摘要
目的分析经羊膜腔穿刺羊水减量术对胎儿消化道畸形合并羊水过多孕产妇的疗效及对新生儿死亡的影响。方法回顾性分析2018年5月—2021年5月确诊为胎儿消化道畸形合并羊水过多的孕产妇及其新生儿的临床资料。根据治疗方法将研究对象分为常规治疗组、利尿剂使用组、经羊膜腔羊水减量组,比较三组孕产妇围产期并发症、分娩方式及妊娠结局,分析新生儿死亡的影响因素。结果纳入胎儿消化道畸形合并羊水过多的孕产妇126例。常规治疗组65例,孕产妇平均年龄(31.0±4.9)岁,首次治疗孕周23~34+6周;利尿剂使用组31例,孕产妇平均年龄(29.3±5.2)岁,首次治疗孕周25~34^(+4)周;经羊膜腔羊水减量组30例,孕产妇平均年龄(31.0±5.3)岁,首次治疗孕周26~34^(+6)周。不同治疗组之间早产、新生儿死亡比例的差异有统计学意义(P<0.05),经羊膜腔羊水减量组的早产率、新生儿死亡比例较低。与存活组相比,死亡组采用剖宫产术以及经羊膜腔羊水减量治疗的比例较低,早产率较高,差异有统计学意义(P<0.05)。采用二分类多因素logistic回归分析发现,早产、常规治疗未行羊水减量术为新生儿死亡的独立危险因素(P<0.05)。结论羊水减量可延长胎儿消化道畸形合并羊水过多孕产妇的孕周,降低早产率,改善新生儿预后。
Objective To analyze the effect of amnioreduction on maternal polyhydramnios induced by fetal gastrointestinal atresia and its influence on neonatal death.Methods The clinical data of pregnant women with polyhydramnios induced by fetal gastrointestinal atresia and the data of their newborns from May 2018 to May 2021 were retrospectively analyzed.According to the treatment methods,the pregnant women were divided into conventional treatment group,diuretic use group and amnioreduction group.The perinatal complications,delivery mode and pregnancy outcome of the three groups were compared,and the influencing factors of neonatal death were analyzed.Results A total of 126 pregnant women with polyhydramnios induced by fetal gastrointestinal atresia were included.There were 65 pregnant women in the conventional treatment group,the average age was(31.0±4.9)years old,and the gestational week of the first treatment was 23-34+6 weeks.In the diuretic use group,the mean age of 31 pregnant women was(29.3±5.2)years old,and the gestational week of the first treatment was 25-34^(+4)weeks.There were 30 pregnant women in the amnioreduction group,the average age was(31.0±5.3)years old,and the gestational week of the first treatment was 26-34^(+6)weeks.There were statistically significant differences in the proportion of premature birth and neonatal death among different treatment groups(P<0.05).The preterm birth rate and neonatal death rate were lower in the amnioreduction group.Compared with the survival group,the proportion of cesarean section and amnioreduction was lower,the rate of premature birth was higher in the death group,and the difference was statistically significant(P<0.05).Binary logistic regression analysis showed that premature delivery and conventional treatment without amnioreduction were independent risk factors for neonatal death(P<0.05).Conclusions Amniotic fluid reduction can prolong the gestational weeks of pregnant women with polyhydramnios induced by fetal gastrointestinal atresia,reduce the rate of premature birth and improve the prognosis of newborns.
作者
倪佳颖
郑涛
王磊
谢文娟
朱泓
NI Jiaying;ZHENG Tao;WANG Lei;XIE Wenjuan;ZHU Hong(Department of Obstetrics and Gynecology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2024年第1期40-45,共6页
Journal of Clinical Pediatrics
关键词
羊膜腔穿刺
羊水减量
新生儿死亡
胎儿消化道畸形
影响因素
amniocentesis
amnioreduction
neonatal death
fetal gastrointestinal atresia
influencing factor
