Antepartum amnioinfusion: a review.
Antepartum amnioinfusion: a review.
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DOI：
10.1080/jmf.14.5.291.296
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发表时间：
2003-11-01
期刊：
影响因子：
--
通讯作者：
Verrotti, C
中科院分区：
文献类型：
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作者：
Gramellini, D;Fieni, S;Verrotti, C
目的：产前羊水输注是随着胎儿医学技术的发展而出现的一种较新的方法。对于重度羊水过少，为避免相关并发症，如肺发育不全、羊水过少畸形、变异性胎心率减速、脑室出血等，一般采用此方法。产前羊水输注也可用于改善羊水过少患者的超声显影。我们的目标是评估与这种方法相关的益处和并发症，与产程中羊水输注相比，这种方法仍然不太常用，因此其风险还没有很好地确定。研究设计：通过搜索MEDLINE、PubMed、Cochrane Collaboration、专业数据库和综述文章的书目来确定研究设计的报告。结果和结论：在产前诊断和良好的围产儿结局方面，羊水输注似乎提供了几个好处。大多数临床经验报告说，羊膜输液对母亲和胎儿都是安全的。然而，根据羊水过少的原因(如胎膜早破、胎儿生长受限、梗阻性尿路疾病和肾发育不全)细分的随机对照组研究可能有助于确定与这一过程相关的优势和风险。因此，在羊水过少的常规治疗中引入该方法之前，应鼓励进行前瞻性随机研究，以澄清对该方法可能存在的任何疑虑。
OBJECTIVE: Antepartum amnioinfusion is a relatively recent procedure introduced with fetal medicine techniques. It is usually indicated for severe oligohydramnios in order to avoid the related complications such as pulmonary hypoplasia, the deforming effects of oligohydramnios, variable fetal heart rate decelerations and intraventricular hemorrhage. Antepartum amnioinfusion is also employed to improve ultrasound visualization in cases with oligohydramnios. Our objective was to evaluate the benefits and complications related to this procedure which is still less commonly used compared to intrapartum amnioinfusion, and whose risks are therefore not well established.STUDY DESIGN: Reports of study designs identified from searches of MEDLINE, PUBMED, the Cochrane Collaboration, specialized databases and bibliographies of review articles were identified. Studies in women who underwent amnioinfusion between 1987 and 2002 were included.RESULTS AND CONCLUSIONS: Amnioinfusion seems to offer several benefits, in terms of both prenatal diagnosis and favorable perinatal outcome. Most clinical experiences report that amnioinfusion is safe, both for the mother and for the fetus. However, randomized control-group studies subdivided on the basis of the cause of oligohydramnios (e.g. premature rupture of membranes, fetal growth restriction, obstructive uropathy and renal agenesis) could help to determine the advantages and risks linked to this procedure. Prospective randomized studies should therefore be encouraged, to clarify any possible doubts regarding the procedure, before it can be introduced into routine practice in the management of oligohydramnios.