특발성 양수과다증과 주산기 예후와의 연관성

Abstract

Objective : There have been conflicting reports as to whether higher rates of poor perinatal outcome carry over in cases of idiopathic hydramnios. Thus, this study was undertaken to determine whether there is any association between idiopathic hydramnios and adverse perinatal outcome. Methods : From January 1995 to December 1999, 103 consecutive women with singleton pregnancies complicated by idiopathic hydramnios(amniotic fluid index≥25cm) who were delivered at the Severance hospital were studied. Measured perinatal outcomes and maternal complications included preterm delivery, small for gestational age, large for gestational age, malpresentation at delivery, primary cesarean section rate, Apgar score at 5 minutes<7, admission to the neonatal intensive care unit, perinatal death, and postpartum hemorrhage. These findings were compared by means of the chi-square test, Fisher exact test, student's t-test, and logistic regression test with those of 320 control subjects with normal amniotic fluid index(5<amniotic fluid index<24). Results : We observed that idiopathic hydramnios was associated with significantly higher rates of preterm delivery(relative risk(RR) 1.9), large for gestational age(RR 3.0), malpresentation at delivery(RR 2.5), primary cesarean section rate(RR 3.2), Apgar score at 5 minutes<7(RR 14.3), and neonatal intensive care unit admission(RR 3.4). Conclusion : Idiopathic hydramnios was associated with poor perinatal outcomes. Thus, careful fetal surveillance is warranted and serial sonograms might be a useful tool to track the development of excessive fetal growth and amniotic fluid volume.