关键词: 羊膜腔穿刺, 羊水减量, 新生儿死亡, 胎儿消化道畸形, 影响因素

Abstract:

Objective To analyze the effect of amnioreduction on maternal polyhydramnios induced by fetal gastrointestinal atresia and its influence on neonatal death. Methods The clinical data of pregnant women with polyhydramnios induced by fetal gastrointestinal atresia and the data of their newborns from May 2018 to May 2021 were retrospectively analyzed. According to the treatment methods, the pregnant women were divided into conventional treatment group, diuretic use group and amnioreduction group. The perinatal complications, delivery mode and pregnancy outcome of the three groups were compared, and the influencing factors of neonatal death were analyzed. Results A total of 126 pregnant women with polyhydramnios induced by fetal gastrointestinal atresia were included. There were 65 pregnant women in the conventional treatment group, the average age was (31.0±4.9) years old, and the gestational week of the first treatment was 23-34⁺⁶ weeks. In the diuretic use group, the mean age of 31 pregnant women was (29.3±5.2) years old, and the gestational week of the first treatment was 25-34⁺⁴ weeks. There were 30 pregnant women in the amnioreduction group, the average age was (31.0±5.3) years old, and the gestational week of the first treatment was 26-34⁺⁶ weeks. There were statistically significant differences in the proportion of premature birth and neonatal death among different treatment groups (P<0.05). The preterm birth rate and neonatal death rate were lower in the amnioreduction group. Compared with the survival group, the proportion of cesarean section and amnioreduction was lower, the rate of premature birth was higher in the death group, and the difference was statistically significant (P<0.05). Binary logistic regression analysis showed that premature delivery and conventional treatment without amnioreduction were independent risk factors for neonatal death (P<0.05). Conclusions Amniotic fluid reduction can prolong the gestational weeks of pregnant women with polyhydramnios induced by fetal gastrointestinal atresia, reduce the rate of premature birth and improve the prognosis of newborns.

Key words: amniocentesis, amnioreduction, neonatal death, fetal gastrointestinal atresia, influencing factor