黄体酮联合地塞米松对胎膜早破孕妇分娩时间及母婴结局的影响

Effect of Progesterone Combined with Dexamethasone on Delivery Time and Maternal-Infant Outcomes of Pregnant Women with Premature Rupture of Membranes

目的探讨黄体酮联合地塞米松对胎膜早破孕妇分娩时间及母婴结局的影响。方法选取海南省澄迈县人民医院2019年3月至2020年3月收治的胎膜早破孕妇120例,按随机数字表法分为对照组和观察组,各60例。两组孕妇均予基础治疗及地塞米松磷酸钠注射液肌肉注射,观察组孕妇加用黄体酮注射液肌肉注射。结果观察组孕妇分娩时间为(86.25±7.45)h,显著长于对照组的(56.25±4.25)h(P<0.05);治疗后48 h,观察组孕妇的肿瘤坏死因子-α(TNF-α)、白细胞介素2(IL-2)、降钙素原(PCT)、C反应蛋白(CRP)、促肾上腺皮质激素释放激素(CRH)水平均显著低于对照组(P<0.05);两组孕妇并发症(产褥感染、产后出血、羊膜腔感染)发生率,顺产、助产、剖宫产情况,以及新生儿不良事件(肺部感染、胎儿宫内窘迫、死亡)发生率、新生儿体质量均无显著差异(P>0.05);观察组新生儿1 min及5 min Apgar评分均显著高于对照组(P<0.05)。结论黄体酮联合地塞米松可有效抑制胎膜早破孕妇CRH的分泌,降低炎性因子水平,相对延长分娩时间,从而提高新生儿Apgar评分。

Objective To investigate the effect of progesterone combined with dexamethasone on delivery time and maternal-infant outcomes of pregnant women with premature rupture of membranes.Methods Totally 120 pregnant women with premature rupture of membranes admitted to Chengmai People’s Hospital from March 2019 to March 2020 were selected and divided into the control group and the observation group according to the random number table method,60 cases in each group.The pregnant women in the two groups were given basic treatment and intramuscular injection of Dexamethasone Sodium Phosphate Injection,on this basis,the pregnant women in the observation group were given intramuscular injection of Progesterone Injection.Results The delivery time of pregnant women in the observation group was(86.25±7.45)h,which was significantly longer than(56.25±4.25)h in the control group(P<0.05).48 h after treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),procalcitonin(PCT),C-reactive protein(CRP)and corticotropin releasing hormone(CRH)in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of complications(puerperal infection,postpartum hemorrhage,amniotic cavity infection),neonatal adverse events(pulmonary infection,fetal distress,death),and the newborns’body mass spontaneous delivery,midwifery and cesarean section between the two groups(P>0.05).The neonatal Apgar scores in the observation group at 1 min and5 min were significantly higher than those in the control group(P<0.05).Conclusion Progesterone combined with dexamethasone can effectively inhibit the secretion of CRH,reduce the levels of inflammatory factors,and relatively prolong the delivery time in pregnant women with premature rupture of membranes,so as to improve the neonatal Apgar score.