Neonatal Outcomes are Similar between Patients with Resolved and Those with Persistent Oligohydramnios.
Neonatal Outcomes are Similar between Patients with Resolved and Those with Persistent Oligohydramnios.
复制标题
羊水过少得到缓解的患者和持续性羊水过少的患者的新生儿结局相似。
DOI：
10.1055/a-2278-8948
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发表时间：
2024
影响因子：
2
通讯作者：
Lewkowitz,AdamK
中科院分区：
文献类型：
--
作者：
Whelan,AnnaR;Has,Phinnara;Savitz,DavidA;Danilack,ValeryA;Lewkowitz,AdamK
羊水过少（定义为羊水量< 5 cm或最深垂直袋< 2 cm）被认为是产前超声的不祥发现。然而，羊水不是静止的，到目前为止，目前还没有研究对诊断为羊水过少的患者和持续性羊水过少的患者的围产期结局进行比较。研究设计这是对美国国立卫生研究院的一项二级分析，对2002年至2013年在三级医院分娩的患有轻度高血压疾病的单胎妊娠进行的资助回顾性队列研究和/或胎儿生长受限（FGR）。产妇的特点，交付，和新生儿的信息提取训练有素的研究护士。确定诊断为羊水过少的患者，并比较分娩时羊水过少缓解与持续的患者。主要结局是分娩时新生儿复苏的复合指标：给氧、面罩通气、持续气道正压通气、插管、胸外按压或心脏药物治疗。次要结果包括胎儿生长迟缓，时间，和方式deliver.ResultsOf 527名妇女符合研究标准，42羊水过少，分娩前解决，而485持续性羊水过少。两组之间的患者人口统计学无显著差异。羊水过少缓解患者诊断时的胎龄显著低于持续性羊水过少患者（中位数：33.0 [四分位距，IQR：29.1-35.9] vs. 38.0 [IQR：36.4-39.3]，p< 0.001）。两组新生儿复苏率无显著差异（41 vs. 32%，p = 0.31）。羊水过少缓解的患者比持续性羊水过少的患者更容易发生FGR（55%对36%，p < 0.02）。分娩时的胎龄、出生体重或新生儿重症监护室的入院时间均无显著差异。结论羊水过少的患者诊断较早，但新生儿复苏率相似，但FGR发生率高于持续性羊水过少的患者。
ObjectiveOligohydramnios (defined as amniotic fluid volume < 5 cm or deepest vertical pocket < 2 cm) is regarded as an ominous finding on prenatal ultrasound. Amniotic fluid, however, is not static, and to date, there have been no studies comparing perinatal outcomes in patients who are diagnosed with oligohydramnios that resolves and those who have persistent oligohydramnios.Study DesignThis is a secondary analysis of a National Institutes of Health–funded retrospective cohort study of singleton gestations delivered at a tertiary care hospital between 2002 and 2013 with mild hypertensive disorders and/or fetal growth restriction (FGR). Maternal characteristics, delivery, and neonatal information were abstracted by trained research nurses. Patients with a diagnosis of oligohydramnios were identified, and those with resolved versus persistent oligohydramnios at the time of delivery were compared. The primary outcome was a composite of neonatal resuscitation at delivery: administration of oxygen, bag–mask ventilation, continuous positive airway pressure, intubation, chest compression, or cardiac medication administration. Secondary outcomes included FGR, timing, and mode of delivery.ResultsOf 527 women meeting study criteria, 42 had oligohydramnios that resolved prior to delivery, whereas 485 had persistent oligohydramnios. There were no significant differences in patient demographics between groups. The gestational age at diagnosis was significantly lower for patients with resolved versus persistent oligohydramnios (median: 33.0 [interquartile range, IQR: 29.1–35.9] vs. 38.0 [IQR: 36.4–39.3],p< 0.001). There was not a substantial difference in rate of neonatal resuscitation (41 vs. 32%,p= 0.31). Patients with resolved oligohydramnios were more likely to have developed FGR than those with persistent oligohydramnios (55 vs. 36%,p< 0.02). There were no significant differences for gestational age at delivery, birth weight, or neonatal intensive care unit admission.ConclusionPatients whose oligohydramnios resolved were diagnosed earlier yet had similar rates of neonatal resuscitation but higher rates of FGR than those who had persistent oligohydramnios.Key Points