318例未足月胎膜早破临床分析

目的探讨未足月胎膜早破(pretermprematureruptureofmembranes,PPROM)发生的危险因素、期待治疗及妊娠结局。方法回顾性分析2002年6月~2005年6月在我院产科住院的未足月胎膜早破的病例318例。结果87.2%的PPROM存在易发因素,其中129例患者经期待治疗延长胎龄21~336h,平均84.3h。比较孕28~33+6周与34~36+6周的PPROM,发现两组PPROM新生儿窒息率、RDS发生率等有显著性差异(P<0.05)。经期待治疗的患者均作CRP检测,CRP≤8mg组与CRP>8mg组新生儿窒息率差异无显著性(P>0.05),CRP>8mg组产后出血率及新生儿病率、产褥病率显著增加(P<0.01)。结论导致PPROM的因素很多;CRP对预示母儿近期预后有一定意义;对孕28~33+6周者宜用期待疗法,尽可能减少母儿感染率,以获得母儿最佳结局。

Clinical analysis on 318 cases of preterm premature rupture of membrane

Objective: To study the high risk factors of preterm premature of rupture of membrane (PPROM) and related factors of affecting maternal and preterm infants in expectation treatments.Methods:A retrospective review was made about 318 cases of PPROM between Jun 2002 and Jun 2005 in the Women and Children's Hospital of GuangZhou.Results:87.2 % of the cases had high risk factors of PPROM. 129 cases of them prolonged pregnant period 21-336h, average 84.3h. A comparison of 28-33+6 weeks with 34-36+6 weeks shown neonatal asphyxia and neonate respiratory distress syndrome (RDS) had significant difference(P<0.05).In cases which nonintervention,care must be taken to c-reactive protein measurements. Compared the group of CRP≤8mg with CRP>8mg, neonatal asphyxia was no obvious difference (P>0.05). The group of CRP>8mg had higher neonatal morbidity, postpartum hemorrhage and puerperal morbidity rates.Conclusion:Many factors con cause PPROM. CRP is significant in maternal and neonatal recent prognosis. We should take expectation treatments in 28-33+6 weeks of PPROM, to reduce neonatal comlictions and maternal infection, and to improve the optimum quality.