摘要
目的:探讨未足月胎膜早破(PPROM)孕产妇早产潜伏期和不同终止妊娠时机及分娩方式对母婴结局影响.方法:回顾性分析2017年1月-2020年6月本院妇产科收治的267例PPROM(孕28^(+3)~36^(+6)周)孕产妇临床资料,根据潜伏期<24h或≥24h及处置方案分为3组,破膜后<24h不加处置待自然分娩为自然临产组52例,破膜≥24h无宫缩给予缩宫素诱导分娩为缩宫素诱导组138例,破膜后给予利托君或硫酸镁抑制宫缩保胎至分娩为期待组77例.比较3组妊娠结局(剖宫产率),母婴并发症(宫内感染率、产褥感染率、产后出血率,新生儿呼吸窘迫综合征及围生儿死亡发生率).结果:267例PPROM早产孕产妇中经剖宫产结束妊娠80例(30.0%),剖宫产率期待组(59.7%)高于缩宫素诱导组及自然临产组(16.7%、21.2%),宫内感染(26.0%)和产褥病率(23.4)均高于缩宫素诱导组及自然临产组(7.2%、5.8%,5.1%、3.9%)(均P<0.05).母婴并发症发生率3组无差异(P>0.05).结论:临床对PPROM早产孕产妇在胎儿已成熟(孕龄≥34周)、破膜后一定时间内(24h内)应考虑及时终止妊娠,以产科常规确定分娩方式,可获得良好妊娠结局.
Objective: To investigate the effects of the incubation period of delivery, the timing of termination, and the mode of delivery of pregnant women with preterm premature rupture of membranes(PPROM) on their pregnancy outcomes. Methods: The clinical data of 267 pregnant women with PPROM(in 35-36 gestational weeks) from January 2017 to June 2020 were analyzed retrospectively. According to the incubation period of delivery < 24 h or ≥ 24 h and the treatment scheme, these women were divided into three groups, which included 52 women without treatment in 24 h after membrane rupture and waiting for natural delivery in group A, 138 women without uterine contraction within 24 hours after rupture of membranes were given oxytocin intravenous drip to induce delivery in group B, and 77 women who had been given ritodrine or magnesium sulfate intravenously after membrane rupture to inhibit uterine contraction and protect the fetus until delivery in group C. The pregnancy outcomes(cesarean section rate), and the maternal and infant complications, such as intrauterine infection rate, puerperal infection rate, postpartum hemorrhage rate, neonatal respiratory distress syndrome, and perinatal death rate of the women were compared among the three groups. Results: 80(30.0%) women in 267 women with PPROM had terminated their pregnancy by cesarean section. The cesarean section rate(59.7%) of the women in group C was significantly higher than that(16.7%) of the women in group B or that(21.2%) of the women in group A. The rates of intrauterine infection(26.0%) and puerperal disease(23.4) of the women in group C were significantly higher than those(7.2% and 5.8%) of the women in group B or those(5.1% and 3.9%)of the women in group A(all P<0.05).There was no significant difference in the incidence of maternal and infant complications of the women among the three groups(P>0.05).Conclusion:The mature fetus(≥34gestational week)of the pregnant women with PPROM and within 24hafter membrane rupture should be consider terminating pregnancy in time,and their mode of delivery should be determined according to obstetric routine,so as to obtain the good pregnancy outcomes.
作者
曾令芳
陈玲
金彩凤
吴全恩
陈敏
ZENMG Lingfang;CHEN Ling;JIN Caifeng;WU Quanen;CHEN Min(Huangshan City people's Hospital,Huangshan,Anhui Province,238000;The First Affiliated Hospital of University of Science and Technology of China,Hefei)
出处
《中国计划生育学杂志》
2022年第10期2321-2324,2329,共5页
Chinese Journal of Family Planning
基金
中华国际科学交流基金会检验检测科技专项基金(Z2019LAH003)。
关键词
胎膜早破
早产
潜伏期
终止妊娠
分娩方式
妊娠结局
Premature rupture of membranes
Preterm delivery
incubation period
Termination of pregnancy
Mode of delivery
Pregnancy outcomes
