孕中期羊膜囊膨出紧急宫颈环扎术后小于28周自发性早产的危险因素分析  

Risk factors of spontaneous preterm birth less than 28 weeks after emergency cervical cerclage for prolapsed membranes in second trimester of pregnancy

作　　者：祝参[1] 刘玉宁 武海英[1] ZHU Can;LIU Yu-ning;WU Hai-ying(Department of Obstetrics,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院产科,郑州450003

出　　处：《医药论坛杂志》2024年第12期1243-1247,共5页Journal of Medical Forum

基　　金：河南省二○一九年科技发展计划(192102310335)。

摘　　要：目的探讨孕中期羊膜囊膨出紧急宫颈环扎术后发生小于28周自发性早产(spontaneous preterm birth,sPTB)的危险因素。方法收集2019年7月—2023年7月河南省人民医院接受紧急宫颈环扎手术的106例孕中期羊膜囊膨出患者的资料及sPTB的发生情况,其中39例发生小于28周自发性早产为病例组,67例未发生自发性早产为对照组,采用单因素分析和logistic回归分析筛选术后发生小于28周sPTB的危险因素。结果106例中,39例术后发生小于28周sPTB,发生率为36.8%。单因素分析结果显示宫颈分泌物培养阳性、宫颈扩张程度、羊膜囊位置、胎盘组织型绒毛膜羊膜炎与sPTB的发生有关(P<0.05),logistic回归分析显示胎盘组织型绒毛膜羊膜炎为孕中期羊膜囊膨出紧急宫颈环扎术后发生sPTB的独立危险因素[OR=12.522,95%CI(2.041~36.808),P<0.05]。结论胎盘组织型绒毛膜羊膜炎是孕中期羊膜囊膨出紧急宫颈环扎术后发生小于28周sPTB的危险因素。Objective To identify risk factors for spontaneous preterm birth(spontaneous preterm birth,sPTB)less than 28 weeks after emergency cervical cerclage for prolapsed membranes in the second trimester of pregnancy.Methods Totally 106 cases with prolapsed membranes in the second trimester of pregnancy who underwent emergency cerclage in Henan Provincial People's Hospital were collected from July 2019-July 2023.39 cases who happened sPTB less than 28 weeks were in case group,and 67 cases were in control group.Univariate analysis and logistic regression analysis were used to identify the risk factors for sPTB less than 28 weeks after emergency cerclage.Results Among the 106 cases,39cases developed sPTB less than 28 weeks,and the incidence was 36.8%.Univariate analysis showed that positive cervical culture,cervical dilatation,the location of amniotic membranesand histologic chorioamnionitis were related with sPTB(P<0.05).Logistic regression analysis showed that histologic chorioamnionitis was the risk factors for sPTB after emergency cerclage in patients with prolapsed membranes in the second trimester of pregnancy[OR=12.522,95%CI(2.041~36.808),P<0.05].Conclusion The independent risk factors of sPTB less than 28 weeks after emergency cerclage with prolapsed membranes in the second trimester of pregnancy was histologic chorioamnionitis.

关 键 词：羊膜囊膨出 紧急宫颈环扎 自发性早产 组织型绒毛膜羊膜炎 

分 类 号：R714.244[医药卫生—妇产科学]