早产因素及阻止早产的临床研究

目的 探讨早产原因及其对母儿的影响，为阻止早产提供经验。方法 回顾分析200例早产的原因及其对母儿的影响，并与同期足月产200例进行对比分析。同时对〈35孕周的足月前胎膜早破（PPROM）性早产是否进行保胎治疗对母儿的影响进行分析比较。结果 胎膜早破、胎盘因素、双胎、臀位、妊娠期肝内胆汁淤积症（ICP）、妊娠高血压疾病等为早产主要原因。〈35孕周的PPROM所致的早产产前给予糖皮质激素联合抗生素及宫缩柳制剂保胎治疗，能有效降低围产期死亡率。孕期各种宫颈阴道炎症，有“早产”、“流产”史及低社会层次未接受孕期保健者为早产高危人群。结论 对〈35周的PPROM给予适当的保胎治疗。对胎膜早破及各种孕期并发症、合并症进行积极治疗，对早产高危人群进行重点孕期保健以及积极治疗孕前各种宫颈及阴道炎症。可有效地降低早产的发生率并减少早产对母儿的危害。

Clinical research of factors for premature labor and preventing premature labor

Objective To investigate the causes of premature delivery and the influence on the pregnant women and fetus, and provide a base for its prevention and cure. Methods Compared with simultaneous term birth in 200 cases, the causes of premature delivery in 200 cases and the influence on the pregnant women and fetus were retrospectively analyzed. Contrasting analysis was performed about the influence of tocolysis and non-tocolysis therapy on the pregnant women and fetus with premature delivery from preterm premature rupture of membrane(PPROM) in 35 gestational weeks. Results The main causes included premature rupture of membrane, placental factors, unknown aetiology, bigeminal, glutea position, intrahepatic cholestasis of gestational period(ICP), gestational hypertension and so on. Tocolysis management including prenatal glucocorticoid combined with antibiotics and suppressant of uterine contraction could effectively lower the perinatal mortality in the patients with premature delivery from PPROM in 35 gestational weeks. High risk group of premature delivery referred to those women with various kinds of gestational cervicovaginitis, with history of premature delivery or abortion, in low social layer and without antenatal care. Conclusions The management for prevention of premature delivery, which includes active treatment of various kinds of cervicovaginitis in progestation, intensive antenatal care in high risk group of premature delivery, prevention and cure of premature rupture of membrane and various kinds of complications and tocolysis therapy of PPROM in 35 gestational weeks, is very important for the improvement of medical quality in perinatology.