胎膜早破早产的诊治进展  

Advances in Diagnosis and Treatment of Preterm Premature Rupture of Membranes

作　　者：姜海利[1] 周建新[1] 路畅[1] 张为远[1] JIANG Haili;ZHOU Jianxin;LU Chang;ZHANG Weiyuan(Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院产科,北京100026

出　　处：《医学综述》2020年第15期2992-2996,共5页Medical Recapitulate

基　　金：北京市委组织部优秀人才培养资助项目(2015000021469G215)。

摘　　要：胎膜早破早产是指妊娠37周前发生的胎膜破裂,它与早产的一系列并发症密切相关,容易导致新生儿呼吸窘迫综合征、新生儿神经系统发育迟缓、新生儿感染以及产褥感染等常见并发症。胎膜早破早产的处理原则不同于足月胎膜早破,临床中多数病例,特别是34周前胎膜早破者,由于分娩孕周小,新生儿各器官发育不成熟,预后差,常需要延长孕周保胎治疗。然而,在胎膜早破早产的治疗中,即使应用抗生素预防感染仍然容易发生感染性并发症。随着我国新生儿诊治水平的大幅提高,未来应权衡新生儿存活率与延长孕周的风险,合理应用抗生素预防感染、糖皮质激素促胎肺成熟,严密监测母胎感染性指标,适时终止妊娠,改善母婴结局。Preterm premature rupture of membranes is defined as membrane rupture before 37 weeks of gestation,which is closely related to a series of complications of preterm birth including neonatal respiratory distress syndrome,developmental delays in the neonatal nervous system,neonatal infections and puerperal infection.The principle of treatment of preterm premature rupture of membranes is different from term premature rupture of membranes.In clinical practice,most cases,especially those with premature rupture of membranes before 34 weeks,due to the small gestational age,immature development of newborn organs and poor prognosis,often need to prolong gestational age to protect the fetus.However,in the treatment of premature rupture of membranes,the use of antibiotics to prevent infection is prone to infectious complications.With the great improvement of the level of diagnosis and treatment of newborns in China,the survival probability of newborns and the risk of prolonging the gestational period in the future should be balanced,antibiotics should be reasonably applied to prevent infection,and glucocorticoid to promote the maturation of fetal lung,the infective index of mother and fetus should be closely monitored to terminate the pregnancy at the right time and improve the maternal and infant outcomes.

关 键 词：胎膜早破早产 宫内感染 新生儿结局 

分 类 号：R714.433[医药卫生—妇产科学]