Analysis The Perinatal Outcomes Of Abnormal Amniotic Fluid In Third Trimester

Objective:Analysis the perinatal outcomes of abnormal amniotic fluid in third trimester,search for the cause of the Abnormal Amniotic Fluid,comprehensive evaluation to find the best time and the best way to delivery,So as to reduce the cesarean section rate and perinatal mortality.Methods:This is a retrospective study based on 340 cases of maternal who labor in hospital from September 2013 to September 2016 in the first Affiliated Hospital Of Fujian Medical University,which include Oligohydramnios group 135cases(A ?)and Polyhydramnios group 70 cases(B ?),the other random collect in the same period in hospital childbirth and the amount of normal pregnant women 135 cases as control group(C ?),all cases are in third trimester.Analyze and compare the pregnancy outcomes of three groups,comprehensive evaluation to choose the best way of the timing of the termination of pregnancy and way,as well as search for the cause of the abnormal amniotic fluid and treatment.Statistical analysis was performed with t-test?Chi-square test and Fisher exact probability test of SPSS 19.0 package.Results: 1.The basic situation of the A?B and C groupwere analyzed,found that A group and C group had no statistical difference in gravidity and parity history(P?0.05),but they had significant difference in the age and gestational age at delivery(P?0.05).B groupand C group in age times of gestation and parity and gestational age were significantly higher(P?0.05).2.The relationship between gestational age and AFI of A?B group were analyzed,found that they had no correlation,but it show that with the increase of gestational age,the amniotic fluid reduced.Most of oligohydramnios delivery in 39-41 weeks and Polyhydramniosdelivery in 39-40 weeks,polyhydramnios doesn't result in pregnancy weeks in advance.3.(1)Compared the delivery way of three groups,found that the cesarean section rate of the A?B group(respectively 87.4% and 71.4%)was obviously higher than C group(38.5%),the difference was statistically significant(P?0.05).(2)They had statistically significant in cesarean delivery time(elective cesarean delivery?emergency cesarean delivery and transit cesarean delivery)of three groups(P?0.05).(3)Analysis the common cause of cesarean delivery,found that the cesarean section in the oligohydramnios group because of intrauterine fetal distress is higher than other reason of cesarean section(social factors?scar uterus?abnormal presentation and pregnancy complications).(4)The cause of transit cesarean delivery between three groups was no significant difference(P?0.05).4.Compared with the umbilical artery S/D ratio between the three group,found that they had significant difference(P?0.05).5.There was a significant difference on meconium-stained amniotic fluid of the degree between the A?B group and the C group(P?0.05),as well as the proportion of amniotic fluid III degree of pollution on A group was higher than C group?Further analysis the relationship between AFI and staining amniotic fluid,found that proportion of staining amniotic fluid of AFI is less than or equal to 2 obviously increase,which had significant difference(P?0.05).Analyze the risk factors of staining amniotic fluid use Logistic regression analysis,found that oligohydramnios?AFI?2cm and delivery gestational age were the main risk factors(P?0.05).Further analyze three factors to predict the value of staining amniotic fluid use ROC curve,it is concluded that the area under curve is 0.56?0.61 and 0.64,showed that three factors can forecast meconium-stained amniotic fluid.6.Compared with the pregnancy complications(gestational hypertension?gestational diabetes mellitus? systemic lupus erythematosus)between the A?B group and the C group,which had significant difference(P?0.05).7.The perinatal outcomes of the A?B group and C group:(1)Compared the neonatal weight between the A?B group and the C group,found that neonatal weight on A group was obviously lower than the normal,while neonatal weight on hydramnios group was obviously higher than C group,which had significant difference(P?0.05).(2)The A?B group 1 minute Apgar score is lower than C group,the difference was statistically significant(P?0.05).(3)Compared with the A group,the incidence of FGR and neonatal pulmonary disease of C group were significantly higher,the two groups had significant difference(P?0.05),while fetal abnormalities and perinatal death between two groups has no statistical significance(P?0.05).(4)Compared with C group,the incidence of macrosomia?fetal abnormalities?perinatal death and neonatal pulmonary disease of B group were significantly higher,the two groups had significant difference(P?0.05).Conclusions: 1.Maternal age ? extended gestational age ? pregnancy complications and fetal malformation is the common reasons for abnormal amniotic fluid.2.The abnormal amniotic fluid increase the rate of meconium-staining amniotic fluid,and oligohydramnios?AFI?2cm and delivery gestational age is a risk factor for amniotic fluid dung to dye.3.Ultrasonic monitoring fetal umbilical artery S/D ratio was contribute to know fetal wellbeing of abnormal amniotic fluid.4.Less than 37 weeks of abnormal amniotic fluid,conservative treatment can be adopted after exclusion of fetal abnormalities,if it appears intrauterine fetal hypoxia in the process of treatment,which should be cesarean section termination timely provided that it can't through vaginal delivery.More than 37 weeks,the opportunity of stopping pregnancy should be determined comprehensively with the gestational age ? fetal condition?pregnancy complications?local medical conditions and family member's wishes.5.Abnormal amniotic fluid increase the cesarean section rate,and the emergency cesarean delivery rate because of fetal intrauterine distress is increased.