P Hourdequin, E Kauffmann, R Gabriel, A D Jotterand, C Chatelet-Cheront, C Quéreux, M Delcroix
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引用次数: 0
摘要
目的:评估产程中羊水输注的结果,在情况下厚的羊膜羊水或在情况下少羊水相关的可变减速胎儿心脏反应。患者和方法:前瞻性非随机研究。羊水输注应用于47例厚的羊膜羊水和18例可变胎心减速合并少羊水。将产科和新生儿数据与未进行羊膜输注的相似组(n = 32)进行比较。结果:两组比较显示羊膜输注在分娩过程中胎儿健康状况较好,根据克雷布胎心评估(8.53 +/- 1.06 vs 6.56 +/- 0.35—p < 0.01),剖宫产率较低(8.5% vs 31.2%—p < 0.01)。羊膜输注也与分娩后1分钟Apgar评分较高(9.4 +/- 0.8 vs 8.7 +/- 1.7—p = 0.01)和较低的厚胎粪吸入率相关(13.7% vs 40.7%—p < 0.01)。儿童出生后的头几天没有差别。我们没有发现羊膜输注后的严重并发症。结论:根据国际文献,我们确认了羊膜输注的普遍共识。羊膜输注需要紧急护理,以防止经典描述的并发症。如果胎膜羊水过厚或羊水过少引起的可变减速,在分娩过程中进行羊水输注可以提供更好的胎儿健康。
[Amnio-infusion during labor: experience and review of the literature].
Objectives: Evaluation of amnioinfusion results during labour in case of thick meconial amniotic fluid or in case of oligo-hydramnios associated with variable deceleration of the fetal heart response.
Patients and methods: Prospective non randomized study. Amnioinfusion was applied to 47 cases of thick meconial amniotic fluid and to 18 cases of variable fetal heart decelerations associated with oligo-hydramnios. Obstetrical and neonatal data were compared with a similar group without amnioinfusion (n = 32).
Results: Comparing both groups shows that amnioinfusion offers a better fetal well-being during labour, according to Kreb's fetal heart evaluation during labour (8.53 +/- 1.06 vs 6.56 +/- 0.35--p < 0.01), lows the cesarean section rate (8.5% vs 31.2%--p < 0.01). Amnioinfusion is also associated with a higher Apgar's score at one minute after delivery (9.4 +/- 0.8 vs 8.7 +/- 1.7--p = 0.01) and a lower rate of thick meconium inhalation (13.7% vs 40.7%--p < 0.01). There was no difference for children's first days of life. We found no serious complication following amnioinfusion.
Conclusion: We confirm general agreement about amnioinfusion, according to international literature. Amnioinfusion needs an acute care to prevent classically described complications. In case of thick meconial amniotic fluid or variable decelerations associated with oligo-hydramnios, amnioinfusion during labour offers a better fetal well-being.