International Medicine and Health Guidance News ›› 2022, Vol. 28 ›› Issue (21): 3064-3066.DOI: 10.3760/cma.j.issn.1007-1245.2022.21.021

• Treatises • Previous Articles     Next Articles

Clinical significance of borderline amniotic fluid index in preterm pregnancy

Chen Xiaoying, Wang Fang, Zhang Rui, Liang Haiying   

  1. Department of Obstetrics and Gynecology, Guangdong Maternal and Child Health Hospital, Guangzhou 510010, China
  • Received:2022-07-20 Online:2022-11-01 Published:2022-11-17
  • Contact: Liang Haiying, Email: 13631316795@sina.cn

超声羊水指数临界值对未足月妊娠的临床意义探讨

陈小莹  王芳  张蕊  梁海英   

  1. 广东省妇幼保健院妇产科,广州 510010
  • 通讯作者: 梁海英,Email:13631316795@sina.cn

Abstract: Objective To investigate the recent changes in the conditions and clinical impact of case characteristics in those preterm pregnant patients in hospital care and followed up by outpatient department without enough borderline amniotic fluid index (50 mm<AFI≤80 mm). Methods This was a retrospective study. The conditions of 114 inpatients and 347 outpatients who were initially found isolated borderline amniotic fluid index (50 mm< AFI<80 mm) at 28 to 37 weeks of gestation between January 2019 and December 2021 were compared and analyzed. The patients were divided into three different outcomes according to the ultrasonic review results within 3 to 10 days. The outcome compositions in the two groups were compared and analyzed. The combined diagnosis features of the patients with different amniotic fluid changes were explored. The χ2 test and Fisher's exact test were applied. Results Twenty-three cases (20.2%) had A outcome, 32 cases (28.1%) B outcome, and 59 cases (51.8%) C outcome in the study group. Eighty-six cases (24.8%) had A outcome, 104 cases (30.0%) B outcome, and 157 cases (45.2%) C outcome in the control group. There was no statistical difference in the three outcomes between the two groups (χ2=1.652,=0.438). There were no statistical differences in the incidence of common co-diagnosis (breech, the pregnant woman of local complications, cord around neck twice, the racket shape the placenta, pregnancy with moderate/severe anemia, and placenta previa) between the three different outcomes in the patients with borderline oligohydramnios (all P>0.05). Conclusions Dynamic observation is necessary for the diagnosis of only borderline oligohydramnios, one examination alone should not be used as references for adverse fetal outcomes. It has not been determined whether traditional treatment such as inpatient fluid infusion and low molecular weight heparin is worthy of application. Follow-up by outpatient department can save medical resources and relieve patients' anxiety.

Key words: borderline oligohydramnios, Amniotic fluid, Preterm pregnancy

摘要: 目的 探讨未足月妊娠羊水指数临界过少(50 mm<AFI≤80 mm)住院监护及门诊随访的患者近期病情变化及病例特征临床影响。方法 采用回顾性研究,对比分析2019年1月至2021年12月的孕28~37周首次发现单纯羊水指数临界值(50 mm<AFI≤80 mm)的住院患者114例(研究组)和门诊患者347例(对照组)的近期病情变化,根据3~10 d内超声复查结果,将患者分为3种不同结局,对比分析两组患者的结局构成差异,探讨近期羊水不同变化的患者其合并诊断的特征。统计学方法采用χ2检验和Fisher精确检验。结果 研究组A结局为23例(占20.2%),B结局为32例(占28.1%),C结局为59例(占51.8%)。对照组A结局为86例(占24.8%),B结局为104例(占30.0%),C结局为157例(占45.2%)。两组患者结局构成差异无统计学意义(χ2=1.652,P=0.438)。羊水临界过少患者的常见合并诊断(臀位、孕妇内外科合并症、脐带绕颈两周、球拍状胎盘、妊娠合并中度/重度贫血、前置胎盘)在病情变化的3种不同结局中发生率对比,差异均无统计学意义(均P>0.05)。结论 对于单纯羊水临界过少的诊断有必要动态观察,不能仅以1次检查作为胎儿不良结局的参考。传统的住院补液、低分子肝素等治疗是否值得应用还未确定,门诊随访可节约医疗资源,减轻患者焦虑情绪。

关键词: 临界羊水过少, 羊水, 未足月妊娠