未足月胎膜早破残余羊水量与妊娠结局的相关性研究

Study on the Correlation between Residual Amniotic Fluid Volume of Preterm Premature Rupture of Membranes and Pregnancy Outcome

目的:探讨未足月胎膜早破残余羊水量与妊娠结局的相关性。方法:选择2005年1月-2011年12月于笔者所在医院住院分娩的105例未足月胎膜早破孕妇,根据胎膜破裂后羊水指数(AFI)的测定结果将孕妇分为羊水量正常组、羊水量偏少组、羊水量过少组,三组均予抗生素预防感染、糖皮质激素促胎肺成熟、宫缩抑制剂抑制宫缩等治疗,观察比较分析三组相关指标。结果:羊水量过少组孕妇破膜后的潜伏时间、羊膜腔感染、新生儿早期败血症、产后子宫内膜炎、胎儿窘迫、新生儿窒息、缺氧缺血心肌损害、围生儿死亡情况等方面比较差异均有统计学意义(均P<0.05);剖宫产率方面,羊水量过少组与羊水量偏少组相当(P>0.05),高于羊水量正常组(P<0.05)。结论:对未足月胎膜早破后孕妇,在期待治疗过程中要密切监测羊水量变化,监测有无感染、胎儿窘迫等症状,评估母儿情况,适当放宽剖宫产指征,紧急时行剖宫产结束妊娠,产后加强抗感染、防治新生儿窒息等疾病的措施,降低产妇的感染率、围生儿患病率和死亡率。

Objective： To investigate the correlation between residual amniotic fluid volume of PPROM and outcome pregnancy.Methods： Selecting from Jan 2005 to Dec 2011 in the author＇s hospital childbirth without premature rupture of membranes at term, 105 cases of pregnant women, according to the membranes rupture of the amniotic fluid index （AFI） after the determination results of pregnant women can be divided into normal group of sheep on the quantity, the amount less, sheep too little water group, 3 group of antibiotics to prevent infection, corticosteroids to promote fetal lung maturation, the treatment such as contraction inhibitors inhibit contraction, observation comparative analysis of three group of related indicators.Results： Too little amount group after rupture in the latent period of pregnant women, amniotic cavity infection, early neonatal sepsis, postpartum endometritis, fetal distress, neonatal asphyxia, deaths in hypoxic ischemic myocardial damage, perinatals significantly higher than the other two groups（all P〈0.05） ; Cesarean delivery rates, and the sheep of too little quantity and amount less group （P〉0.05）, higher than the amount of normal group （P〈0.05）.Conclusion： In pregnant women without premature rupture of membranes at term, looking for water treatment process to close monitoring of the sheep, monitoring for symptoms such as infection, fetal distress, assess mother son, relax appropriately cesarean section indications, its emergency cesarean delivery end of pregnancy, postpartum and strengthening resistance to infection, prevention and treatment of diseases such as neonatal asphyxia, maternal infection, perinatal morbidity and mortality.