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目的研究足月胎膜早破产妇的影响因素,分析其对妊娠结局的影响,为提高围生期母婴安全提供依据。方法将2012年3月-2015年6月该院收治的足月胎膜早破产妇100例为研究组,选择同期正常分娩产妇94例为对照组,收集两组研究对象临床相关资料,进行影响因素回顾性分析。结果研究组产妇糖尿病、妊娠期高血压疾病、引产/流产史、阴道炎宫颈炎史及性生活频繁的发生率均高于对照组,差异均有统计学意义(均P<0.05);研究组双胎及多胎妊娠、胎位异常、瘢痕子宫及巨大儿的发生率均高于对照组,差异均有统计学意义(均P<0.05)。Logistic回归分析结果显示,足月胎膜早破产妇与妊娠期高血压疾病/糖尿病、阴道炎/宫颈炎史、引产/流产史、性生活频繁、双胎及多胎妊娠、瘢痕子宫、巨大儿以及胎位异常等因素相关,差异均有统计学意义(均P<0.05);研究组阴道顺产率低于对照组,而阴道助产和剖宫产率高于对照组,差异均有统计学意义(均P<0.05)。研究组新生儿Apgar评分低于对照组,分娩后卧床时间长于对照组,差异均有统计学意义(均P<0.05);研究组产褥感染、产后出血、绒毛膜羊膜炎、新生儿窒息、新生儿肺炎发生率高于对照组,差异均有统计学意义(均P<0.05)。结论围生期产妇出现足月胎膜早破的主要因素有妊娠期高血压疾病/糖尿病、阴道炎/宫颈炎史、引产/流产史、性生活频繁、双胎及多胎妊娠、瘢痕子宫、巨大儿及胎位异常,足月胎膜早破能降低阴道顺产率、新生儿Apgar评分,延长分娩后卧床时间,增加阴道助产和剖宫产率、产褥感染、产后出血、绒毛膜羊膜炎、新生儿窒息、新生儿肺炎发生率。
Objective To study the influential factors of premature rupture of membranes of premature rupture of membranes and analyze its influence on pregnancy outcome, so as to provide basis for improving maternal and perinatal safety. Methods 100 cases of preterm premature rupture of membranes from March 2012 to June 2015 in our hospital were selected as the research group. Ninety-four cases of normal delivery women were selected as the control group, and the clinical data of two groups were collected to influence Retrospective analysis of factors. Results The incidence of maternal diabetes, pregnancy-induced hypertension, abortion history, history of vaginitis cervicitis and sex life were higher in the study group than in the control group (all P <0.05). The study group Twins and multiple pregnancies, fetal position abnormalities, scar uterus and macrosomia were higher than the control group, the differences were statistically significant (P <0.05). Logistic regression analysis showed that full-term premature rupture of membranes and hypertensive disorders of pregnancy / diabetes mellitus, history of vaginitis / cervicitis, abortion history, frequent sexual life, twin and multiple pregnancies, scarring of the uterus, macrosomia and Fetal abnormalities and other factors, the differences were statistically significant (all P <0.05); study group vaginal delivery rate was lower than the control group, vaginal delivery and cesarean section rate was higher than the control group, the differences were statistically significant ( All P <0.05). The Apgar score of neonates in the study group was lower than that in the control group, and the bed-rest time in the study group was longer than that in the control group (all P <0.05). The puerperal infection, postpartum hemorrhage, chorioamnionitis, neonatal asphyxia, The incidence of neonatal pneumonia was higher than the control group, the difference was statistically significant (P <0.05). Conclusions The main causes of preterm premature rupture of membranes in perinatal women are gestational hypertension / diabetes mellitus, history of vaginitis / cervicitis, induction of labor / miscarriage, frequent sexual life, twin and multiple pregnancies, scarring of the uterus, Child and fetal position abnormalities, term premature rupture of membranes can reduce vaginal delivery, neonatal Apgar score, prolonged postpartum bed time, increased vaginal delivery and cesarean section rate, puerperal infection, postpartum hemorrhage, chorioamnionitis, Neonatal asphyxia, neonatal pneumonia incidence.