摘要
目的探讨未足月胎膜早破(preterm premature rupture of membranes,PPROM)残余羊水指数对母婴结局的影响。方法选取2021年1月至2023年1月潍坊市妇幼保健院产科收治的168例PPROM孕妇作为研究对象,应用超声测定羊水指数(amniotic fluid index,AFI),根据AFI分为羊水过少组(AFI≤5 cm),羊水偏少组(5 cm<AFI≤8 cm),羊水正常组(8 cm<AFI≤25 cm)。比较3组年龄、孕次、产次、瘢痕子宫、入院羊水指数、破膜孕龄、破膜至分娩时间、分娩孕龄、分娩方式、胎盘粘连、绒毛膜羊膜炎及新生儿出生时体质量、Apgar评分、新生儿窒息、新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)、湿肺、新生儿感染、脑损伤、心肌损伤、凝血功能障碍、支气管肺发育不良、消化道出血等情况,探讨对母婴的影响。结果168例PPROM孕妇中,羊水过少56例,羊水偏少66例,羊水正常46例。3组孕妇瘢痕子宫、破膜至分娩时间及胎盘粘连、绒毛膜羊膜炎发生情况比较差异无统计学意义;3组孕妇年龄、孕次、产次、入院羊水指数、破膜孕龄、分娩孕龄、分娩方式比较差异有统计学意义(P<0.05)。3组新生儿窒息、湿肺、新生儿感染、脑损伤、心肌损伤、凝血功能障碍、消化道出血发生情况比较差异无统计学意义;3组新生儿出生体质量、1 min与5 min Apgar评分、NRDS及支气管肺发育不良发生情况比较差异有统计学意义(P<0.05)。结论年龄越大、孕产次越多、破膜孕龄越小越易发生羊水过少及医源性早产,且对新生儿活力影响越大,其不良结局发生率越高。
Objective To investigate the impact of the residual amniotic fluid index(AFI)on maternal and neonatal outcomes in patients with preterm premature rupture of membranes(PPROM).Methods A total of 168 pregnant women with PPROM admitted to the department of Obstetrics at Weifang Maternal and Child Health Hospital from January 2021 to January 2023 were selected as the study subjects.The amniotic fluid index(AFI)was measured by ultrasound,participants were divided into the oligohydramnios group(AFI≤5 cm),low amniotic fluid group(5 cm<AFI≤8 cm),and normal amniotic fluid group(8 cm<AFI≤25 cm).The maternal age,gravidity,parity,uterine scars,admission AFI,gestational age at membrane rupture,latency period from membrane rupture to delivery,gestational age at delivery,mode of delivery,placental adhesion,chorioamnionitis,as well as neonatal birth weight,Apgar scores,neonatal asphyxia,neonatal respiratory distress syndrome(NRDS),wet lung,neonatal infection,brain injury,myocardial injury,coagulation dysfunction,bronchopulmonary dysplasia,and gastrointestinal hemorrhage to assess the impact on mothers and neonates were compared among the three groups.Results Among the 168 PPROM patients,56 cases in the oligohydramnios group,66 cases in the low amniotic fluid group,and 46 cases in the normal amniotic fluid group.There were no statistically significant differences in the comparison of scarred uterus,the time from rupture of membranes to delivery,and the occurrence of placental adhesion and chorioamnionitis among the three groups of pregnant women.There were statistically significant differences in age,number of pregnancies,number of deliveries,amniotic fluid index at admission,gestational age at rupture of membranes,gestational age at delivery and mode of delivery among the three groups of pregnant women(P<0.05).There were no statistically significant differences in the occurrence of neonatal asphyxia,wet lung,neonatal infection,brain injury,myocardial damage,coagulation dysfunction and gastrointestinal bleeding among the three groups.There were statistically significant differences in the birth weight,1 min and 5 min Apgar scores,NRDS and the occurrence of bronchopulmonary dysplasia among the three groups of newborns(P<0.05).Conclusion The older the age,the higher the parity and the earlier the gestational age at rupture of membranes,the more likely it is to develop oligohydramnios and iatrogenic preterm birth;additionally,the greater the impact on neonatal vitality and the higher the incidence of adverse outcomes.
作者
孙玲玲
范钟婷
崔娟娟
曹怀明
SUN Lingling;FAN Zhongting;CUI Juanjuan;CAO Huaiming(Weifang Maternal and Child Health Hospital,Weifang,Shandong,261000,China)
出处
《当代医学》
2025年第15期135-139,共5页
Contemporary Medicine
基金
潍坊市卫生健康委员会科研项目(WFWSJK-2020-228、WFWSJK-2021-218)。
关键词
未足月胎膜早破
羊水指数
宫内感染
早产
Preterm premature rupture of membranes
Amniotic fluid index
Intrauterine infection
Premature birth
