Premature rupture of membranes (PROM) is a frequent phenomenon that occurs in about 4% - 7%. However, the associated sequent problems are proportionally high. Almost two thirds of PROM are spontaneous, common risk fac...Premature rupture of membranes (PROM) is a frequent phenomenon that occurs in about 4% - 7%. However, the associated sequent problems are proportionally high. Almost two thirds of PROM are spontaneous, common risk factor young mother, multiple pregnancy, genital tract infection, previous preterm delivery. The complications range from induction of labour, caesarean section, fetal pulmonary morbidity and even mortality. Objectives of the Study: To identify and quantify the risk factors and complications of premature rupture of membrane in pregnant women in Benghazi, Libya, 2012. Material and Methods: 100 pregnant women diagnosed as PROM were examined for the physical signs. Detailed gynaecological and obstetric history was reported. Laboratory investigations included cervical swabs and posterior fornix swabs under aseptic conditions Drugs including types of antibiotics, Dexamethasone and tocolytics were also included. Results: The mean age of 100 patients was 28.9 years. Most of them, 66.1% of patients received antibiotis mostly Erythromycin. Dexamethasone was given for 32.1%. FTND accounted for 62% and PTND for 10% and Caesarean section was performed for 28%. The main indications for C/S were failed induction, in 50%, 11.8% were equally distributed between;macrosomia, previous scars, drained liquor, previous C/S, breech presentation. Only 1% of new born babies had complication. Conclusions and Recommendations: Further large studies should be done for more elaboration and analytical studies to quantify the strength of each risk factor. Strategy for management of PROM should be adopted for proper timing of induction, emergency caesarean intervention with ultimate goals of minimizing and or preventing maternal and fetal complications of disease.展开更多
目的分析不同孕周胎膜早破性早产（preterm premature rupture of membrane,PPROM）妊娠结局以及产前使用糖皮质激素干预对早产新生儿结局的影响。方法：对411例未足月PPROM病例的临床资料进行回顾性分析,比较不同孕周PPROM及产前是否...目的分析不同孕周胎膜早破性早产（preterm premature rupture of membrane,PPROM）妊娠结局以及产前使用糖皮质激素干预对早产新生儿结局的影响。方法：对411例未足月PPROM病例的临床资料进行回顾性分析,比较不同孕周PPROM及产前是否使用糖皮质激素干预治疗的各种早产儿结局。结果：〈34孕周PPROM的新生儿体重、呼吸窘迫综合症（RDS）、窒息发生率、死亡率均明显高于34^＋1-36^＋6孕周PPROM者（P〈0.001）。32-34孕周组PPROM的新生儿重度窒息发生率、RDS、死亡率在糖皮质激素干预组明显低于对照组,两组间比较差异有显著性（P〈0.05）。28-31^＋6孕周组及34^＋1-36^＋6孕周组PPROM新生儿结局的各项指标在干预组与对照组间无显著差异（P〉0.05）。结论：对于〈34孕周的PPROM宜采取积极期待治疗,延长孕周,降低新生儿死亡率。32-34孕周的PPROM产前使用糖皮质激素干预能显著改善新生儿结局。展开更多
目的对比两种不同的抗菌治疗方案对于未足月胎膜早破(PPROM)患者抗菌治疗的有效性及其对新生儿结局的影响。方法回顾性分析212例PPROM患者的围生期结局,患者在妊娠期<34周分别给予2种抗菌方案治疗;通过羊水培养阳性和羊水中MMP-8浓...目的对比两种不同的抗菌治疗方案对于未足月胎膜早破(PPROM)患者抗菌治疗的有效性及其对新生儿结局的影响。方法回顾性分析212例PPROM患者的围生期结局,患者在妊娠期<34周分别给予2种抗菌方案治疗;通过羊水培养阳性和羊水中MMP-8浓度升高评估羊膜内感染/发炎。结果给予方案二治疗的患者中位抗菌至分娩的时间较方案一延长(29.9 d vs.8.8 d,P<0.01);方案二治疗组患者急性组织学绒毛羊膜炎和脐带炎的发生率(50.4%、14.2%)低于方案一治疗组(66.7%、42.4%),差异有统计学意义(P<0.01);方案二组新生儿的心室内出血、脐带炎和大脑性麻痹的发生率低于方案一组(P<0.05)。结论头孢曲松、克拉霉素和甲硝唑联合疗法对于PPROM患者可以延长潜伏期,降低急性组织学绒毛膜羊膜炎和脐带炎发生率,改善新生儿的临床结局,表明联合用药(头孢曲松、克拉霉素和甲硝唑)有助于改善PPROM围生期结局。展开更多
