目的：分析不同孕周发生的未足月胎膜早破及其期待期对妊娠结局的影响。方法对2010年1月~2015年4月在我院住院分娩的322例(28~36+6周)PPROM临床病例资料进行分析。按PPROM发生时孕周分成两组：①P28~33+6周；②P34~36+6周。根据期待期是否达到48 h,两组再各分为两个组,分别对比两组不同期待期与妊娠结局的关系。结果孕28~33+6周PPROM组发生绒毛膜炎、胎儿窘迫、新生儿呼吸窘迫综合征均高于孕34~36+6周PPROM组；孕34~36+6周PPROM孕妇,期待期超过48 h组发生绒毛膜炎、产后出血、新生儿感染的比例明显高于期待期在48 h内组。孕28~33+6周PPROM孕妇,期待期超过48 h组发生胎儿窘迫、新生儿窒息均低于期待期在48 h内组；并未增加母儿其他不良反应发生。结论对孕28~33+6周PPROM 可采取促胎肺成熟、抑制宫缩和预防感染处理,尽可能延长期待期48 h以上或34周后终止妊娠；对孕34~36+6周PPROM应尽快终止妊娠。%Objective To explore the effects of different gestational weeks and latency on pregnancy in preterm prema-ture rupture of membranes. Methods All 322 cases of PPROM (28-36+6 weeks) hospitalized from January 2010 to April 2015 were retrospective studied. All cases were divided into two groups by gestational weeks(1)28-33+6 gesta-tional weeks;(2)34-36+6 gestational weeks;each group was further divided into two subgroups by latency,the analysis on the relationship between pregnant weeks,latency and maternal-neonatal outcome was conducted. Results The inci-dences of chorioamnionitis,fetal distress and NRDS in 28-33+6 weeks group were significantly higher than which in 34-33+6 weeks group. In 34-36+6 weeks of PPROM,the incidences of chorioamnionitis,postpartum hemorrhage and neonatal infection were higher in latency over 48 h group than latency within 48 h group. In 28-33+6 group, the incidences of fetal distress and neonatal asphyxia were lower in group of latency over 48 h than which in group of latency within 48 h. There was no difference of other maternal-neonatal complication incidence between the different latency. Conclusion The suitable measures to treat PPROM of 28-33+6 gestational weeks are uterine contraction inhibition,fetal lung matu-ration promotion, infection prevention, extending lantency over 48 h or terminating pregnancy after 34 gestational weeks. To the patients with PPROM at 34-36+6 gestational weeks,the termination of pregnance promptly is the suitable measure to treat.
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