Full-term Pregnancy Oligoamnios Clinical Analysis Of 103 Cases

Objective: To investigate the effect of the full-term pregnancy oligoamnios without complication on perinatal outcome of children and mode of delivery, and explore how to find the best mode of delivery by the comprehensive evaluation of antepartum monitoring to reduct cesarean section rate.Methods: Cases comes from lying-in women in the First Affiliated Hospital of Dalian Medical University from July 2005 to July 2010.103 cases of the full-term pregnancy oligoamnios were taken as the study group,which taken ultrasound within a week before delivery ,single births,head,yonger than 35 years old,without pregnancy complications,postpartum confirmed amniotic fluid <300ml. According to the different results of prenatal ultrasonographic in amniotic fluid index will be divided into three groups of A,B and C, including 16 cases of amniotic fluid index≤5cm in group A, 59 cases of amniotic fluid index 5.1-8.0 cm in group B, 28 cases of amniotic fluid index 8.1-18.0 cm in group C ;And Using the method of 1:1 paired select normal amniotic fluid(300～2000ml) 103 cases of pregnant women as the control group, which taken ultrasound within a week before delivery ,single births,head,yonger than 35 years old,without pregnancy complications too.Matching condition is gestational weeks of identical, births times are identical, a similar weight, the same delivery date or less than a week in control group and study group. Retrospective and comparative study were applied to the clinical data,comparing with each group with respect to antepartum monitoring, perinatal outcome of children and mode of delivery.Results:1. antepartum monitoring:①NST of no reaction incidence rate:the study group was higher than the control group(P<0.05), A group was higher than C group(P<0.05).②placental function of②grade rate: the study group was higher than the control group(P<0.05), A group was higher than B group and C group(P<0.05;P<0.05).③abnormal middle cerebral artery peak-systolic /diastolic ration(MCA S/D)rate:A group was higher than B group and C group(P<0.05;P<0.05).2. Perinatal outcome of children:①FGR (fetal growth restriction)rate: the study group was higher than the control group(P<0.05).②newborn average birth weight: the study group was lower than the control group(P<0.05).3. placenta and amniotic fluid:①amniotic fluid pollution②degree rate: the study group was higher than the control group(P<0.05), A group was higher than C group(P<0.05).②amniotic fluid<50ml rate: A group was higher than B group and C group(P<0.05;P<0.05).③placenta appearance can see calcific focus of infection rate: the study group was higher than the control group(P<0.05), A group was higher than B group(P<0.05).4. Mode of delivery:①Rate of total cesarean section: the study group was higher than the control group(P<0.05), A group and B group was higher than C group(P<0.05;P<0.05).②Rate of emergency cesarean section: the study group was higher than the control group(P<0.05), A group was higher than B group and C group(P<0.05;P<0.05).Conclusion:1. Oligohydramnios can increase the abnormal result of fetal heart monitor and placental function,the fewer of amniotic fluid index,the higher incidence rate of abnormal middle cerebral artery peak-systolic /diastolic ration and amniotic fluid pollution②degree , especially when less than 5cm in amniotic fluid index,it should pay attention.2. Oligohydramnios can increase the rate of FGR,so it should strengthen the prenatal care work of oligohydramnios,it should be to avoid affecting birth weight by early detection and timely treatment.3.The rate of total cesarean section and emergency cesarean section rised apparently when amniotic fluid index≤5cm,and newborn Apgar scores are good,so it is advisable to choose cesarean section;oligohydramnios with amniotic fluid index > 5cm can consider vaginal delivery under tight antepartum monitoring.