早产合并胎膜早破108例分析

早产和胎膜早破经常同时存在 ,但胎膜早破使早产的处理变得复杂化 ,且早产并胎膜早破的围生儿病率和病死率相当高。所以恰当处理早产合并胎膜早破 (ｐｒｅｍａｔｕｒｅｌａｂｏｒｃｏｍｐｌｉｃａｔｅｄｗｉｔｈｐｒｅｍａｔｕｒｅｒｕｐｔｕｒｅｏｆｍｅｍｂｒａｎｅ,ＰＰＲＯＭ )将是减少围生儿死亡的关键。本文将我院 1996 1999年内早产并胎膜早破病例 10 8例诊治情况总结报道如下。1　临床资料早产合并胎膜早破是指孕满 2 8周而不满 37周 ,胎膜在临产前自然破裂的病例。收集我院 1996年 1月至 1999年 12月住院分娩的早产并胎膜早破病例 …     

292例早产的临床因素分析

目的分析与人工早产和自然早产有关的危险因素.方法选取我院1993年1月至1999年7月间分娩的早产292例,将早产分为自然早产(250例)和人工早产(42例),分别与同期分娩的足月对照组295例相比,进行早产的临床因素分析.结果孕期母亲未作产前检查、胎膜早破、多胎、产前出血、中重度妊高征、内科合并症、胎儿畸形等均与早产有关;人工早产者产前检查率最低,剖宫产率最高,并主要与产前出血、中重度妊高征、多胎有关;自然早产者产前检查率低于足月对照组,其主要与胎膜早破、不明原因早产有关.结论孕期多种因素与早产有关;且自然早产和人工早产具有不同的危险因素.     

浅谈胎膜早破合并早产妊娠的结局

临产前胎膜破裂,称为胎膜早破。早产是指妊娠满28周至不满37足周间分娩者称早产。娩出的新生儿称早产儿。胎膜早破为产科常见并发症之一,亦是引起早产的主要原因之一,恰当处理胎膜早破合并早产将是减少围生儿死亡率的关键。我院分娩的胎膜早破合并早产的43例产妇进行调查报告如下:1资料与方法1.1一般资料:我院自2009年1月至2010年12月住院分娩的胎膜早     

早产的临床诊断与治疗推荐指南(草案)

一、早产的定义妊娠满28周至不足37周问分娩称为早产。分为自发性早产和治疗性早产两种，自发性早产包括未足月分娩和未足月胎膜早破，治疗性早产为妊娠并发症或合并症而需要提前终止妊娠者。     

基层医院未足月妊娠胎膜早破90例治疗体会

胎膜早破是指在临产前胎膜自然破裂，胎膜早破在足月前发生称为早产胎膜早破，是威胁母婴健康的常见并发症。及时而恰当地处理早产胎膜早破，对母婴预后有重要影响。2003年1月1日～2004年12月31日我院分娩总数为1484例，其中早产215例，早产率14．5％，发生胎膜早破90例，占早产总数41．9％。年龄17～40岁，初产妇52例，占57．8％。基层地区因医疗设施、诊治条件及育儿水平、人员意识与全国水平有一定差距，治疗处理有其特异性，现将笔者治疗体会与大家探讨如下。     

宫颈支原体感染与胎膜早破的关系探讨

目的探讨宫颈支原体感染与胎膜早破的关系及其对妊娠结局的影响。方法对北京市海淀区妇幼保健院2004年6月至2005年6月收治的93例胎膜早破孕妇(观察组)和96例孕足月、无胎膜早破住院待产孕妇(对照组)的宫颈分泌物,进行人型支原体(Mh)、解脲支原体(Uu)培养,并对其妊娠结局进行分析。结果观察组Mh感染率(6.45%)高于对照组(4.17%),但差异无统计学意义(P>0.05);观察组Uu感染率66.67%与对照组感染率55.21%比较,差异无统计学意义(P>0.05),观察组按是否早产再分两组,早产胎膜早破组产妇解脲支原体感染率为100%,明显高于足月胎膜早破组产妇61.73%,差异有统计学意义(P<0.05),早产胎膜早破组人型支原体感染率16.67%与足月胎膜早破产妇感染率2.47%比较,差异无统计学意义(P>0.05),但解脲支原体阳性孕妇分娩新生儿高胆红素血症明显增多,差异有统计学意义(P<0.05)。结论孕妇Mh、Uu感染与胎膜早破相关性不明显;Uu感染对早产的胎膜早破有明显影响,可能是导致早产胎膜早破的重要原因,并可能与新生儿高胆红素血症有关。     

403例胎膜早破的临床分析

目的:探讨胎膜早破对母婴的影响,分析其发生的原因,寻找正确的处理方法。保证母婴健康。方法:对我院2009年1月至12月403例胎膜早破和无胎膜早破500例临床资料进行回顾性分析。结果:早产、新生儿窒息、产褥感染、脐带脱垂及剖宫产率明显高于对照组。结论:加强产前及孕期保健积极治疗和避免各种高危因素,降低胎膜早破的发生率,提高围产儿的成活率。     

