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目的:探讨孕产妇发生早产合并胎膜早破的相关影响因素,并分析孕产妇的妊娠结局。方法:选取2014年1月至2015年6月重庆市巴南区妇幼保健院收治的早产合并胎膜早破孕产妇96例作为观察组,另选取同期早产无胎膜早破孕产妇56例作为对照组。对观察组进行调查早产合并胎膜早破的相关影响因素,并记录、比较两组患者孕产妇的临床结局。结果:观察组96例孕产妇中,存在阴道炎22例(22.92%),流产引产史25例(26.04%),胎位不正14例(14.58%),妊高症12例(12.50%),瘢痕子宫9例(9.38%),单因素回顾分析显示流产引产史(OR=2.513,95%CI=1.01~5.39)、阴道炎(OR=2.179,95%CI=1.13~4.17)、胎位不正(OR=1.316,95%CI=1.95~4.09)、妊高症(OR=1.169,95%CI=2.01~3.89)与早产合并胎膜早破的发生具有正性相关关系,差异具有统计学意义(P<0.05);观察组孕产妇行剖宫产30例,经阴道分娩66例,发生产后出血9例,胎儿窘迫45例,新生儿窒息10例,新生儿肺炎10例,低体质量14例;对照组剖宫产6例经阴道分娩50例,产后出血3例,胎儿窘迫2例,新生儿窒息2例,新生儿肺炎2例,低体质量儿3例,观察组孕产妇妊娠结局明显较对照组差,差异具有统计学意义(P<0.05)。结论:流产引产史、阴道炎感染、胎位不正、妊高症是导致孕产妇早产合并胎膜早破的主要原因,并且这类孕产妇一般妊娠结局较差,剖宫产率较高,因此应积极加强妊娠期孕妇管理,避免感染、胎位不正、妊高症的发生,并且提高对具有流产引产史孕产妇警惕,及早采取干预治疗措施。
Objective: To explore the related factors of preterm birth and premature rupture of membranes in pregnant women and to analyze the pregnant outcome of pregnant women. Methods: Ninety-six pregnant women with premature rupture of membranes combined with premature rupture of membranes in Banan District MCH from January 2014 to June 2015 were selected as the observation group. Another 56 pregnant women with premature rupture without premature rupture of membranes Control group. The observation group to investigate the impact of premature rupture of premature rupture of the influencing factors, and record and compare the clinical outcomes of the two groups of maternal. Results: Among the 96 pregnant women in the observation group, there were 22 cases (22.92%) with vaginitis, 25 cases (26.04%) with induced abortion, 14 cases (14.58%) with fetal malposition, 12 cases (12.50% Uterine 9 cases (9.38%), univariate analysis showed that the history of abortion (OR = 2.513,95% CI = 1.01 ~ 5.39), vaginitis (OR = 2.179,95% CI = 1.13 ~ 4.17) = 1.316, 95% CI = 1.95 ~ 4.09), pregnancy-induced hypertension (OR = 1.169,95% CI = 2.01-3.89) had a positive correlation with the occurrence of premature rupture of membranes, the difference was statistically significant <0.05). In the observation group, there were 30 cases of cesarean section, 66 cases of vaginal delivery, 9 cases of postpartum hemorrhage, 45 cases of fetal distress, 10 cases of neonatal asphyxia, 10 cases of neonatal pneumonia and 14 cases of low body weight. 6 cases of cesarean section in the control group, vaginal delivery in 50 cases, 3 cases of postpartum hemorrhage, fetal distress in 2 cases, 2 cases of neonatal asphyxia, neonatal pneumonia in 2 cases, 3 cases of low birth weight, observation group pregnant women pregnancy outcome was significantly The difference between the control group and the difference was statistically significant (P <0.05). Conclusions: Abortion induced abortion history, vaginitis infection, malposition of fetus and pregnancy induced hypertension are the main reasons leading to premature rupture of membranes in pregnant women. And such pregnant women generally have poor pregnancy outcome and high cesarean section rate, therefore, Actively strengthen the management of pregnant women during pregnancy, to avoid infection, malposition of fetus, pregnancy-induced hypertension, and to improve the history of abortion with vigilance pregnant women, early intervention measures.