孕34周前胎膜早破128例妊娠结局分析

目的探讨孕34周前发生胎膜早破者期待治疗的妊娠结局。方法选择2008年1月-2009年12月我院住院分娩的未足月胎膜早破（PPROM）孕妇128例。根据胎膜破裂时孕周将孕妇分为两组，其中孕周28～31＋6周为组I，共52例；孕周32～33＋6周为组Ⅱ，共76例。对两组的妊娠结局进行分析。结果组I新生儿窒息、新生儿呼吸窘迫综合症（NRDS）、新生儿缺血缺氧性脑病（HIE）、颅内出血、围产儿死亡率高于组Ⅱ，差异有统计学意义（P〈0．05）。两组孕妇分娩方式的差异无统计学意义（P〉0．05）。结论PPROM是国产儿发病和死亡的主要原因；胎龄越小、死亡率越高。在临床工作中应提高PPROM的预防、诊断及治疗水平，从而提高产科治疗质量，降低同产儿病率。

The pregnancy outcomes of preterm premature rupture of membranes prior to 34 weeks's gestation in 128 women

Objective To explore the pregnancy outcomes of preterm premature rupture of membranes (PPROM) prior to 34 weeks' gestation. Methods 128 women with PPROM who had experienced labor in our hosptial during the period of January 2008 to December 2009 were assigned to group with 28 to 31 week's gestation (52 women, group Ⅰ)or group with 32 to 34 week's gestation (76women, group Ⅱ) based on their gestational age. The pregnancy outcomes were analyed in the two groups.Results The incidences of neonatal asphyxia, neonatal respiratory distress syndrome, neonatal hypoxic-ischemicencephalopathy, intracranial hemorrhages, and perinatal death were significantly higher in group Ⅰ than in group Ⅱ (P<0.05). There was no significant difference in labor pattern between the two groups (P> 0.05). Conclusions Preterm premature rupture of membranes is a primary cause of perinatal diseases and death. The shorter the gestational age, the higher the perinatal death rate. The quality of obstetric care can be improved and the perinatal morbidity can be reduced by elevating the level of prevention, diagnosis, and treatment.