胎膜早破患者胎盘病理与新生儿预后相关性研究

Correlation between placental pathology and neonatal in patients with premature rupture of membranes

目的探讨胎膜早破患者胎盘病理与新生儿预后的相关性,评估胎盘病理对新生儿预后的意义。方法回顾性分析2012年1月1日至2012年12月31日在我院分娩的454例胎膜早破患者的胎盘病理情况及新生儿结局,根据产后胎盘病理将其分成正常、轻度、中度、重度以及慢性绒毛膜羊膜炎症等5组,比较各组间孕产妇分娩前白细胞、C反应蛋白、新生儿窒息发生率、新生儿娩出当日白细胞、C反应蛋白的差异。结果胎盘病理表现为正常、轻度、中度、重度以及慢性绒毛膜羊膜炎组新生儿窒息率分别为10.47%、11.94%、10%、37.5%、28.57%,各组间差异有统计学意义(P=0.003);新生儿娩出当日CRP分别为(0.21±0.58)mg/L、(0.26±0.66)mg/L、(6.2±19.0)mg/L、(9.6±15.4)mg/L、(0.0±0.0)mg/L,白细胞分别为(10.7±2.84)×109/L、(10.2±3.45)×109/L、(17.6±5.57)×109/L、(22.9±14.6)×109/L、(12.8±8.05)×109/L,进行两两比较,发现胎盘病理呈现重度绒毛膜羊膜炎的孕产妇,新生儿娩出当日CRP、白细胞均显著高于其他各组(P<0.05)。结论胎膜早破患者胎盘病理类型与新生儿预后存在一定相关性,重度绒毛膜羊膜炎可能预示新生儿预后不良。

Objective To study the correlationbetween placentalpathology and neonatalin patients with premature rupture of membranes（PROM）. Methods The data of chorioamnionitis and the newborns outcomes in 454patients with PROM who labored in NanFang hosipital from Jan 2012 to Dec 2012 were analyzed rettrospectively. According to the pathology results of placenta, the patients were divided into normal, mild, moderate, severe and chronic chorioamnionitis groups. Antepartum maternal WBC, CRP, neonatal asphyxia ratio, leukocyte and CRP of newboens of those groups were compared. Results The neonatal asphyxia ratio of normal, mild, moderate, severe and chronic chorioamnionitis groups were 10.47%, 11.94%, 10%, 37.5%, 28.57%, respectively, and the differences among them showed statistically significant. The CRP concentration of newborns of those groups were（0.21±0.58） mg/L,（0.26±0.66） mg/L,（6.2±19.0） mg/L,（9.6±15.4） mg/L and（0.0±0.0） mg/L, respectively. The WBC of newborns of those groups were（10.7±2.84）×109/L,（10.2±3.45）×109/L,（17.6±5.57）×109/L,（22.9±14.6）×109/L and（12.8±8.05）×109/L, respectively. The CRP and the WBC of newborns in chorioamnionitis group were significantly higher than those of other groups. Conclusion There is a close correlation between Chorioamnionitis and the newborns outcomes, and the occurence of severe chorioamnionitis may indicate poor prognosis of newborns.