不同时机使用抗生素对孕周胎膜早破母婴结局的影响  

Effect of different timing of antibiotics on maternal and infant outcomes of premature rupture of membranes during pregnancy

作　　者：王利平[1] WANG Li-ping(Tengzhou Maternal and Child Health Hospital,Zaozhuang 277599,China)

机构地区：[1]山东省枣庄市滕州市妇幼保健院,277599

出　　处：《中国实用医药》2023年第1期132-135,共4页China Practical Medicine

摘　　要：目的 探讨孕周胎膜早破(PROM)患者不同时机使用抗生素对母婴结局的影响。方法 138例孕周胎膜早破患者,随机分为A组、B组、C组,各46例。A组患者在胎膜早破<12 h使用抗生素, B组患者在胎膜早破12~24 h使用抗生素, C组患者在胎膜早破24 h后使用抗生素。对比三组患者妊娠结局及新生儿结局。结果 A组患者入院至分娩>48 h占比86.96%明显高于B组的45.65%和C组的69.57%,绒毛膜羊膜炎发生率2.17%、宫内感染发生率0、产后出血发生率2.17%、产褥感染发生率0均明显低于B组的15.22%、8.70%、13.04%、15.22%和C组的19.57%、17.39%、21.74%、15.22%,差异有统计学意义(P<0.05)。A组新生儿Apgar评分≥8分占比91.30%明显高于B组的76.09%和C组的63.04%, Apgar评分<4分占比0和新生儿感染发生率0均明显低于B组的13.04%、15.22%和C组的15.22%、19.57%,差异有统计学意义(P<0.05)。结论 孕周胎膜早破患者使用抗生素能预防宫内感染、产后出血、新生儿窒息等一系列不良母婴结局发生,且在12 h内使用抗生素效果最佳。Objective To discuss the effect of different timing of antibiotics on maternal and infant outcomes of premature rupture of membranes(PROM) during pregnancy. Methods A total of 138 cases of premature rupture of membranes during pregnancy were randomly divided into group A, group B and group C,with 46 cases in each group. Patients in group A used antibiotics at<12 h after premature rupture of membranes,patients in group B used antibiotics at 12-24 h after premature rupture of membranes, and patients in group C used antibiotics at >24 h after premature rupture of membranes. The pregnancy outcome and neonatal outcome of the three groups were compared. Results The percentage of admission to delivery >48 h was 86.96% in group A, which was significantly higher than 45.65% in group B and 69.57% in group C;group A had incidence of chorioamnionitis of 2.17%, incidence of intrauterine infection of 0, incidence of postpartum hemorrhage of 2.17% and incidence of puerperal infection of 0, which were significantly lower than 15.22%, 8.70%, 13.04%,15.22% in group B and 19.57%, 17.39%, 21.74%, 15.22% in group C. the differences were statistically significant(P<0.05). The percentage of neonatal Apgar score ≥8 points in group A was 91.30%, which was obviously higher than 76.09% in group B and 63.04% in group C;group A had percentage of neonatal Apgar score <4 points of 0and incidence of neonatal infection of 0, which were significantly lower than 13.04% and 15.22% in group B and 15.22% and 19.57% in group C;the differences were statistically significant(P<0.05). Conclusion The use of antibiotics in patients with premature rupture of membranes during pregnancy can prevent the occurrence of intrauterine infection, postpartum hemorrhage, neonatal asphyxia, and other adverse maternal and infant outcomes,and is most effective when administered within 12 h.

关 键 词：胎膜早破 抗生素 母婴结局 不同时机 新生儿窒息 

分 类 号：R714.433[医药卫生—妇产科学]