未足月胎膜早破入院期待时间影响因素与妊娠结局

Expected time and pregancy outcome of hospitalized women for preterm premature rupture of membranes

目的探讨未足月胎膜早破入院期待时间长短的影响因素,及不同期待时间与母儿妊娠结局关系。方法回顾观察合肥市第一人民医院2011年1月至2013年1月住院分娩PPROM单胎产妇129例,按入院至分娩期待时间分成3组,T<12 h组(46例)、12h≤T≤72 h组(55例),T>72 h组(28例),观察各组临床特征及母儿预后。结果 (1)年龄、入院距破膜时间、体温、AFI、阴道分泌物培养三组比较无统计学差异,是否为经产妇三组比较有统计学差异(P<0.05),T>72 h组孕周明显小于其他两组(P<0.01);(2)T>72 h组入院白细胞数、中性粒细胞比明显小于T<12 h组(P<0.01),T>72 h组CRP较前两组减小,有统计学差异(P<0.05);(3)T>72 h组新生儿出生体重小于其他两组(P<0.01),T>72 h组新生儿1分钟Apgar评分小于其他两组(P<0.05),其余各项妊娠结局三组无统计学差异。结论 PPROM入院期待时间与孕周、是否为经产妇、白细胞数、中性粒细胞比、CRP等有关,而不同期待时间新生儿体重、新生儿1 min Apgar评分有差异,其他母儿妊娠结局无明显差异。

Objective To explore the impact factors for expected time of hospitalized women for preteim premature rupure of membranes and the relationship between expected time and pregnancy outcome. Methods Retrospective amalycis was made in Hefei First People＇s Hospital between January 2011 and January 2013 of 129 cases hospitalized childbirth PPROM single fetal women, which were assigned into tl＇.ree groups according to expected delivery time,T 〈 12 h group（34 cases） ,t2 h~〈T~〈72 h group（56 cases） ,T 〉72 h group（34 cases）. Clinical features and pregnancy outcome were observed. Results There was no statistical difference in age,interval between time for rupture and hospitalization, temperature, AFI, vaginal secretion culture. It was statistically different in whether the patients were mul- tipara or not（P 〈0.05 ） ,gestational age in T 〉72 h was less than the other two groups（ P 〈 0.01 ） ;White blood cell count, neutrophils ratio were less in T 〉 72 h group than T 〈 12 h group（ P 〈 0.01 ）. CRP in T 〉 72 h group was less than the other two groups（ P 〈 0.05 ） ; In T 〉 72 h group neonatal birth weight was less than the other two groups （P 〈 0. 01 ）, and 1 minute neonatal Apgar score was lower than the other two groups （ P 〈 0.05 ）. As for the rest pregnancy outcome there was no statistical difference. Conclusion In this study, we have identified several predictive factors ineluding：gestational age,whether the patient is multipara or not,white blood cell count, neutro- phils ratio, CRP and so on. And at different expected time, neonatal birth weight, 1 min Apgar score have differences, while no difference is fouud between the pregnancy outcomes.