183例胎膜早破临床特征分析

Analysis on Clinical Features of 183 Patients with Premature Rupture of Membrane

【目的】探讨胎膜早破发生的高危因素、分娩方式与母婴并发症的关系及处理、预防方法。【方法】回顾性分析2008年1月至2010年12月在本院住院分娩的183例胎膜早破孕妇，另随机抽取本院同期无胎膜早破的孕妇183例作为对照组，比较两组的分娩方式及母婴并发症，分析胎膜早破的高危因素。【结果】胎膜早破的高危因素主要是头盆不称、阴道炎、流产引产史、胎位异常。观察组的剖宫产率（56．83％）明显高于对照组（40．98％）（P〈0．01）；观察组发生产后出血（P〈0．01）、早产、胎儿窘迫、新生儿窒息、新生儿肺炎、死胎、早期新生儿死亡的发病率明显高于对照组（P〈0．05），但两组发生产褥感染的比例差异无统计学意义（P〉0．05）。【结论】胎膜早破的剖宫产率、产后出血、胎儿窘迫、新生儿窒息、新生儿肺炎、死胎、早期新生儿死亡的发生率升高，应重视胎膜早破的高危因素及处理，适时终止妊娠，减少难产及母婴并发症的发生。

[Objective]To explore the high risk factors, delivery way of premature rupture of membrane and its relationship with maternal and neonatal complications and their management and prevention methods. [Methods] Totally 183 pregnant women with premature rupture of membrane from Jan. 2008 to Dec. 2010 in our hospital were analyzed retrospectively. Moreover, 183 pregnant women without premature rupture of membrane were randomly chosen as control group. The delivery way and maternal and neonatal complications were compared between two groups. The high risk factors of premature rupture of membrane were analyzed. [Results]The high risk factors of premature rupture of membrane were mainly cephalopelvic disproportion, vaginitis, the history of abortion and induced labor and abnormal fetal position. The rate of caesarean section in observation group（56.83% ） was significantly higher than that that in control group（40.98%）（ P 〈0.01）. The incidence rates of postpartum hemorrhage, premature delivery, fetal distress, neonatal asphyxia, neonatal pneumonia, fetal death and early newborn death in observation group were significantly higher than those in control group（ P 〈0.05）, but there was no significant difference in the incidence rate of puerperal infection between the two groups（ P 〉 0.05）. [Conclusion] The rate of caesarean section and the incidence rates of postpartum hemorrhage, fetal distress, neonatal asphyxia, neonatal pneumonia, fetal death and early newborn death in premature rupture of membrane increase. It is necessary to pay more attention to the high risk factors and treatment of premature rupture of membrane. Timely termination of pregnancy can reduce the incidence of difficult labor and maternal and neonatal complications.