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目的:探索改善羊水偏少孕妇的围产期结局的方法。方法:450例足月妊娠羊水偏少,宫颈评分<7分的孕妇随机分成观察组和对照组,观察组150例采用输液及饮水扩溶治疗,并予米索前列醇促宫颈成熟,缩宫素引产,第1对照组采用与观察组相同的扩容治疗,只促宫颈成熟不予引产,第2对照组只扩容治疗不予促宫颈成熟及引产。结果:观察组阴道顺产率明显高于两个对照组(P<0.05,P<0.01),第1对照组明显高于第2对照组(P<0.05)。3组剖宫产原因比较,因羊水过少剖宫产率3组相比无统计学差异(P>0.05),因宫颈不成熟剖宫产率观察组及第1对照组明显低于第2对照组(P<0.01),观察组与第1对照组相比无统计学差异(P>0.05);因羊水Ⅱ°以上胎粪污染剖宫产率观察组明显高于第1对照组及第2对照组(P<0.05),因频发变异减速及晚期减速剖宫产率3组相比无统计学差异(P>0.05),因产程异常剖宫产率观察组低于第1对照组(P<0.05),但与第2对照组相比无统计学差异(P>0.05),第1对照组与第2对照组相比无统计学差异(P>0.05)。新生儿轻度窒息率观察组与第1对照组相比无统计学意义(P>0.05),观察组和第2对照组比较有统计学差异(P<0.05)。结论:扩容的同时行促宫颈成熟或促宫颈成熟后催产素引产能提高羊水偏少孕妇的阴道分娩率,改善围产期结局。但人工干预会增加羊水污染程度。
Objective: To explore ways to improve the perinatal outcome of partial oligohydramnios. Methods: 450 cases of term pregnancy with amniotic fluid less than normal, cervical score <7 points were randomly divided into observation group and control group, the observation group of 150 cases of infusion and drinking water treatment, and misoprostol to promote cervical ripening, Prime induced labor, the first control group with the observation group the same dilatation treatment, only to promote cervical ripening induction of labor, the second control group only expansion therapy does not promote cervical ripening and induction of labor. Results: The vaginal cisternia rate in the observation group was significantly higher than that in the two control groups (P <0.05, P <0.01). The first control group was significantly higher than the second control group (P <0.05). There was no significant difference in cesarean section rate between the three groups (P> 0.05). The rate of cesarean section in the cervical premature uterine cervix was significantly lower than that in the control group 2 (P <0.01). There was no significant difference between the observation group and the first control group (P> 0.05). The observation group of cesarean section rate of amniotic fluid with meconium-stained more than Ⅱ ° was significantly higher than that of the control group and the first control group 2 control group (P <0.05). There was no significant difference between the control group and the control group (P> 0.05). The rate of abnormal cesarean section in the observation group was lower than that in the control group (P <0.05), but there was no significant difference compared with the second control group (P> 0.05). There was no significant difference between the first control group and the second control group (P> 0.05). There was no significant difference between the observation group and the control group (P> 0.05). There was significant difference between the observation group and the second control group (P <0.05). Conclusions: At the same time of expansion, oxytocin induction of cervical ripening or cervical ripening can increase vaginal delivery rate and reduce perinatal outcome. But manual intervention will increase the degree of amniotic fluid pollution.