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目的探讨经腹羊膜腔穿刺羊水减量术治疗羊水过多的效果及其对妊娠结局的影响。方法选取有明显症状的羊水过多孕妇8例,行经腹羊膜腔穿刺羊水减量术,回顾性分析患者相关临床资料。结果 8例孕妇中,胎儿先天异常3例、双胎输血综合征1例、原因不明4例。共进行17次羊水减量术,放羊水量750~5200ml,其中9次超过1500ml,羊水减量术间隔时间3~24d。3例孕妇羊水减量术后口服盐酸利托君抑制宫缩治疗48h;5例术后未予药物治疗。最后1次羊水减量术治疗距分娩时间2d~10~(+2)周。8例孕妇中,顺产4例,剖宫产4例;2例足月分娩,6例早产(孕29~(+5)~35~(+6)周)。7例新生儿预后好,1例因早产儿存在先天性发育异常,家属放弃抢救而死亡。结论经腹羊膜腔穿刺羊水减量术治疗羊水过多安全、有效、微创,可快速降低羊水量、减轻压迫症状,延长孕周、改善妊娠结局。
Objective To investigate the effect of transabdominal amniocentesis of amniotic fluid for the treatment of polyhydramnios and its effect on pregnancy outcome. Methods Eighty pregnant women with obvious symptoms of polyhydramnios were selected for amniotic fluid transabdominal amniocentesis. The clinical data of patients were retrospectively analyzed. Results 8 pregnant women, 3 cases of fetal congenital anomalies, twin transfusion syndrome in 1 case, 4 cases of unknown cause. A total of 17 amniotic fluid reduction surgery, amniotic fluid volume 750 ~ 5200ml, of which more than 1500ml, amniotic fluid reduction surgery interval of 3 ~ 24d. 3 cases of pregnant women after amniotic fluid reduction of oral administration of ritodrine hydrochloride inhibition of uterine contraction for 48h; 5 patients without medication. The last 1 amniotic fluid reduction surgery from the delivery time of 2d ~ 10 ~ (+2) weeks. Of the 8 pregnant women, 4 had spontaneous delivery and 4 had cesarean delivery; 2 delivered full-term and 6 were premature (29 ~ (+5) ~ 35 ~ (+6) weeks pregnant). Seven newborns with good prognosis, one case of congenital premature children with congenital dysplasia, family members to give up the rescue and death. Conclusion Transabdominal amniocentesis for the treatment of amniotic fluid loss is safe, effective and minimally invasive, which can rapidly reduce the amniotic fluid volume, relieve the symptoms of oppression, prolong the gestational age and improve the pregnancy outcome.