胎膜早破合并早产100例妊娠结局分析

Pregnancy outcomes for premature rupture of fetal membranes

目的 了解胎膜早破合并早产的妊娠结局。方法 分析100例不足月妊娠胎膜早破的原因、分娩方式、剖宫产指征、新生儿结局。结果 100例胎膜早破原因中，原因不明的占首位（占45．00％），第二位是过去有流产和引产史（占23．00％），第三位为臀位（占19．00％）；阴道分娩68例，剖宫产32例。32例剖宫产中胎儿窘迫15例（46．88％）。臀位11例（34．38％）。孕28～33^6周23例，存活新生儿22例，发生各种并发症14例；孕34～36^＋6周77例，存活新生儿79例。发生各种并发症20例，两者比较，P〈0．01。结论 重视胎膜早破的病因，孕前常规妇检，避免多次人流和引产，根据产科情况综合考虑分娩方式，一旦发现胎儿窘迫，必须果断行剖宫产。孕34周以前促胎肺成熟，尽量延长孕龄，可减少新生儿并发症。

Objective The purpose of fetal membranes. Methods The causes, membranes were retrospectively reviewed in this study is to describe the pregnancy outcomes for premature rupture of labor way and cesarean section indication of premature rupture of fetal 100 cases with incomplete pregnancy. Results In 100 cases of premature rupture of fetal membranes, the leading cause was unknown cause （45.00%）, the second was with history of abortion and induced labor （23.00%）, the third was breech presentation （19.00%） ; of the 68 cases underwent vaginal delivery and 32 cases underwent cesarean section. In 32 cases undergone cesarean section, of the 15 cases （46.88%） were found with fetal distress, 11 cases （34.88%） with breech presentation. Of the 23 cases with 28～33 ^＋ 6 weeks＇ gestation, 22 newborns were survival, of the 14 cases were associated with various eomplication; of the 77 cases with 34～36^＋6 weeks＇ gestation, 79 newborns survived, of the 20 cases were associated with various complication, in comparison of the above data between these two gestational groups, there was statistical significance of difference, P 〈0.01. Conclusion The causes of premature rupture of fetal membranes should be addressed, and the routine obstetric examination should be done before pregnancy, and avoid multi - abortion and multi- induced labor, the gyneeological eondition should be under eonsideration for labor way, once fetal distress occurred, the cesarean section should be performed. To facilitate the fetal lung maturity before 34 weeks＇ gestation and to prolong the gestational age can reduce the incidence of neonatal complications.