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目的探讨胎膜早破性早产(preterm premature rupture of membranes,PPROM)儿的妊娠结局。方法对312例PPROM的孕妇及其分娩的320例早产儿进行回顾性分析,对不同潜伏期的新生儿结局,孕28～33+6周与孕34～37周胎膜早破性早产儿情况进行比较分析。结果潜伏期平均为30 h,新生儿死产,死亡,感染的发生率在破水时间超过40h组大于破水时间在40h内者,有统计学差异(P<0.05)。孕28～33+6周与孕34～37周间PPROM分娩方式的比较,无统计学差异(P>0.05)。孕28～33+6周PPROM新生儿呼吸窘迫综合征(neonatal respiratory distress syndrom,NRDS)的发生率和死亡率明显高于孕34～37周者(P<0.01)。80%PPROM新生儿死亡发生在32周之前。结论 PPROM的潜伏期尽量控制在40小时内,孕28～34周PPROM宜采取期待疗法,以减少新生儿合并症的发生。对于孕周小者,尽量延长孕周至32周以上,最好达到34周,以降低新生儿死亡率。
Objective To investigate the pregnancy outcome of preterm premature rupture of membranes (PPROM). Methods A retrospective analysis was performed on 312 pregnant women with PPROM and 320 premature infants who gave birth. The outcomes of newborns with different latent periods, 28-33 + 6 weeks of pregnancy, and 34-37 weeks of preterm premature rupture of membranes comparative analysis. Results The average incubation period was 30 h. The incidence of stillbirth, death and infection in neonates was significantly higher than that in the 40-h break-in time of more than 40 hours (P <0.05). There was no significant difference in PPROM delivery between 28 ~ 33 + 6 weeks pregnant and 34 ~ 37 weeks pregnant (P> 0.05). The incidence and mortality of neonatal respiratory distress syndrom (PPARDM) neonatal respiratory distress syndrome (PPARMS) at 28-33 + 6 weeks of pregnancy were significantly higher than those at 34-37 weeks of pregnancy (P <0.01). 80% of PPROM neonatal deaths occurred 32 weeks ago. Conclusion The incubation period of PPROM should be controlled within 40 hours. PPROM at 28 ~ 34 weeks pregnant should be treated with expectant therapy to reduce the incidence of neonatal complications. For small gestational weeks, try to extend the gestational age to 32 weeks or more, preferably up to 34 weeks, in order to reduce neonatal mortality.