611例胎膜早破危险因素及妊娠结局的临床回顾性分析

目的 探讨胎膜早破的高危因素、分娩方式及对妊娠结局的影响.方法 回顾性分析2011年1月至2012年12月在山西医科大学第一医院住院分娩的611例胎膜早破孕妇的相关临床资料（本研究遵循的程序符合山西医科大学第一医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象知情同意,并与之签署临床研究知情同意书）.结果 研究结果认为：①本院胎膜早破的发生率为15.1%（611/4 047）,其中未足月胎膜早破的发生率为2.6%（104/4 047）,足月胎膜早破发生率为12.5%（507/4 047）.②导致胎膜早破的高危因素主要为生殖道感染、流产或引产史与宫腔内压力增加（因巨大儿、双胎与多胎妊娠、羊水过多所致）,妊娠期高血压疾病等.③足月胎膜早破的阴道分娩率高于未足月胎膜早破,而足月胎膜早破的剖宫产率低于未足月胎膜早破.足月胎膜早破的胎儿窘迫及新生儿窒息的发生率低于未足月胎膜早破,且差异有统计学意义（P〈0.05）.结论 胎膜早破可对母婴造成不良影响,应重视胎膜早破的高危因素,加强孕前和孕期保健,降低胎膜早破的发生率,并对不同孕周胎膜早破患者加强临床监护,给予正确处理,减少母婴并发症.

Retrospective Analyze of Clinical Risk Factors and Pregnancy Outcome of 611 Cases Premature Rupture of Membranes

Objective To summary the high risk factors,deliver way of premature rupture of membrane, and its influence on pregnancy outcomes.Methods The clinic data of 611 pregnant women with premature rupture of membrane from January 2011 to December 2012 in Shanxi Medical University First Hospital were analyzed retrospectively. The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of Shanxi Medical University First Hospital.Informed consent was obtained from each participating patient. Results 15.1%（611/4 047） in our hospital,the incidence of preterm premature rupture of membrane was 2.6%（104/4 047） and the incidence of term premature rupture of membranes were the history of abortion or induced labor, reproductive tract infections, intrauterine pressure increases（large for date infant, twins and vaginal delivery rate of term premature rupture of membranes is higher than preterm premature rupture of membranes, and the cesarean delivery rate is significantly lower than preterm one. The incidence of fetal distress and neonatal asphyxia of term premature rupture of membranes is lower than preterm one（P〈0.05）. Conclusions Premature rupture of membranes can be adverse effects on the maternal and infant.We should pay more attention about the high risk factors of premature rupture of membrane, strengthen the pre-gestation and antenatal care to reduce the incidence rate of premature rupture of membranes, and take more clinical guardianship and correct treatment for the patients to reduce maternal and infant complications.