未足月胎膜早破患者易发因素分析及妊娠结局探讨

Analysis of risk factors and outcome of pregnancy in patients with preterm premature rupture of membranes

目的分析未足月胎膜早破（PPROM）的易发因素及对母儿结局的影响。方法选取深圳市福田区人民医院收治的89例PPROM患者作为研究对象,同时选取102例足月胎膜早破患者作为对照组。分析PPROM的易发因素,并比较两组产妇及围产儿结局。结果未足月胎膜早破患者人工流产（人流）史≥2次、臀位妊娠、阴道炎发生率明显高于足月胎膜早破患者（P〈0.05）;非条件Logistics多因素回归分析结果显示,人流史≥2次、阴道炎、臀位是引发PPROM的高危因素（P〈0.05）;观察组新生儿感染及并发症、新生儿窒息及胎儿窘迫发生率依次为23.60%、11.24%和12.36%,均明显高于对照组（P〈0.05）;两组产妇产后出血、产褥感染及剖宫产发生率方面比较,差异无统计学意义（P〉0.05）。结论未足月胎膜早破病因复杂,了解其易发因素对临床积极防治该病意义重大,针对孕周在28~34周的患者应采取期待治疗,保胎至〉34周,再适时终止妊娠,可改善妊娠结局。

Objective To analyze the risk factors of preterm premature rupture of membranes（ PPROM） and the effect on the outcomes of mothers and infants. Methods 89 patients with PPROM treated in People＇s Hospital of Futian District were selected as the research object,and 102 cases with no preterm premature rupture of membranes were selected as control group. The factors of PPROM were analyzed; the outcomes of pregnant women and fetus between the two groups were compared. Results The incidence of introduce abortions≥2 times,breech pregnancy and vaginitis of observation group were higher than those of control group,and the difference was statistically significant（ P 0. 05）. Non conditional Logisticss regression analysis showed that the history of more than two introduce abortions or equal to two times,breech pregnancy and vaginitis were the risk factors of PPROM（ P 0. 05）. The rates of neonatal infections and complications,neonatal asphyxia and fetal distress of observation group were 23. 60%,11. 24% and 12. 36%respectively,which were significantly higher than those of control group（ P 0. 05）. The difference was not statistically significant in postpartum hemorrhage,puerperal infection and cesarean section（ P 0. 05）. Conclusion The cause for preterm premature rupture of membranes was complex,it is important to understand the risk factors for clinical prevention and treatment. To pregnant women during 28 to 34 weeks,expectant treatment should be taken until pregnancy more than 34 weeks,and then termination of pregnancy timely,these methods can improve pregnancy outcome.