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,差异有统计学意义(P<0.05)；孕34~36+6周PPROM,潜伏期>48 h者与高于<48 h者剖宫产率与母婴合并症发生率,差异无统计学意义(P>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(P<0.05),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。%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(P<0.05);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.