未足月胎膜早破的影响因素及妊娠结局分析  

Analysis of the Influencing Factors and Pregnancy Outcome of Preterm Premature Rupture of Membranes

作　　者：曾华华 章盈 郭三英 ZENG Huahua;ZHANG Ying;GUO Sanying(Department of Obstetrics and Gynecology,Fujian Longyan People´s Hospital,Longyan,Fujian Province,364000 China)

机构地区：[1]福建省龙岩人民医院产科,福建龙岩364000

出　　处：《中外医疗》2023年第15期53-56,61,共5页China & Foreign Medical Treatment

摘　　要：目的分析未足月胎膜早破(preterm premature rupture of membranes,PPROM)的影响因素及妊娠结局。方法回顾性分析2020年10月—2021年10月于福建省龙岩人民医院产科分娩的92例PPROM患者及同时期收治的90例足月未发生胎膜早破产妇,分析PPROM发生的影响因素,并比较不同孕周、不同破膜时间妊娠结局的差异。结果单因素分析显示PPROM患者与足月未发生胎膜早破产妇在流产史、妊高症、胎位异常方面比较,差异无统计学意义(P>0.05),但在生殖道感染、GDM方面比较,差异有统计学意义(P<0.05)。进一步经Logistic回归分析证实,生殖道感染、GDM是PPROM发生的影响因素(P<0.05);PPROM患者孕28~31^(+6)周、32~33^(+6)周、34~36^(+6)周,绒毛膜羊膜炎发生率依次为21.88%、42.42%、3.70%,新生儿窒息发生率依次为40.63%、21.21%、7.41%,新生儿感染率依次为81.25%、75.76%、51.85%,新生儿呼吸窘迫综合征发生率依次为40.63%、27.27%、3.70%,差异有统计学意义(χ^(2)=12.349、9.087、6.751、10.788,P<0.05)。PROM患者胎膜早破时间<72 h时新生儿感染率低于≥72 h,差异有统计学意义(P<0.05)。PPROM患者绒毛膜羊膜炎、胎盘早剥、新生儿窒息、新生儿感染、新生儿黄疸、NRDS、转新生儿科发生率均高于足月未发生胎膜早破产妇,差异有统计学意义(P<0.05)。结论PPROM受到诸多因素的影响,其中破膜孕周、破膜时间会对患者的母婴结局产生影响。Objective To analyze the influencing factors and pregnancy outcome of preterm premature rupture of membranes(PPROM).Methods Retrospective analysis of 92 patients with PPROM delivered in the obstetrics department of Fujian Longyan People's Hospital from October 2020 to October 2021 and 90 women admitted at the same period who did not have preterm premature rupture of membranes.The factors influencing the occurrence of PPROM were analyzed,and the differences in pregnancy outcomes at different gestational weeks and times of rupture of membranes were compared.Results Univariate analysis showed that there was no statistically significant difference between PPROM patients and postpartum women without premature rupture of membranes in terms of abortion history,pregnancy induced hypertension,and abnormal fetal position(P>0.05).However,there was a statistically significant difference in terms of reproductive tract infections and GDM(P<0.05).Further Logistic regression analysis confirmed that reproductive tract infections and GDM were the influencing factors for the occurrence of PPROM(P<0.05).The incidence of chorioamnionitis in PPROM patients at 28~31^(+6) weeks,32~33^(+6) weeks,and 34~36^(+6) weeks of pregnancy was 21.88%,42.42%,and 3.70%,respectively.The incidence of neonatal asphyxia was 40.63%,21.21%,and 7.41%,respectively the incidence of neonatal infection was 81.25%,75.76%,and 51.85%,respectively;the incidence of neonatal respiratory distress syndrome was 40.63%,27.27%,and 3.70%,respectively,and the difference was statistically significant(χ^(2)=12.349,9.087,6.751,10.788,P<0.05).The neonatal infection rate in PROM patients with premature rupture of membranes<72 hours was lower than≥72 hours,and the difference was statistically significant(P<0.05).The incidence of chorioamnionitis,placental abruption,neonatal asphyxia,neonatal infection,neonatal jaundice,NRDS,and conversion to neonatal pediatrics in PPROM patients was higher than that in full-term women without premature rupture of membranes,and the difference w

关 键 词：未足月胎膜早破 妊娠结局 影响因素 剖宫产 围产儿死亡 

分 类 号：R714[医药卫生—妇产科学]