Clinical Analysis Of Association Of Isolated Idiopathic Oligohydramnios With Adverse Perinatal Outcomes At Term

Objective Explore the impact of isolated idiopathic oligohydramnios on term pregnancy outcome, and discuss the question of whether we can improve the opportunity of vaginal delivery when a puerpera is isolated idiopathic oligohydramnios on term pregnancy. In order to reduce the rate of cesarean section in the condition of the safety of mother and baby.Methods Select 185 cases of puerperas as the observation group, from January 2011 to March 2012 in the Obstetrics of The First Affiliated Hospital of Medical University of Anhui, the amniotic fluid index?8cm, the gestational age is in the between 37weeks to 42weeks, and without other pregnancy complications and fetal malformation. According to the observation group and the principle of comparability, select equal amounts of normal pregnant women as the control group over the same period. Then look up the medical records and eliminate the inconsistent conditions maternal according to the exclusion criteria. In the end, there are 165 cases in the observation group and 157 cases in the control group. According to amniotic fluid index (AFI), the observation group is divided into two groups:Group A's AFI<5cm, Group B's5cm< API?8cm. Carries on the clinical observation to object of study's pregnancy outcome, mainly includes the following several targets:fetal heart monitoring, S/D ratio, meconium-stained amniotic fluid, neonatal asphyxia and neonatal death, delivery mode, neonatal birth weight, the duration of normal labor. Compare these targets between the observation group and the control group, and between the group A and group B.Results By arranging and analysising each index of all cases in the observation group and the control group, it finds that there are 18 cases of S/D?3.0 in the observation group and 4 cases in the control group. The difference between the two group is statistically significant (P<0.05). There are 11 cases of mild neonatal asphyxia and 0 case of severe neonatal asphyxia in the observation group. In the control group there is 4 cases of mild neonatal asphyxia and 1 case of severe neonatal asphyxia. There is no significant difference between the two groups(P>0.05). The number of meconium-stained amniotic fluid is 39 cases in the observation group. Among them,16 cases is ?°meconium-stained amniotic fluid. In the control group the number of meconium-stained amniotic fluid is 23 cases. Among them,6 cases is ?° meconium-stained amniotic fluid. The difference between the two group is statistically significant(P<0.05). There are 15 cases of NST score<8 score in the observation group, and 12 cases in the control group. The difference between the two group is not statistically significant(P>0.05). The number of low birth weight infant is 11 cases in in the observation group, is 0 case in the control group. There is significant difference between the two groups (P<0.001). In delivery mode, there are 130 cases of uterine-incision delivery in the observation group, and 93 cases in the control group. The difference between the observation group and the control group is statistically significant(P< 0.001). Comparing the duration of normal delivery between the two groups, there is no significant difference(P>0.05). Between the group A and B, there is significant difference in the aspect of ?° meconium-stained amniotic fluid, low birth weight infant and delivery mode(P<0.05). But there is no significant difference about S/D?3.0, NST score<8 score, meconium-stained amniotic fluid and asphyxia neonatorum(P>0.05).Conclusion In part, oligohydramnios has effect on perinatal health. Different degree of oligohydramnios have different effect on delivery mode. When AFI?5cm, the rate of cesarean section rise sharply. To isolated oligohydramnios in mature gestation, when 5<AFI?8cm, vaginal delivery trial is feasible in the condition of close monitoring. It is a way to reduce the rate of cesarean section. When AFI?5cm, we need to monitor the amniotic fluid volume every day, and comprehensively evaluate the perinatal health at the same time. If the other monitoring indicators is normal, vaginal delivery is feasible. If the other monitoring indicators is abnormal, we need to terminate pregnancy timely by cesarean section in order to reduce the effect on perinatal health.