不同孕周胎膜早破对妊娠结局的影响及治疗

Effects and treatment of different gestational weeks on pregnancy outcomes in premature rupture of membranes

目的：探讨不同孕周胎膜早破（PROM）及不同潜伏期对妊娠结局的影响及治疗。方法回顾性分析120例孕28～36＋6周PROM孕产妇和新生儿的临床资料。结果孕28～35周PROM组新生儿呼吸困难、缺血缺氧性脑病和死亡及绒毛膜炎的发生率均明显高于孕35＋1～36＋6周PROM组。孕28～35周PROM组潜伏期在12h以内者新生儿呼吸困难、缺血缺氧性脑病和死亡均高于潜伏期在12h以后者，两组比较差异有统计学意义（P＜0.05）。孕35＋1～36＋6周PROM组潜伏期在12h以内者的孕产妇与潜伏期在12h以后者相关并发症发生率差异无统计学意义。结论对孕28～35周PROM应采取促胎肺成熟和预防感染等措施，延长孕周，适时终止妊娠；而孕35＋1～36＋6周PROM胎儿肺成熟者应在破膜12h以内终止妊娠。

Objective To study the effects and treatment of different gestational weeks and latent period on pregnancy in premature rupture of membranes（PROM）. Methods The clinical data from 120 gravidas between 28-36＋6 weeks with PROM and neonata information were retrospectively analyzed. Results Transient respiratory hypoxia ischemic encephalopathy（HIE） and death as well as the chorioamnionitis were higher in 28-35 weeks of PROM than those in 35＋1-36＋6 weeks of PROM. In 28-35 eeks of PROM, transient respiratory distress, HIE and death of the newborn were higher in group of latent period within 12h than that in group of latent period over 12h.there was statistic difference （P〈0.05）.In 35＋1-36＋6 weeks of PROM, there was no statistic difference of maternal complication incidences between the different latent period. Conclusion The suitable measures to treat the patients with PROM at 28-35 gestational weeks are promoting fetal lung maturation, preventing infection, extending the gestational week and termination the pregnancy at the right time, while to the patients with PROM at 35＋1-36＋6 gestational week with maturation of fetal lung it should terminate the pregnancy within 12h after the rupture of membrane.