胎膜早破的临床特点与母婴结局及影响因素分析  

Analysis of clinical characteristics,maternal and fetal outcomes and influencing factors of premature rupture of membranes

作　　者：李秋敏[1] 王飞[1] 张莉莉[1] 刘飞飞 刘云 LI Qiumin;WANG Fei;ZHANG Lili;LIU Feifei;LIU Yun(Department of Obstetrics and Gynecology,Shanxi People's Hospital,Xi'an 716000,China)

机构地区：[1]陕西省人民医院产科,陕西西安716000

出　　处：《西部医学》2018年第11期1612-1615,共4页Medical Journal of West China

基　　金：陕西省科技计划项目(2012KRM31)

摘　　要：目的探讨胎膜早破的影响因素,为胎膜早破的预防提供理论依据。方法纳入对象为2015年11月~2017年11月于我院住院的200例胎膜早破孕产妇(观察组)及200例正常孕产妇(对照组),观察胎膜早破孕产妇的临床特点,记录分娩方式以及胎儿结局,调查两组孕产妇文化程度、感染、年龄等,通过单因素及多因素分析胎膜早破的危险因素。结果胎膜早破以突然阴道排液,可混有胎粪或胎脂为主要临床表现;200例胎膜早破孕产妇剖宫产125例,阴道分娩45例,臀牵引18例,产钳助产12例;202例新生儿发生新生儿窒息27例,早产56例,新生儿肺炎18例,宫内感染24例,胎儿窘迫21例,新生儿死亡9例,均显著高于对照组,差异有统计学意义(P<0.05);两组感染情况、流产史、胎位异常等差异亦有统计学意义(P<0.05);多因素分析显示,CRP≥10mg/L、胎位异常、感染是胎膜早破的独立危险因素。结论胎膜早破孕产妇多采用剖宫产、臀牵引、产钳助产等,新生儿并发症发生率较高,CRP≥10mg/L、胎位异常、感染均会增加胎膜早破风险。Objective To investigate the clinical characteristics,maternal and fetal outcomes of premature rupture of membranes(PROM),and to analyze the influencing factors and provide theoretical basis for prevention of PROM.Methods 200 women with PROM and 200 normal pregnant women hospitalized in our hospital from November 2015 to November 2017 were enrolled and divided into observation group and control group.The clinical characteristics of PROM were observed,and the mode of delivery and fetal outcome were recorded.The maternal education,infection and age of the two groups were investigated,and the risk factors of PROM were analyzed by single factor and multiple factors.Results The main clinical manifestations of PROM were sudden vaginal discharge,meconium mixed or vernix caseosa.Among 200 PROM,there were 125 cases of cesarean section,45 cases of vaginal delivery,18 cases of breech extraction,and 12 cases of forceps delivery;Among 202 new born,There were 27 cases of neonatal asphyxia,56 cases of premature birth,18 cases of neonatal pneumonia,24 cases of intrauterine infection,21 cases of fetal distress,and 9 cases of neonatal death in the observation group,which was significantly higher than those in the control group,the difference was statistically significant(P<0.05);Infections,history of abortion,and abnormal fetal position between two groups were statistically significant(P<0.05).Multivariate analysis showed that CRP≥10mg/L,abnormal fetal position,infection were the independent risk factors of PROM.Conclusion For PROM patients,cesarean section,breech extraction,forceps delivery are mostly chosen,and the incidence of neonatal complications is higher.CRP≥10mg/L,abnormal fetal position,and infection will increase the risks of PROM.

关 键 词：胎膜早破 临床特点 母儿结局 影响因素 

分 类 号：R714.433[医药卫生—妇产科学]