未足月胎膜早破的临床处理对妊娠结局的影响

目的分析未足月胎膜早破的临床处理对妊娠结局的影响。方法将144例未足月胎膜早破患者根据孕周不同分为28~33孕周组(66例)和34~36孕周组(78例),根据孕周对其进行不同的处理。比较两组的治疗效果。结果两组入院后48 h的hs-CPR、CPR、IL-6、IL-8水平均升高,入院后72 h均降低,且34~36孕周组不同时间点上述指标水平均低于28~33孕周组(P<0.05)。两组潜伏期>48 h的母婴结局均比潜伏期≤48 h差。28~33孕周组潜伏期≤48 h的剖宫产率和潜伏期>48 h的新生儿呼吸窘迫发生率均高于34~36孕周组同潜伏期(P<0.05)。结论对妊娠28~33周胎膜早破患者给予期待保胎治疗,适当延长潜伏期,可提高胎儿娩出存活率,但要根据母婴情况适时结束妊娠,以降低不良母婴结局;对妊娠34~36周的胎膜早破且胎肺成熟者,应在48 h内结束妊娠,缩短潜伏期,以减少不良妊娠结局。

Influence of clinical procedures of preterm premature rupture of membranes on pregnancy outcome

Objective To analyze the influence of clinical procedures of preterm premature rupture of membranes on pregnancy outcome.Methods According to different gestational weeks,144 patients with preterm premature rupture of membranes were divided into 28-33 gestational weeks group(66 cases)and 34-36 gestational weeks group(78 cases),and were treated differently according to gestational age.The therapeutic effects of the two groups were compared.Results At 48 h after admission,the hs-CPR,CPR,IL-6,IL-8 levels in the two groups increased,and those at 72 h after admission decreased,and levels of those indexes at different time points in the 34-36 gestational weeks group were lower than the 28-33 gestational weeks group(P<0.05).The maternal and infant outcomes of latent period>48 h in both groups were worse than those of latent period≤48 h.Cesarean section rate of latent period≤48 h and the incidence of neonatal respiratory distress of latent period>48 h in the 28-33 gestational weeks group were higher than those of same latent period in the 34-36 gestation weeks group(P<0.05).Conclusion Expectant foetal protection treatment in patients with preterm premature rupture of membranes at 28-33 gestation weeks,and appropriately extending latent period can improve the survival rate of fetal delivery,but the pregnancy should be terminated timely according to maternal and infant conditions to reduce adverse maternal and infant outcomes.For patients with premature rupture of membranes and fetal lung maturity at 34-36 gestation weeks should be terminated timely within 48 h,shorten the latent period to reduce adverse pregnancy outcome.