未足月胎膜早破后残余羊水指数对妊娠结局和新生儿的影响

Effect of residual amniotic fluid index on pregnancy outcomes and neonatal outcomes after PPROM

目的探讨未足月胎膜早破(PPROM)后残余羊水指数(AFI)对妊娠结局及新生儿的影响。方法回顾性分析561例妊娠PPROM患者的临床资料,根据AFI值将其分为I组196例(AFI≤40 mm)和II组365例(AFI>40 mm)。比较两组妊娠结局及新生儿预后。结果 I组破膜至分娩时间短于II组(P<0.01);新生儿出生体质量、Apgar评分均低于II组(P<0.01);新生儿病死率高于II组(P<0.05)。Logistic回归分析结果表明,AFI≤40 mm及破膜时孕周为新生儿死亡的影响因素(P<0.05);AFI≤40 mm为新生儿窒息的影响因素(P<0.05)。结论 PPROM后AFI与多项母婴不良结局相关,可将AFI≤40 mm作为终止妊娠的指标,以减少不良妊娠发生。

Objective To investigate residual amniotic fluid index on pregnancy outcome and neonatal outcomes after preterm premature rupture of membrane（ PPROM）. Methods Five hundred and sixty-one cases of PPROM pregnancy were retrospectively analyzed and were divided into two groups according to AFI,group I had 196 cases（ AFI≤ 40 mm） and group II had 365 cases（ AFI 40mm）. Pregnancy outcomes and prognosis of new borns were compared. Results In Group I,the time between rupture and delivery was significantly shorter than that of group II（ P〈0.01）. Newborns neonatal mortality in group I was higher than that of group II（ P〈0.05）. Logistic regression analysis showed that AFI≤40 mm and pregnancy weeks at rupture were the factors affecting neonatal mortality（ P〈0.05） and AFI≤40 mm was the factor affecting neonatal asphyxia（ P〈0.05）. Conclusion AFI after PPROM is correlated with several motherhood and maternal adverse outcomes. AFI≤40 mm may be considered an index to terminate pregnancy in order to reduce adverse pregnancy.