未足月胎膜早破不同孕周及潜伏期长短对母婴结局的影响.docVIP

未足月胎膜早破不同孕周及潜伏期长短对母婴结局的影响 　　【摘要】 目的 探讨未足月胎膜早破（PPROM）破膜孕周及不同潜伏期长短对母婴妊娠结局的影响及临床意义。方法 回顾性分析160例孕28～36+6周PPROM， 孕产妇和新生儿的临床资料。结果 孕28～33+6周PPROM组， 潜伏期48 h者剖宫产率高于48 h者与高于0.05）；孕34～36+6周PPROM组， 潜伏期48 h者羊膜腔感染率率高于48 h者， 差异有统计学意义（P0.05）， 而新生儿结局差异无统计学意义。结论 对孕28～33+6周PPROM应采取促胎肺成熟的同时， 可适当延长孕周，并考虑剖宫产作为终止妊娠首选；而孕34～36+6周PPROM胎儿肺成熟者应在破膜48 h以内终止妊娠。 　　【关键词】 胎膜早破；潜伏期；妊娠结局 　　【Abstract】 Objective To study the effects and clinical significances of different gestational weeks and latent period on pregnancy outcomes in preterm premature rupture of membrane（PPROM ）. Methods The clinical data from 160 gravidas between 28～36+6weeks with PPROM and neonate information were retrospectively analyzed. Results Among the pregnant women with PPROM during 28～33+6 weeks， the rate of cesarean section in the latency period more than 48 hours was significantly higher than that of less than 48 hours（P0.05）； Among the pregnant women with PPROM during 34～36+6 weeks， all the statistical date showed that the maternal and neonatal complications between latency period more than 48 hours and less than 48 hours had no statistical difference； Among the pregnant women with PPROM during 34～36+6 weeks，the rate of chorioamnionitis in the latency period more than 48hours was significantly higher than that of less than 48 hours. Conclusion The pregnant women with PPROM during 28～33+6 weeks needed to make the fetal lung mature， preventing infection and to extend gestational weeks properly， taking cesarean section as prime choice. The patients with PPROM at 34～36+6 gestational week with maturation of the fetal lung it should terminate the pregnancy within 48h after the rupture of membrane. 　　【Key words】 Premature rupture of membrane； Latent period； Pregnancy outcome 　　未足月胎膜早破（preterm premature rupture of the membranes， PPROM）是指妊娠未满37周胎膜在临产前自发发生破裂，发生率约为3% ～4%。PPROM可导致宫内感染、胎盘早剥、产后出血、胎儿窘迫等一系列并发症[1]。PPROM主要根据综合评估不同孕周和潜伏期长短的相对风险来采取不同的治疗措施、延长孕周和适时终止妊娠。本文对本院住院的160例PPROM进行回顾性分析，现报告如下。 　　3 讨论 　　PPROM对母儿的危害很大， 发生后选择尽量延长潜伏期