未足月胎膜早破影响因素及不同孕周发生未足月胎膜早破治疗的妊娠结局研究

Influential factors of premature rupture of fetal membranes and pregnancy outcomes of premature rupture of membranes in different gestational weeks

目的探讨未足月胎膜早破影响因素及不同孕周发生未足月胎膜早破治疗的妊娠结局。方法选取我院产科2018年1~10月收治的未足月胎膜早破孕妇200例作为本次研究对象,按照孕妇妊娠周数分为三组:第一组孕28~31+6周70例、第二组孕32~33+6周64例、第三组孕34~36+6周66例。选取同一时间段产检孕妇100例作为对照组。研究对象入院后根据患者情况给予不同的治疗。统计未足月胎膜早破的影响因素、临床治疗时长、妊娠结局。结果胎位异常、引产流产史和生殖道感染是影响未足月胎膜早破发病的独立危险因素(P<0.05)。第二组治疗时长比第一组和第三组有显著延长(P<0.05)。第一组的Apgar评分显著低于第二组和第三组(P<0.05),第一组的宫内感染、胎儿宫内窘迫综合征、新生儿窒息和死亡率显著高于第二组和第三组(P<0.05)。结论未足月胎膜早破与胎位异常、引产流产史和生殖道感染有关。妊娠32~33+6周出现胎膜早破采用糖皮质激素、硫酸镁和抗生素处理方案,可有效改善妊娠结局。

Objective To study the influencing factors of premature rupture of fetal membranes and the pregnancy outcome of premature rupture of membranes in different gestational weeks. Methods A total of 200 pregnant women with premature rupture of membranes from January to October 2018 in the department of obstetrics in our hospital were enrolled. The subjects were divided into three groups according to the number of pregnant women: the first group with70 cases of pregnancy 28-31+6 weeks, the second group with 64 cases of pregnancy 32-33+6 weeks, and the third group with 36 cases of pregnancy 34-36+6 weeks. 100 pregnant women in the same period of time were selected as blank control group. Subjects were treated differently depending on the patient’s condition after admission. The factors affecting premature rupture of fetal membranes, length of clinical treatment, and pregnancy outcome were analyzed. Results Abnormal fetal position, history of induced abortion and genital tract infection were independent risk factors for the premature rupture of fetal membranes(P<0.05). The treatment period in the second group was significantly longer than that of the first group and the third group(P<0.05). The Apgar score of the first group was significantly lower than that of the second group and the third group(P<0.05). The intrauterine infection, intrauterine distress syndrome, neonatal asphyxia and mortality in the first group were significantly higher than those of the second group and the third group(P<0.05).Conclusion Premature rupture of membranes is associated with abnormal fetal position, history of induced abortion and genital tract infection. The glucocorticoidsm magnesium sulfate and antibiotics for the premature rupture of membranes at gestation 32-33+6 weeks can improve pregnancy outcomes.