切换至 "中华医学电子期刊资源库"

中华产科急救电子杂志 ›› 2015, Vol. 04 ›› Issue (02) : 87 -89. doi: 10.3877/cma.j.issn.2095-3259.2015.02.006

所属专题: 文献

专家论坛

孕期羊膜腔输注治疗羊水过少
贺芳1, 陈敦金1,()   
  1. 1. 510150 广州医科大学附属第三医院妇产科 广州重症孕产妇救治中心
  • 收稿日期:2014-12-30 出版日期:2015-05-18
  • 通信作者: 陈敦金

Amniotic infusion for oligohydramnios

Fang He1, Dunjin Chen1()   

  • Received:2014-12-30 Published:2015-05-18
  • Corresponding author: Dunjin Chen
引用本文:

贺芳, 陈敦金. 孕期羊膜腔输注治疗羊水过少[J]. 中华产科急救电子杂志, 2015, 04(02): 87-89.

Fang He, Dunjin Chen. Amniotic infusion for oligohydramnios[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2015, 04(02): 87-89.

羊水过少可发生在妊娠的任何阶段,羊水指数≤3 cm与不良妊娠结局相关。羊膜腔输注是将生理盐水或乳酸林格氏液经腹或宫颈输入羊膜囊,纠正羊水过少。羊膜腔输注已经被证明是安全的,但仍需在充分评估羊膜腔输注的利弊后实施。羊膜腔输注目前主要应用在未足月胎膜早破的患者,可延长破膜至分娩的时间,预防肺发育不良和感染。但要推广羊膜腔输注作为临床的常规治疗手段,仍需更多的证据。

Oligohydramnios is characterized by a deficiency of amniotic fluid surrounding the fetus and can occur at any stage of pregnancy. Amniotic fluid index less than 3 cm is significantly associated with adverse pregnancy outcomes. Amniotic infusion is referred that instillation of saline or Ringer′s lactate is instilled into the amniotic cavity through abdomen or cervix to correct oligohydramnios. Amniotic infusion is proved to be safe, but a complete evaluation of the benefits and complications of the operation is necessary before operation. Amniotic infusion is mainly applied in patients with preterm premature rupture of membranes, which can extend rupture-delivery time window and prevent risks of pulmonary hypoplasia and infection. However, more evidences are still required to promote amniotic infusion as a routine clinical treatment.

