14省市自治区足月胎膜早破产妇分娩方式及围产结局分析  

Mode of delivery and perinatal outcomes in women with premature rupture of membranes at term

作　　者：侯磊[1] 王欣[1] 邹丽颖[1] 阮焱[1] 陈奕[1] 李光辉[1] 张为远[1] 

机构地区：[1]首都医科大学附属北京妇产医院,100026

出　　处：《中华医学杂志》2016年第13期1058-1061,共4页National Medical Journal of China

基　　金：国家卫生与计划生育委员会卫生公益性行业科研专项（201002013）

摘　　要：目的探讨足月胎膜早破的产妇及新生儿结局，为临床处理提供评估依据。方法选择2011年1月1日至12月31日间，中国大陆北京、上海、吉林、辽宁、江苏等14个省、市、自治区共39家医院的所有住院分娩产妇临床资料，共103124例，组间率的比较采用）（。检验，分娩结局采用多因素Logistic回归。结果足月胎膜早破发病率13．6％（14073／103124），足月胎膜早破产妇妊娠期糖尿病、胎儿窘迫发病率显著高于对照组（P〈0．05），剖宫产率显著低于对照组（44．9％比56．0％）。胎膜早破产妇产后出血、产后并发症及新生儿并发症均显著高于正常对照组，主要表现为新生儿呼吸窘迫综合征及胎粪吸入性肺炎发病率的增加。胎膜早破新生儿中1min的APGAR评分〈7者显著少于对照组。结论足月胎膜早破产妇的剖宫产率显著下降，其不良分娩结局的发生风险增高主要表现在产后出血、产后并发症及新生儿并发症方面。Objective Comparative study of delivery mode and perinatal outcomes in women with premature rupture of membranes at term compared to those with intact membranes. Methods A cross sectional survey of all deliveries in 39 hospitals in 3 geographic regions of China's Mainland from January 1 to December 31, 2011 was carried out to investigate the demographic data and delivery outcomes. Results In our analysis of 103 124 pregnancies, 14 073 （13.6%） were complicated by premature rupture of membranes. Compared to those with intact membrane, the risks of postpartum hemorrhage, maternal complications and neonatal complications were increased significantly for women with premature rupture of membranes at term, especially the prevalence of neonatal respiratory distress syndrome （NRDS） and meconium aspiration syndrome. The risk of low Apgar （ 〈 7） at 1 minute was decreased for women with premature rupture of membranes at term. Conclusion The adverse perinatal outcomes are slightly higher in women with term premature rupture of membranes than those with intact membrane.

关 键 词：胎膜早破 足月分娩 妊娠结局 

分 类 号：R714.433[医药卫生—妇产科学]