预测胎肺成熟在未足月胎膜早破期待治疗中的价值

Value of prediction of fetal lung maturity in the temporization of preterm premature rupture of the membrane

目的探讨应用羊水泡沫振荡试验预测胎儿肺成熟在未足月胎膜早破期待治疗中的价值。方法采用前瞻性研究方法把2011年9月～2012年12月妊娠28周～36〈周胎膜早破需期待治疗的孕妇分为研究组和对照组,研究组116例，孕周35周时或终止妊娠72 h前取阴道内羊水行泡沫振荡试验，试验阴性再次予地塞米松治疗1个疗程;对照组103例，孕周〈35周按常规促胎儿肺成熟，孕周〉35周终止妊娠。对两组围生儿结局进行统计学分析。结果羊水泡沫振荡试验预测胎肺成熟度敏感性66.7%，特异性96.3%，不成熟预测准确率33.3%，成熟预测准确率99.1%。研究组的新生儿窒息、肺透明膜病和围生儿死亡等发生率低于对照组。结论未足月胎膜早破期待治疗中预测并促进胎肺成熟能显著改善围生儿结局,在临床上易推广应用。

Objective To explore the value of prediction of fetal lung maturity in the temporization of preterm premature rupture of the membrane by foam test of amniotic fluid. Methods The pregnant women with premature rupture offetal membranes needing the temporization at 28th weeks to 3646th weeks of gestation form September 2011 to December 2012 were divided into the study group and the control group by prospective study methods. 116 cases of the studygroup were done foam test of amniotic fluid at 35 weeks of gestation or when termination of pregnancy within 72 hoursago, and if the test results were negative,the pregnant women were given again a treatment course of dexamethasone;In 103 cases of control group, 〈35 weeks gestational age pregnant women promoted fetal lung maturity by conven-tional methods, while ≥ 35 weeks gestational age pregnant women terminated pregnancy. The perinatal fetus outcomeof two groups were analyzed statically. Results The sensitivity of prediction of fetal lung maturity by foam test of amniotic fluid was 66.7%, the specificity was 96.3%, the prediction accuracy rate of premature was 33.3%, the predictionaccuracy rate of mature was 99.1%. The incidence rate of asphyxia neonatorum, hyaline membrane disease and perinatal mortality in the study group were lower than those in the control group. Conclusion Predicting and promoting fetal lung maturity in the temporization of preterm premature rupture of the membrane can significantly improve perinatal outcomes and is easy to clinical popularization and application.