臀位单胎未足月胎膜早破的临床特点和妊娠结局

Clinical feature and pregnancy outcome of premature rupture of the mem-brane of single fetal breech pregnancy

目的探讨臀位单胎未足月胎膜早破的临床特点和妊娠结局。方法选取本院2014年1月~2015年12月的60例臀位单胎未足月胎膜早破产妇作为研究组,随机抽取同期的60例头位单胎未足月胎膜早破产妇作为对照组。比较两组终止妊娠的孕周及胎膜早破发生的时间、早产率、妊娠结局等指标。结果研究组的胎膜早破时间为（33.8±2.3）孕周,显著短于对照组的（35.4±1.7）周,差异有统计学意义（P〈0.05）。研究组胎膜早破前有不规则宫缩21例（35%）,显著高于对照组的9例（15%）,差异有统计学意义（P〈0.05）。研究组给予地塞米松促胎肺成熟〈48 h的比例高于对照组,差异有统计学意义（P〈0.05）。研究组使用宫缩抑制剂的比例高于对照组,差异有统计学意义（P〈0.05）。研究组的早产率、剖宫产率、新生儿窒息发生率显著高于对照组,差异有统计学意义（P〈0.05）。研究组的新生儿体重低于对照组,差异有统计学意义（P〈0.05）。研究组的羊水过少发生率显著高于对照组,差异有统计学意义（P〈0.05）。两组的绒毛膜羊膜炎发生率比较,差异无统计学意义（P〉0.05）。结论臀位妊娠合并胎膜早破的早产儿、胎儿窘迫及新生儿窒息、羊水过少发生率较高,能够增加剖宫产率,且新生儿预后较差,应积极预防处理。

Objective To explore the clinical feature and pregnancy outcome of premature rupture of the membrane of single fetal breech pregnancy.Methods 60 puerperae of premature rupture of the membrane of single fetal breech pregnancy from January 2014 to December 2015 in our hospital were selected as the study group,and 60 puerperae of premature rupture of the membrane of single fetal head position pregnancy at the same period in our hospital were selected as the control group.The indicators of the pregnant week of pregnancy termination and premature rupture of membrane time,premature birth rate,pregnancy outcome and so on in the two groups was compared.Results The time of premature rupture of membrane in the study group was（33.8 ±2.3） pregnant weeks,which was shorter than（35.4 ±1.7） pregnant weeks in the control group,with significant difference（P〈0.05）.Irregular contraction in the study group before premature rupture of the membrane was 21 cases（35%）,which was higher than 9 cases（15%） in the control group,with significant difference（P〈0.05）.The proportion of dexamethasone promoting fetal lung maturity time more than 48 hours in the study group was higher than that in the control group,with significant difference（P〈0.05）.The proportion of using tocolysis in the study group was higher than that in the control group,with significant difference（P〈0.05）.The rate of premature birth,cesarean section,neonatal asphyxia in the study group was higher than that in the control group,with significant difference（P〈0.05）.Neonatal weight in the study group was lower than that in the control group,with significant difference（P〈0.05）.The incidence rate of hypamnion in the study group was higher than that in the control group,with significant difference（P〈0.05）.There was no significant difference in the incidence rate of chorioamnionitis between the two groups（P〉0.05）.Conclusion The incidence rate of preterm,fetal distress and neonatal asphyxia,hypamnion in the breech pregnancy with premature rupture of the membrane is higher,which can increase the rate of cesarean section and neonatal prognosis is poor,it should be positive prevention and treatment.