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目的:探讨未足月胎膜早破(PPROM)发病相关因素及对妊娠结局的影响。方法:选择PPROM 158例,根据不同妊娠期分为A组(28～31+6周)49例、B组(32～33+6周)55例和C组(34～36+6周)54例。分析PPROM发病相关因素,比较各组分娩情况、母体并发症发生情况及新生儿结局。结果:(1)本组67.72%的患者存在胎膜早破发生相关因素,其中,构成比居前3位的依次为生殖道感染(29.11%)、人工流产史(22.15%)和胎位异常(12.66%)。(2)A组剖宫产率显著高于B组(P<0.05),非常显著高于C组(P<0.01);B组与C组比较,差异不显著(P>0.05)。(3)A组羊膜腔感染、胎盘早剥及产褥病发生率均非常显著高于B组和C组(P<0.01);3组间产后出血发生率比较,差异不显著(P>0.05)。(4)A组新生儿肺炎、呼吸窘迫综合征(NRDS)发生率均显著高于B组和C组新生儿(P<0.05);窒息、高胆红素血症、颅内出血发生率及自动出院和病死率,均非常显著高于B组和C组新生儿(P<0.01)。结论:生殖道感染是导致PPROM发生的主要因素;应针对不同妊娠期选择合适的分娩方式,以减少母婴并发症,提高新生儿生存率,获得满意妊娠结局。
Objective: To investigate the factors related to the pathogenesis of unprotected premature rupture of membranes (PPROM) and its effect on pregnancy outcome. Methods Fifty-eight cases of PPROM were selected and divided into two groups according to different gestational age: 49 cases in group A (28-31 + 6 weeks), 55 cases in group B (32-33 + 6 weeks) and group C (34-36 + 6 weeks) example. Analysis of PPROM pathogenesis-related factors, compared the situation of each group of childbirth, maternal complications and neonatal outcomes. Results: (1) There were 67.72% patients with premature rupture of membranes in this group, among which, the incidences of reproductive tract infection (29.11%), abortion history (22.15%) and abnormal fetal position 12.66%). (2) The cesarean section rate in group A was significantly higher than that in group B (P <0.05), which was significantly higher than that in group C (P <0.01). There was no significant difference between group B and group C (P> 0.05). (3) The incidences of amniotic cavity infection, placental abruption and puerperal disease in group A were significantly higher than those in group B and C (P <0.01); The incidence of postpartum hemorrhage in the three groups was not significantly different (P> 0.05 ). (4) The incidence of neonatal pneumonia and respiratory distress syndrome (NRDS) in group A was significantly higher than that in group B and C (P <0.05); asphyxia, hyperbilirubinemia, the incidence of intracranial hemorrhage and automatic Discharge and mortality were significantly higher than those of group B and group C (P <0.01). Conclusion: Reproductive tract infection is the main factor leading to the occurrence of PPROM. Choosing the appropriate mode of delivery for different gestational periods to reduce the complications of maternal and infant, improve the survival rate of newborn and achieve satisfactory pregnancy outcome.