摘要
目的探讨未足月胎膜早破分娩母儿结局及处理方法。方法选取2011年1月至2012年1月临汾市妇幼保健院产科住院分娩的头位未足月胎膜早破入院病例76例为胎膜早破组，选取同时间段的先兆早产孕妇80例为对照组，比较两组临床资料（胎儿窘迫、剖宫产、绒毛膜羊膜炎、新生儿窒息及围生儿死亡发生率）。比较两组孕28—31＋6周的绒毛膜羊膜炎发生率及孕周延长成功率，比较两组存活新生儿并发症发生情况。结果胎膜早破组的胎儿窘迫、剖宫产、绒毛膜羊膜炎及新生儿窒息的发生率均明显高于对照组（χ2=5．076，4．025，14．834，4．015，P=0．024，0．045，0．000，0．045）。孕28—31＋6周胎膜早破组的绒毛膜羊膜炎、病理确证绒毛膜羊膜炎发生率均明显高于对照组（χ2=6．059，4．674，P=0．014，0．031）。孕28～31“周胎膜早破组延长孕周成功的发生率高于对照组（χ2=9．291，P=0．014，0．002）。胎膜早破组的颅内出血、呼吸窘迫、高胆红素症、新生儿肺炎发生率均高于对照组（χ2=9．456，5．248，15．630，21．165，P=0．002，0．022，0．000，0．000）。而孕周〈34＋6周的发生率则高于≥34＋6周（χ2=8．900，5．594，10．312，10．880，P=0．003，0．018，0．001，0．001）。结论不同孕周的未足月胎膜早破者需予以不同的处理方式，通过对母体、胎儿及新生儿并发症的评估予以对应的治疗措施，从而在延长孕周提高新生儿存活率的同时降低母婴并发症的措施。
Objective To investigate the ending and handling methods of mothers and children with premature rupture of membranes. Methods Seventy-six cases of premature rupture of membranes from January 2011 to January 2012 in maternal and child health hospital of Linfen were selected as premature rupture of membranes group. Eighty cases of threatened premature labor gravida with the same period were chose as the control group. The clinical data（fetal distress, cesarean section, chorioamnionitis, neonatal asphyxia and death rate） between the two groups were compared. Incidence rate of chorioamnionitis and success rate of gestational week extension of the two groups in 28 to 31 ＋6 weeks will be compared. Both groups of living neonatal complications will be compared. Results All the following incidence rates of group of premature rupture of membranes were higher than that in control group, such as, fetal distress, cesarean section, chorioamnionitis and the incidence of neonatal asphyxia （χ2 = 5.076, 4. 025,14. 834,4. 015 ,P = 0. 024,0. 045,0. 000,0. 045 ）. The following incidences rate of group of premature rupture of membranes in 28 to 31 ＋6 weeks were higher than those of the control group, such as chorioamnionitis, pathology confirmed chorioamnionitis（ χ2 = 6. 059,4. 674 ,P = 0. 014,0. 031 ） . The incidence rate of pregnancy week extension of the group of premature rupture of membranes in 28 to 31 ＋6 weeks was higher than that of the control group（ χ2 =9. 291 ,P =0. 014,0. 002）. The following incidence rates of the group of premature rupture of membranes were higher than those of the control group, such as, intraventricular hemorrhage, respiratory distress, high bilirubin, neonatal pneumonia （χ2 = 9. 456, 34 ＋ 6 week ≥ 34 ＋6 week （ χ2 = 8. 900,5. 594,10. 312,10. 880, P = 0. 003,0. 018,0. 001,0. 001 ）. Conclusions The different handling methods should be given to the different gestational weeks of premature rupture of membranes. The corresponding treatment measures will be given through the review of maternal, fetal and neonatal complications, so that as the pregnancy week will be extended and survival rate of neonate is improved, maternal and infant complications will be reduced.
出处
《中国实用医刊》
2014年第6期10-12,共3页
Chinese Journal of Practical Medicine
关键词
未足月胎膜早破
绒毛膜羊膜炎
临床分析
Premature rupture of membranes before term
Chorioamnionitis
Clinical analysis
