Discussion Of The Mode Of Delivery In Oligohydramnios During The Late Pregnancy

Objective: Oligohydramnios is a common complications of pregnancy in obstetrics, the incidence rate of which is about 0.5% to 5.5%, which can occur in each period of pregnancy, but most common in late pregnancy. The umbilical cord of oligohydramnios fetus is compressed easily in late pregnancy, especially during child-birthing. Fetal ischemia and hypoxia result in fetal distress, neonatal asphyxia and so on, which made the rate of perinatal disease and mortality increased significantly. To reduce perinatal mortality of oligohydramnios, improve quality of obstetrics, strengthen monitoring and the proper and timely prenatal treatment is extremely important. The key is obstetrics treatment for patients with oligohydramnios in late pregnancy. The purpose of this study was to explore the prognosis of maternals and children under different modes of delivery in the third trimester oligohydramnios patients.Methods: The prospective clinical observation of 83 cases who were ultrasonic diagnosised oligohydramnios on admission from January 2010 to February 2011 in our hospital. According to fetal heart rate monitor after admission, bishop score for cervical ripeness, oxytocin test and whether laboring, patients were given selective cesarean section, vaginal trial production and selective induction of labor. The process of vaginal trial production needs intensive care and timely process abnormal. Application of SPSS 13.0 statistical software, using Mann-Whitney U rank sum test, X~2 test, fisher exact test to compare the different amniotic fluid index and different treatments on the prognosis of patients and neonatal, P<0.05 is considered statistical significance.Results: In this study, 83 cases were basis of the ultrasound diagnosis at admission, 47 cases were given cesarean section and 36 cases were given vaginal delivery after selective induct for some cases, and cesarean section rate was 56.6%. Using Fisher exact test to compare the rate of meconium, neonatal asphyxia, birth weight and perinatal mortality under A, B, C three groups of different amniotic fluid index (AFI), which shows no statistical difference (P>0.05). Using X~2 test to compare the total efficiency of dinoprostone and misoprostol for induction of labor, the difference was statistically significant (P<0.01), that is the total efficiency of dinoprostone was significantly higher than misoprostol. Comparing the rate of vaginal delivery after induced labor, fetal distress, meconium and neonatal asphyxia in dinoprostone group, misoprostol group and oxytocin group with fisher exact test, which shows no significant difference(P′>0.0125).Using fisher exact test to compare the rate of meconium, neonatal asphyxia and perinatal child mortality between cesarean section and vaginal delivery, which shows no statistical difference (P>0.05). For all the cases into groups using fisher exact test to compare the rate of neonatal asphyxia, meconium and perinatal mortality under different delivery modes, the difference was not statistically significant (P > 0.05). Using analysis of variance to pairwise compare postpartum hemorrhage in two hours in different modes of delivery, the results show that vaginal delivery group two-hour post-partum haemorrhage was significantly less than the selective cesarean section group and emergency cesarean section group, the difference was significantly (P<0.01); while the difference of two-hour postpartum haemorrhage between the selective cesarean section group and the emergency cesarean section group was no significant difference (P>0.05).Conclusion: On fetal in good condition and no other risk factors in patients with oligohydramnios and ripe cervix in late pregnancy, who were given vaginal delivery, closing monitor fetal heart rate, amniotic fluid characteristics and the progress of labor, who can also receive good pregnancy outcome under terminate pregnancy timely. Patients with unripe cervix can give induction of labor selectively, especially with dinoprostone which can significantly reduce the cesarean section rate and reduce complications.