0.05）；there were signifi－cant differences between 31-50 and 66-80 groups（P<0.05），31-50 and 81-250 groups（P<0.05），31-50 and 66-80 groups（P<0.05），31-50 and 81-250 groups（P<0.05）. There was no significant difference between 51-65 and 66-80 groups（P>0.05），51-65 and 81-250 groups（P>0.05），66-80 and 81-250 groups（P>0.05）. Conclusion：The amniotic fluid index of 80 mm and 50 mm has definite guiding significance，while more detailed grouping of amniotic fluid volume has no obvious guiding significance for clinical work in this study.