未足月双胎胎膜早破46例临床分析

目的讨论双胎未足月胎膜早破（PPROM）的临床特点和妊娠结局。方法回顾性分析双胎PPROM（研究组）46例及同期随机选择的单胎PPROM（对照组）60例,比较两组胎膜早破的发生孕周、并发症合并症发生率、期待疗法、新生儿预后等情况。结果研究组早产儿的体重明显低于对照组,研究组早产儿的窒息率、呼吸窘迫综合征（RDS）等新生儿并发症均高于对照组（P〈0.05或P〈0.01）;研究组破膜前32.6%新生儿有较明显宫缩,对照组破膜前18.3%新生儿有明显宫缩（P〈0.05）。研究组早产率（95.8%）明显高于对照组（31.7%）（P〈0.01）。结论双胎妊娠是导致PPROM的高危因素;双胎合并PPROM的临床处理棘手,早产发生率显著升高,并且新生儿预后差,应积极预防。

Clinical analysis of 46 cases of preterm premature rupture of membranes of twins

Objective To discuss the clinical character and the results of preterm premature rupture of membranes PPROM of twins.Methods 46 cases of PPROM of twins(study group) and 60 cases of PPROM of singletons chosen randomly at the same time(control group) were reviewed retrospectively.The ratio of rupture of membranes,the period of the pregnancy,the rate of complications,temporization and the prognosis of neonates were compared between the two groups.Results The weight of neonates in the study group was much lower than the control group,and the ratio of choke and complications such as respiratory distress syndrome(RDS) of neonates in the study group were all significantly higher than the control group(P < 0.05 or P < 0.01).The uterine contraction appeared before membranes ruptured among 32.6% of neonates in the study group and 18.3% of neonates in the control group(P < 0.05).The ratio of premature birth was 95.8% in the study group,higher than the control group(31.7%)(P < 0.01).Conclusion The twins pregnancy is the risk factor of causing PPROM;the clinical treatment of twins pregnancy combined with PPROM is difficult,the radio of premature birth is significantly increased and the prognosis of neonates is bad,therefore,aggressive prevention should be taken.