早产合并胎膜早破孕妇的妊娠结局临床分析

Clinical analysis of pregnancy outcome in preterm combined with premature rupture of membranes

摘要:

目的：通过研究早产合并胎膜早破（preterm premature rupture of membranes，PPROM）孕妇的妊娠结局，探讨PPROM对产妇和早产新生儿的影响。方法：选择2013年7月至2014年6月我院妇产科收治的PPROM孕妇91例为研究组，同期收治的早产无胎膜早破孕妇89例为对照组，比较两组孕妇的妊娠结局。结果：PPROM组91例孕妇中，剖宫产者62例（68.1%）；产后出血者8例（8.8%）。早产组孕妇89例，剖宫产者19例（21.3%）；产后出血者1例（1.1%）。PPROM组新生儿结局：胎儿窘迫46例（50.5％），新生儿肺炎7例（7.7％），新生儿窒息9例（9.9％），低体质量13例（14.3％）；早产组新生儿结局：胎儿窘迫8例（9.0％），新生儿肺炎1例（1.1％），新生儿窒息2例（2.2％），低体质量4例（5.0％）。PPROM孕妇的剖宫产、产后出血、胎儿窘迫、低体质量的发生率均明显高于早产无胎膜早破孕妇（P<0.05）。结论：PPROM对产妇和新生儿均有很大危害，应及时采取措施应对。

Abstract:

Objective：To investigate the effect of preterm combined with premature rupture of membranes（PPROM） on maternal and preterm infants by observing the pregnancy outcome of pregnant women with PPROM. Method：Totally 91 pregnant women with PPROM in our department of obstetrics and gyne－cology from Jul，2013 to Jun，2014 were enrolled as study group. Meanwhile，89 women of premature delivery without rupture of membranes were selected as control. The pregnancy outcome of the two groups were compared. Results：In study group，cesarean section rate was 68.1%（62/91），and the rate of postpartum hemor－rhage was 8.8% （8/91）. In control group，rates of cesarean section and postpartum hemorrhage were 21.3%（19/89） and 1.1%（1/89）. For the outcome of newborn，rates of fetal distress，neonatal pneumonia，neonatal asphyxia and low-birth weight were 50.5%（46/91），7.7%（7/91），9.9%（9/91） and 14.3%（13/91） in study group，while were 9.0%（8/89），1.1%（1/89），2.2%（2/89） and 5.0%（4/89） in control group. The adverse event rate was significantly higher in study group than in control group，including cesarean section，post－partum hemorrhage，fetal distress，and the incidence of low body weight（P<0.05）. Conclusion：PPROM is obviously harmful for preg－nancy woman and newborn，which we need take positive strategy to prevent and handle with.