早产早破水病人的胎心率与胎儿窘迫

对早产及早产胎膜早破(PROM)病人的胎儿窘迫发生率和胎儿窘迫对病人处理的严重影响尚无恰当的评价。本文选用加利福尼亚三所医院1977年5月至1980年7月 PROM 进行前瞻性研究。早产胎膜未破系回顾性地选用1978年8月至1982年3月的病历。均为单胎,在孕28—35周期间分娩。35周前破水而在35周后分娩者除外,两组病人孕周相同。PROM 在入院后经窥器及 pH 试纸测定阴道穹窿液体而证实。早产诊断根据胎心监护仪有规律宫     

早产与产妇及新生儿感染的危险性增加有关

产妇产道感染及有关的炎症过程被认为是早产及胎膜早破(PROM)的病因。对1980年7月至1985年7月9 642例单胎分娩进行了回顾性研究,其中已除外炎症引产及非羊膜绒毛膜炎(简称羊绒炎)的感染病例。在未确诊羊绒炎前产前一般不给抗生素。结果:早产孕妇的羊绒炎发病率比足月产孕妇明显高,无 PROM 时发病率分别为5. 8%和1. 7%,     

2001年(第17卷)总目次

全国妇产科第 11届专题学术会会议纪要 (产科部份 ) (1)……专题讨论胎膜早破　胎膜早破的病因和发病机理 (3)……………………………　胎膜早破的并发症 (5 )………………………………………　足月妊娠胎膜早破的处理 (6 )………………………………　早产与胎膜早破 (7)…………………………………………　早产胎膜早破并发宫内感染的早期诊断 (8)………………　早产、胎膜早破与促胎肺成熟 (9)……………………………　早产胎膜早破的预防性抗生素治疗 (11)……………………　未足月胎膜早破的宫缩抑制剂治疗 (12 )……………………　胎膜…     

Continuous fetal tissue pH monitoring. A preliminary experience

Measurement of fetal scalp pH can aid in the detection of fetal acidosis. In order to evaluate fetal status further and possibly reduce fetal and neonatal mortality and morbidity, as well as reduce unnecessary cesarean section, continuous assessment of fetal pH is being investigated. Discussion of a six-month experience with a continuous + pH scalp electrode and monitor is presented, together with results of the limited study, as well as specific nursing action appropriate to an invasive method of research.     

Continuous Fetal Tissue pH Monitoring

Measurement of fetal scalp pH can aid in the detection of fetal acidosis. In order to evaluate fetal status, further and possibly reduce fetal and neonatal mortality and morbidity, as well as reduce unnecessary cesarean section, continuous assessment of fetal pH is being investigated. Discussion of a six-month experience with a continuous + pH scalp electrode and monitor is presented, together with results of the limited study, as well as special nursing actions appropriate to an invasive method of research.     

Decreasing frequency of iatrogenic neonatal respiratory distress syndrome

A retrospective study was undertaken to evaluate the obstetric events preceding delivery of infants who developed respiratory distress syndrome (RDS) at one New York City hospital between January 1970 and July 1973, and January 1980 and July 1983. Elective delivery without adequate documentation of fetal maturity occurred in 7 (11.1%) of 63 pregnancies resulting in RDS during 1970-1973 as compared to only 1 (1.4%) of 71 pregnancies resulting in RDS during 1980-1983 (P less than 0.05). This decline in "iatrogenic" RDS presumably reflects improved physician diligence in the prevention of unnecessary RDS, increased availability of ultrasound and fetal lung maturity studies, and advances in the application and interpretation of these diagnostic procedures.     

Ultrasonographic monitoring of pregnancies complicated by red blood cell alloimmunization in a cohort with mild to moderate risk according to previous obstetric outcome

AIM: To evaluate the detection rate of fetal anemia and pregnancy outcome as related to our policy of monitoring pregnancies with red blood cell alloimmunization. METHODS: From August 1997 to July 2000 35 pregnant women with maternal red blood cell alloantibodies were monitored by ultrasonographic measurements of the fetal spleen perimeter and peak systolic Doppler flow velocities of the middle cerebral artery, by semiquantification of maternal antibody titers and by general ultrasonographic and clinical evaluation. According to previous obstetric outcome they all had mild to moderate risk of developing fetal anemia. RESULTS: Eleven fetuses were anemic defined as a hemoglobin value < or = 2SD according to gestational age. A spleen perimeter > + 2SD and a middle cerebral artery peak systolic velocity > 95% prediction interval showed sensitivity and specificity of 64 and 92% and 45 and 100%, respectively. The area under receiver operating characteristic curves was 0.926 (95% CI 0.842-1.000; P < 0.001) for the spleen perimeter and 0.837 (95% CI 0.688-0.987; P < 0.01) for the middle cerebral artery peak systolic velocity. Cordocentesis was performed in one pregnancy only. None of the fetuses developed hydrops and all infants survived. Twelve women delivered before 37 weeks gestation. In 10 patients cesarean section was performed due to possible fetal anemia. Six of the 10 neonates had normal hemoglobin values. CONCLUSIONS: The ultrasonographic parameters did not predict all cases of fetal anemia defined as a hemoglobin concentration < or = 2SD according to gestational age. The present policy of monitoring seemed to reduce the number of invasive tests but possibly increased the number of preterm and cesarean deliveries.     

