未足月胎膜早破后羊水指数对孕妇妊娠结局及新生儿的影响

Effect of amniotic fluid index after preterm premature rupture of membrane on pregnancy outcome and neonatal outcome

目的探究未足月胎膜早破后羊水指数对孕妇妊娠结局及新生儿的影响。方法选择2015年4月至2016年8月本院收治的120例未足月胎膜早破孕妇为研究对象，按羊水量分为对照组（羊水量正常）和观察组（羊水量异常），每组60例。比较两组孕妇分娩方式、围产期并发症发生情况以及新生儿情况。结果两组孕妇经阴助产率比较，差异无统计学意义（P〉0．05）；观察组剖宫产率为65．00％，明显高于对照组的25．00％；观察组经阴正常产率为23．33％，低于对照组的60．00％；观察组脐带脱垂、产褥感染、绒毛膜羊膜炎等并发症发生率明显高于对照组，差异有统计学意义（均P〈0．05）；观察组新生儿死亡率为18．33％，新生儿宫内感染率为15．00％，羊水粪染率为13．33％，新生儿窒息率为16．67％，对照组新生儿死亡率为5．00％，新生儿宫内感染率为1．67％，羊水粪染率为1．67％，新生儿窒息率为3．33％，组间比较，差异有统计学意义（均P〈0．05）。结论未足月胎膜早破后羊水过少或过多均可增加孕妇剖宫产率，增加孕妇并发症及新生儿不良情况的风险，可将胎膜早破后检测的羊水指数作为观察母婴情况的重要指标。

Objective To investigate the effect of amniotic fluid index after preterm premature rupture of membrane （PPRM） on pregnancy outcome and neonatal outcome. Methods 120 PPRM pregnant women treated at our hospital from April, 2015 to August, 2016 were selected as study objects and were divided into a control group （normal amniotic fluid） and an observation group （amniotic fluid volume abnormality） according to the amount of amniotic fluid, 60 cases for each group. The delivery method, perinatal complications, and neonatal situation were compared between these two groups. Results There was no statistical difference in vaginal accouche rate between these two groups （P 〉 0.05）. The cesarean section rate was 65.00% in the observation group and 25.00% in the control group. The normal vaginal delivery rate was 23.33% in the observation group and 60.00% in the control group. The incidences of umbilical cord prolapse, puerperal infection, and chorioamnionitis were significantly higher in the observation group than in the control group, with statistical differences （all P 〈 0.05）. The neonatal mortality rate was 18.33%, the intrauterine infection rate was 15.00%, the rate of meconium stained amniotic fluid was 13.33%, and the neonatal asphyxia rate was 16.67% in the observation group and which were 5.00%, 1.67%, 1.67%, and 3.33% in the control group, with statistical differences （all P 〈 0.05）. Conclusions After preterm premature rupture of membrane, too much and too little amniotic fluid both can increase the cesarean section rate and the risk of maternal complications and neonatal adverse circumstances, so amniotic fluid index after premature rupture can be used as an important index to observe the maternal and infant conditons.