文摘Premature rupture of membranes (PROM) is a frequent phenomenon that occurs in about 4% - 7%. However, the associated sequent problems are proportionally high. Almost two thirds of PROM are spontaneous, common risk factor young mother, multiple pregnancy, genital tract infection, previous preterm delivery. The complications range from induction of labour, caesarean section, fetal pulmonary morbidity and even mortality. Objectives of the Study: To identify and quantify the risk factors and complications of premature rupture of membrane in pregnant women in Benghazi, Libya, 2012. Material and Methods: 100 pregnant women diagnosed as PROM were examined for the physical signs. Detailed gynaecological and obstetric history was reported. Laboratory investigations included cervical swabs and posterior fornix swabs under aseptic conditions Drugs including types of antibiotics, Dexamethasone and tocolytics were also included. Results: The mean age of 100 patients was 28.9 years. Most of them, 66.1% of patients received antibiotis mostly Erythromycin. Dexamethasone was given for 32.1%. FTND accounted for 62% and PTND for 10% and Caesarean section was performed for 28%. The main indications for C/S were failed induction, in 50%, 11.8% were equally distributed between;macrosomia, previous scars, drained liquor, previous C/S, breech presentation. Only 1% of new born babies had complication. Conclusions and Recommendations: Further large studies should be done for more elaboration and analytical studies to quantify the strength of each risk factor. Strategy for management of PROM should be adopted for proper timing of induction, emergency caesarean intervention with ultimate goals of minimizing and or preventing maternal and fetal complications of disease.
文摘目的分析不同孕周胎膜早破性早产（preterm premature rupture of membrane,PPROM）妊娠结局以及产前使用糖皮质激素干预对早产新生儿结局的影响。方法：对411例未足月PPROM病例的临床资料进行回顾性分析,比较不同孕周PPROM及产前是否使用糖皮质激素干预治疗的各种早产儿结局。结果：〈34孕周PPROM的新生儿体重、呼吸窘迫综合症（RDS）、窒息发生率、死亡率均明显高于34^＋1-36^＋6孕周PPROM者（P〈0.001）。32-34孕周组PPROM的新生儿重度窒息发生率、RDS、死亡率在糖皮质激素干预组明显低于对照组,两组间比较差异有显著性（P〈0.05）。28-31^＋6孕周组及34^＋1-36^＋6孕周组PPROM新生儿结局的各项指标在干预组与对照组间无显著差异（P〉0.05）。结论：对于〈34孕周的PPROM宜采取积极期待治疗,延长孕周,降低新生儿死亡率。32-34孕周的PPROM产前使用糖皮质激素干预能显著改善新生儿结局。
文摘目的对比两种不同的抗菌治疗方案对于未足月胎膜早破(PPROM)患者抗菌治疗的有效性及其对新生儿结局的影响。方法回顾性分析212例PPROM患者的围生期结局,患者在妊娠期<34周分别给予2种抗菌方案治疗;通过羊水培养阳性和羊水中MMP-8浓度升高评估羊膜内感染/发炎。结果给予方案二治疗的患者中位抗菌至分娩的时间较方案一延长(29.9 d vs.8.8 d,P<0.01);方案二治疗组患者急性组织学绒毛羊膜炎和脐带炎的发生率(50.4%、14.2%)低于方案一治疗组(66.7%、42.4%),差异有统计学意义(P<0.01);方案二组新生儿的心室内出血、脐带炎和大脑性麻痹的发生率低于方案一组(P<0.05)。结论头孢曲松、克拉霉素和甲硝唑联合疗法对于PPROM患者可以延长潜伏期,降低急性组织学绒毛膜羊膜炎和脐带炎发生率,改善新生儿的临床结局,表明联合用药(头孢曲松、克拉霉素和甲硝唑)有助于改善PPROM围生期结局。
