未足月胎膜早破潜伏期对母婴结局的影响  

Effect of Maternal and Neonatal Outcomes Associated with Latency Period after Preterm Premature Rupture of Membrane

作　　者：李玲[1] 吴金芝[1] 李萍[1] 陈新娟[1] 范建辉[1] 

机构地区：[1]中山大学附属第三医院产科,广东广州510630

出　　处：《中山大学学报（医学科学版）》2013年第4期590-595,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2011B061300030)

摘　　要：[目的]观察不同孕周未足月胎膜早破（PPROM）孕妇潜伏期的长短对分娩方式及母婴并发症的影响.[方法]收集2009年1月至2012年3月在我院住院分娩的妊娠28～36周PPROM孕妇160例,对其一般资料和母婴并发症进行统计分析.计量资料采用t检验,定性资料采用卡方检验或Fisher确切概率法.[结果]妊娠28～ 31＋6周PPROM,潜伏期＞72h,剖宫产率为70％,比潜伏期＜72h增加了41.4％（P＜0.05）;妊娠32 ～ 33＋6周PPROM,潜伏期＞72h和潜伏期＜72h,剖宫产率和母婴合并症发生率未见差异;妊娠34～36周PPROM潜伏期＜24 h和潜伏期＞24 h组,绒毛膜羊膜炎的发生率呈现明显递增趋势（26.4％,59.3％,P＜ 0.05）,而新生儿结局差异无统计学意义.[结论]对于妊娠28～31＋6周PPROM孕妇,在促胎肺成熟的同时,可适当延长孕周,并考虑剖宫产作为分娩时首选;对于妊娠32 ～ 33＋6周PPROM孕妇,用促胎肺成熟一疗程后酌情选择分娩方式;对于＞ 34周的PPROM孕妇,建议评估胎儿情况后予以引产.[Objective] To observe what is the effect of maternal and neonatal outcomes associated with latency period after preterm premature rupture of membrane （PPROM）. [ Methods ] One hundred and sixty pregnant women with PPROM who had delivered in the Third Affiliated Hospital of Sun Yat-sen University from January 2009 to March 2012 were enrolled, their fetal membranes were ruptured during 28-36 weeks. The general conditions and maternal and neonatal complications date were analyzed. The measurement date were analyzed by t test, qualitative date were analyzed by chi square test or Fisher exact test. [ Resuhs ] 1. Among the pregnant women with PPROM during 28-31 ＋6 weeks, the rate of cesarean section in the latency period more than 72 hours was significantly higher than that of less than 72 hours （70.0% vs 28.6% ,P 〈 0.05）. 2.Among the pregnant women with PPROM during 32-33＋6 weeks, all the statistical date showed that the maternal and neonatal complications between latency period more than 72 hours and less than 72 hours had no statistical difference. 3. Among the pregnant women with PPROM during 34-36 weeks, the rate of chorioamnionitis in the latency period more than 24 hours was significantly higher than that of less than 24 hours （59.3% vs 26.4%, P 〈 0.05 ）. [ Conclusion ] 1 .The pregnant women with PPROM during 28-31 ＋6 weeks needed to make the fetal lung mature and to extend gestational weeks properly, taking caesarean section as prime choice. 2.The pregnant women with PPROM during 32-33＋6 weeks considered to choice the delivery modes once the fetal lung was mature by a course of treatment. 3.The pregnant women with PPROM during 34-36 weeks were advised to labor induction after evaluating the fetal conditions.

关 键 词：未足月胎膜早破 潜伏期 剖宫产 绒毛膜羊膜炎 

分 类 号：R714.7[医药卫生—妇产科学]