未足月妊娠胎膜早破临床分析

目的探讨未足月胎膜早破(PPROM)的妊娠结局及临床处理。方法宝鸡市第三人民医院妇产科2005年1月至2010年12月孕28～36+6周PPROM孕妇98例,选择同期足月胎膜早破(PROM)98例作为对照组。观察胎膜早破对母婴的影响。结果孕28～33+6周与孕34～36+6周PPROM相比,新生儿感染、窒息、病死率的差异有统计学意义(P<0.05)。PPROM组与PROM相比,产褥感染、产后出血、新生儿窒息等差异有统计学意义(P<0.05),分娩方式间差异无统计学意义(P>0.05)。结论 PPROM孕妇选择合适分娩时机及分娩方式,能获得良好的妊娠结局。采取期待疗法时,应用预防感染、促进胎肺成熟及抑制宫缩等方法,以达到提高新生儿存活率、减少新生儿并发症的目的。

Clinical Analysis of Expectant Management of Preterm Premature Rupture of Membranes

Objective To analyze clinical management and pregnancy outcome in pregnancy complicated with preterm premature rupture of membranes（PPROM）.Methods The clinical data of 98 patients with PPROM at 28-36＋6 weeks in The Third People′s Hospital of Baoji from January 2005 to December 2010 were retrospectively studied.At the same time 98 cases of full-term pregnancy with PROM hospitalized in the same period were randomly selected as contrast group for comparison.Results In patients at 28-33＋6 weeks gestation compared with 34-36＋6 weeks gestation on PPROM,the neonatal infection,the asphyxiated newborns the neonatal mortality were statistically significant（P0.05）.The group of PPROM compared with contrast group,the puerperal infection,the postpartum hemorrhage,the asphyxiated newborns and the neonatal mortality were statistically different（P0.05）.Compared with the contrast group,the delivery methods was not statistically different（P0.05）.Conclusion Pregnancy with PPROM need expectant management,including the prevetion of infection,the promotion of fetal lung maturity and the inhibition of uterine contraction,to reduce neonatal complications.Appropriate selection of the delivery moment and proper delivery mode are helpful for good pregnancy outcome.