[1]
Shanks A, Tuuli M, Schaecher C, et al. Assessing the optimal definition of oligohydramnios associated with adverse neonatal outcomes[J]. J Ultrasound Med, 2011, 30(3):303-307.
[2]
Moses J, Doherty DA, Magann EF, et al. A randomized clinical trial of the intrapartum assessment of amniotic fluid volume: amniotic fluid index versus the single deepest pocket technique[J]. Am J Obstet Gynecol, 2004, 190(6):1564-1569.
[3]
Harman CR. Amniotic fluid abnormalities[J]. Semin Perinatol, 2008, 32(4):288-294.
[4]
Rossi AC, Prefumo F. Perinatal outcomes of isolated oligohydramnios at term and post-term pregnancy: a systematic review of literature with meta-analysis[J]. Eur J Obstet Gynecol Reprod Biol, 2013, 169(2):149-154.
[5]
Ulker K. Maternal hydration therapy improves the quantity of amniotic fluid and the pregnancy outcome in third-trimester isolated oligohydramnios[J]. J Ultrasound Med, 2014, 33(5):922.
[6]
Gramellini D, Piantelli G, Delle CL, et al. Amnioinfusion in the management of oligohydramnios[J]. J Perinat Med, 1998, 26(4):293-301.
[7]
Amin AF, Mohammed MS, Sayed GH, et al. Prophylactic transcervical amnioinfusion in laboring women with oligohydramnios[J]. Int J Gynaecol Obstet, 2003, 81(2):183-189.
[8]
Van Teeffelen S, Pajkrt E, Willekes C, et al. Transabdominal amnioinfusion for improving fetal outcomes after oligohydramnios secondary to preterm prelabour rupture of membranes before 26 weeks[J]. Cochrane Database Syst Rev, 2013, 8:CD009952.
[9]
Smith K, Leash J, Cadawas T, et al. Improving Obstetric Rapid Response Teams: Multidisciplinary Simulation Training Using the Plan-Do-Study-Act Cycle[J]. J Obstet Gynecol Neonatal Nurs, 2013, 42(Suppl): S56-S57.
[10]
Singla A, Yadav P, Vaid NB, et al. Transabdominal amnioinfusion in preterm premature rupture of membranes[J]. Int J Gynaecol Obstet, 2009, 108(3):199-202.
[11]
Tranquilli AL, Giannubilo SR, Bezzeccheri V, et al. Transabdominal amnioinfusion in preterm premature rupture of membranes: a randomised controlled trial[J]. BJOG, 2005, 112(6):759-763.
[12]
Pryde PG, Hallak M, Lauria MR, et al. Severe oligohydramnios with intact membranes: an indication for diagnostic amnioinfusion[J]. Fetal Diagn Ther, 2000, 15(1):46-49.
[13]
Mercer BM. Preterm premature rupture of the membranes: current approaches to evaluation and management[J]. Obstet Gynecol Clin North Am, 2005, 32(3):411-428.
[14]
De Santis M, Scavo M, Noia G, et al. Transabdominal amnioinfusion treatment of severe oligohydramnios in preterm premature rupture of membranes at less than 26 gestational weeks[J]. Fetal Diagn Ther, 2003, 18(6):412-417.
[15]
Locatelli A, Vergani P, Di Pirro G, et al. Role of amnioinfusion in the management of premature rupture of the membranes at <26 weeks′ gestation[J]. Am J Obstet Gynecol, 2000, 183(4):878-882.
[16]
Porat S, Amsalem H, Shah PS, et al. Transabdominal amnioinfusion for preterm premature rupture of membranes: a systematic review and metaanalysis of randomized and observational studies[J]. Am J Obstet Gynecol, 2012, 207(5): 393.e1-393.e11.
[17]
Macri CJ, Schrimmer DB, Leung A, et al. Prophylactic amnioinfusion improves outcome of pregnancy complicated by thick meconium and oligohydramnios[J]. Am J Obstet Gynecol, 1992, 167(1):117-121.
[18]
Fraser WD, Hofmeyr J, Lede R, et al. Amnioinfusion for the prevention of the meconium aspiration syndrome[J]. N Engl J Med, 2005, 353(9): 909-917.
[19]
Hofmeyr GJ. WITHDRAWN: Amnioinfusion for meconium-stained liquor in labour[J]. Cochrane Database Syst Rev, 2009, 97(1): CD000014.
[20]
Hofmeyr GJ, Essilfie-Appiah G, Lawrie TA. Amnioinfusion for preterm premature rupture of membranes[J]. Cochrane Database Syst Rev, 2011, 12(47): CD000942.
[1] 徐燕, 茹彤, 郑明明, 顾燕, 朱湘玉, 严陈晨, 陈玲, 戴晨燕. Miller-Dieker综合征胎儿产前超声、磁共振影像学特征及遗传学分析[J]. 中华医学超声杂志(电子版), 2024, 21(03): 281-287.
[2] 王德辉, 邓学东. 胎儿室间隔完整型肺动脉闭锁的超声心动图评估及预后分析[J]. 中华医学超声杂志(电子版), 2023, 20(12): 1266-1270.
[3] 杨水华, 何桂丹, 覃桂灿, 梁蒙凤, 罗艳合, 李雪芹, 唐娟松. 胎儿孤立性完全型肺静脉异位引流的超声心动图特征及高分辨率血流联合时间-空间相关成像的应用[J]. 中华医学超声杂志(电子版), 2023, 20(10): 1061-1067.
[4] 戢秀勤, 杨小红, 赵胜, 路小军, 张晓燕, 张涛, 黄晓宇. 早孕期双胎反向动脉灌注序列征的产前超声诊断[J]. 中华医学超声杂志(电子版), 2022, 19(12): 1355-1360.
[5] 曾晴, 文华轩, 袁鹰, 丁妍, 罗丹丹, 廖伊梅, 梁美玲, 秦越, 彭桂艳, 林毅, 邹于, 李胜利. 二维横切面新方法对胎儿胼胝体结构异常的诊断价值[J]. 中华医学超声杂志(电子版), 2022, 19(09): 899-907.
[6] 任芸芸. 无创产前诊断时代早孕期超声检查的价值[J]. 中华医学超声杂志(电子版), 2022, 19(09): 873-876.
[7] 薛超, 张烨, 赵映, 韩建成, 谷孝艳, 孙琳, 刘晓伟, 宋伟, 何怡华. 胎儿先天性肺动脉瓣缺如综合征的超声特征及预后分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 410-418.
[8] 张雯, 张彦春, 刘凯波, 徐宏燕. 北京市胎儿先天性脑积水的产前MRI诊断及围产期转归[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 345-349.
[9] 曾照敏, 余海燕. 超雌综合征的临床认知[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(02): 145-150.
[10] 胡青, 余海燕. 胎儿宫内治疗及风险评估[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(01): 23-30.
[11] 张禾璇, 宋咏刚, 杨雪. 孕妇无创产前检测结果的大样本分析[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(06): 685-691.
[12] 陈金卫, 戴常平, 申屠伟慧, 张伟娟, 张蕊, 王红英. 胎儿超声筛查不同胎龄胎儿先天性唇腭裂的检查时间及检出率比较[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(04): 442-448.
[13] 贺江梅, 刘红梅, 郑梅玲, 张志莉. 无创产前检测筛查胎儿染色体拷贝数变异临床价值[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(03): 300-306.
[14] 谭剑平, 胡搏文, 汤景, 刘颖娜, 杜涛, 祝丽琼, 刘颖琳, 曹春伟, 陈慧. 复发性流产产前诊断指征与妊娠结局60例临床分析[J]. 中华产科急救电子杂志, 2022, 11(04): 234-240.
[15] 谌燕, 冯宗辉, 姜淑敏, 李敏, 易凤梅, 谭颖. 结节性硬化症一家系的TSC2基因变异分析和产前诊断[J]. 中华诊断学电子杂志, 2024, 12(02): 112-115.
阅读次数
全文


摘要