足月和近足月胎膜早破促宫颈成熟干预效果的探索  

The study of promoting cervical mature of patients with premature rupture of membranes at full-term and near full-term

作　　者：蔡迪利 陈志琴[1] 朱丹阳[1] 严德文 

机构地区：[1]浙江省台州市第一人民医院妇产科,318020

出　　处：《中国计划生育学杂志》2015年第11期759-761,765,共4页Chinese Journal of Family Planning

摘　　要：目的：探讨不同引产方法对近足月或足月胎膜早破围产期母儿结局的影响.方法：选取2012年1月～2015年1月在本院住院孕≥35周胎膜早破孕妇共450例,根据孕妇及其家属意愿自行选择立即引产（观察组）或等待8～12h后行引产（对照组）.观察组（n=340）包括宫颈成熟组（n=225）和宫颈不成熟组（n=115）,对照组（n=1110）.比较两组临产及产程时间、羊水粪染率、分娩方式、产后出血量及围产期母儿病率,并记录使用控释地诺前列酮栓病例子宫过度刺激情况及其他不良反应.结果：观察组中宫颈成熟组与宫颈不成熟组相比,产后出血、宫内感染、产褥病及新生儿围生期病发病率比较差异均无统计学意义（x（2=0.001、2.943、1.951、1.963,均P＞0.05）;观察组与对照组相比产后出血发生率无差异（x2=0.393,P＞0.05）,观察组宫内感染、产褥病及新生儿围生期病发病率均低于对照组（x2=10.621、17.413、14.130,均P＜0.05）.观察组宫颈不成熟组羊水浑浊率高于宫颈成熟组（x2=39.393,P＜0.05）.观察组总产程低于对照组（t=3.0782,P＜0.01）、阴道分娩率高于对照组（x2=6.973,P＞0.05）.两组均无严重不良反应.结论：根据宫颈成熟度决定引产方式对母儿围产期预后、临产率和产程时间更具优势.Objective： To explore the effects of different promoting cervical mature and induced labor methods for pa- tients with premature rupture of membranes at full-term and near full-term. Methods： From January 2012 to January 2015 in the first people＇s hospital of Taizhou, a total of 450 pregnant women with premature rupture of membranes were recruited, whose gestational age were all over 35 weeks. According to wills of the women and their families, these included women were divided into observation group （n = 340） and control group （n = 110）. The observation group included women with cervical mature （n = 225） and women with cervical immature （n = 115）, and all of them had been induced immediately. Women in control group had been induced after waiting for 8-12hours. The outcomes includ- ed state of Labor , labor time, rate of amniotic fluid dyeing dung, delivery way, postpartum hemorrhage, and morbid- ity of mother and baby in perinatal, and analysis the rate over stimulate uterine and other adverse effects after using Di- noprostone. Results： In observation group, there was no statistical significance differences for postpartum hemor- rhage, intrauterine infection, puerperal disease and neonatal morbidity of patients with cervical mature compared with that of cervical immature group（X2 = 0.001, 2.943, 1.951, 2.943, P〉 0.05）.The incidence of postpartum hemorrhage in the observation group and the control group was no significant difference （X2 = 0.393, P 〉 0.05）. The incidence rates of intrauterine infection, puerperal disease and neonatal morbidity of observation group were significant lower than those of control group （X2 =10.621, 17.413 and 14.130, P 〈 0.05）. Rate of amniotic fluid turbidity of cervical immature group was higher than that of cervix mature group （Z2= 39.393, P 〈 0.05）. The time of total labor of ob- servation group was significantly shorter than that of control group （t = 3.0782, P 〈 0.01）. Rate of vaginal delivery of observation group was higher

关 键 词：胎膜早破 合理干预 母儿结局 

分 类 号：R719.3[医药卫生—妇产科学]