28例紧急宫颈环扎术后合并胎膜早破的影响因素分析

Analysis of the influencing factors of 28 cases of premature rupture of membranes after emergency cervical cerclage surgery

目的对28例紧急宫颈环扎术后合并胎膜早破的影响因素进行分析。方法回顾性分析本院妇产科收治的28例紧急宫颈环扎术后合并胎膜早破患者的临床资料,根据孕周分为<28周组(6例)、≥28周组(22例),分析紧急宫颈环扎术后合并胎膜早破的影响因素,并建立预测分娩孕周的数学模型。结果<28周组的平均年龄、经产妇比例高于≥28周组,人工流产次数多于≥28周组,胎膜膨出阴道直径大于≥28周组,平均分娩孕周小于≥28周组,差异有统计学意义(P<0.05);28例孕妇的自然分娩率为89.3%;<28周组产褥感染、新生儿视网膜病变发生率高于≥28周组,差异有统计学意义(P<0.05);产妇分娩孕周和术前C-反应蛋白、分娩时白细胞计数呈不同程度的负相关(P<0.05)。结论高龄、经产妇、人工流产次数多、胎膜膨出阴道直径大是紧急宫颈环扎术合并胎膜早破预后的高危因素,术前C-反应蛋白、分娩时白细胞计数对分娩孕周有预测作用。

Objective To analyze the influencing factors of 28 cases of premature rupture of membranes after emergency cervical cerclage surgery.Methods A retrospective analysis was conducted on the clinical data of 28 patients with emergency cervical cerclage combined with premature rupture of membranes admitted to our hospital's obstetrics and gynecology department.They were divided into a<28 week group(6 cases)and a≥28 week group(22 cases)based on gestational age.The influencing factors of premature rupture of membranes after emergency cervical cerclage were analyzed,and a mathematical model was established to predict the gestational age of delivery.Results The average age and proportion of postpartum women in the<28 week group were higher than those in the≥28 week group,and the number of induced abortions was higher than that in the≥28 week group.The vaginal diameter of fetal membrane bulges was greater than that in the≥28 week group,and the average gestational age of delivery was less than that in the≥28 week group.The difference was statistically significant(P<0.05);The natural delivery rate of 28 pregnant women was 89.3%The incidence of postpartum infection and neonatal retinopathy in the 28 week group was higher than that in the≥28 week group,with statistical significance(P<0.05);There is a varying degree of negative correlation(P<o.05)between the gestational week of delivery and preoperative C-reactive protein,as well as the white blood cell count during delivery.Conclusion Elderly age,multiparous women,frequent induced abortions,and large vaginal diameter of fetal membranes are high-risk factors for the prognosis of emergency cervical cerclage combined with premature rupture of membranes.Preoperative C-reactive protein and white blood cell count during delivery have predictive effects on the gestational ageofdelivery.