Fetal abdominal wall defect: a new complication of vesicoamniotic shunting.

Vesicoamniotic shunting for fetal obstructive uropathy is beneficial in selected cases. We report a new complication, fetal abdominal wall defect secondary to vesicoamniotic shunting. Placement of the shunt should be as low and as close to the fetal midline as possible in order to reduce the risk of this complication.     

Fetal electrocardiotocography in labor and neonatal outcome: an observational study in 1889 patients in the French center of Edouard Herriot, Lyon.

BACKGROUND: The STAN methodology has been shown to reduce both operative delivery for fetal distress and the cord artery metabolic acidosis rate. OBJECTIVE: The objective of this study was to monitor delivery modes and perinatal outcomes following the introduction of the STAN methodology and the evolution of its use at our institution. METHODS: Two periods were characterized: June 2000-June 2002 (period 1) and July 2002-April 2005 (period 2). Parity, mode of labor and delivery, ST events, and neonatal outcome (Apgar score and pH of the umbilical cord artery and vein), cases of metabolic acidosis and operative delivery for fetal distress were studied. RESULTS: One thousand eight hundred and eighty-nine women were included in the study. The rate of use of STAN increased from 13.5% to 16% over these two time periods. The rate of metabolic acidosis was low: 0.28% and 0.45%, respectively. No cases of neonatal encephalopathy or of perinatal death were diagnosed. There was a decrease in the rate of operative delivery for fetal distress (163/701 (22.9%) vs. 228/1111 (20.3%), p = 0.26). CONCLUSIONS: According to the literature, our use of the STAN appears to be very successful; the metabolic acidosis rate was 0.38% and the rate of operative delivery for fetal distress decreased. We improved the accuracy of the interpretation of the fetal heart rate.     

433例胎儿心电图临床分析

目的探讨二代胎儿心电图检查对检测异常胎儿的临床价值。方法把2019年1月至2019年7月在深圳市龙岗区妇幼保健院进行产检的433例产妇分为3组:产检无异常的健康孕妇300例为A组;产检存在异常情况的70例为B组;母体合并内科疾病的63例为C组。对比3组孕妇的胎儿心电图阳性率。结果3组孕妇组对比,B组的胎儿心电图异常检出率(44.29%)高于A组(1%)和C组(15.87%)。3组数据资料对比有统计学意义。结论第二代胎儿心电图可以及时发现胎儿的心律失常,值得广泛运用于产检。     

Intrauterine fetal death in twins after 32 weeks of gestation

A retrospective review of the outcome in multifetal pregnancies from January 1, 1980 to July 31, 1983 was undertaken to evaluate the role of nonstress test, followed by contraction stress test when indicated, in reduction of intrauterine fetal deaths in twins after 32 weeks of gestation. Of the 90 twin pregnancies managed under the authors' protocol, there were no intrauterine fetal deaths. Intervention leading to delivery occurred in six twin pregnancies with an abnormal nonstress test followed by an equivocal or positive contraction stress test. The authors believe that routine use of weekly nonstress tests after 30 weeks of gestation coupled with contraction stress tests when indicated, and use of other parameters of fetal assessments such as ultrasound, intrauterine fetal death in twin gestation after 32 weeks of gestation, can be significantly reduced.     

胎儿期心律失常的诊断及其对新生儿预后的影响

目的了解胎儿期心律失常的诊断方法、临床意义及对新生儿预后的影响。方法选择2004年6月至2006年1月于浙江大学医学院附属妇产科医院产前检查中发现胎儿心律失常孕妇57例,分析孕妇病史、胎儿心电图、胎儿超声心动图、妊娠结局。结果胎儿心律失常中胎儿心动过速、胎儿心动过缓和不规则胎儿心律的构成比分别为17.4%、4.3%和78.3%。首次发现胎儿心律失常的孕周及胎儿心律失常的类型与新生儿预后没有显著关联。持续发作心律失常的胎儿,其预后显著差于偶发心律失常的胎儿。经期待疗法,孕期胎儿心率恢复正常的有21例(36.8%),出生后新生儿心率迅速恢复正常的有15例(26.3%),经对症治疗后有14例新生儿恢复正常心率(24.6%)。发现4例(7.0%)胎儿心脏结构异常。59.7%的孕妇合并产科并发症。结论大部分心律失常的胎儿预后良好,在临床上可以密切随访,可在分娩前或出生后恢复正常心率;与胎儿预后不良有关的因素为持续发作心律失常、胎儿伴有水肿。     

Use of fetal pulse oximetry during labor

Fetal surveillance during labor is mainly based on fetal heart rate monitoring in France. In case of abnormal FHR, fetal scalp blood analysis may reduce the rate of cesarean section. Fetal pulse oximetry, a recent second-line technique of fetal monitoring could also reduce obstetrical interventions. Several maternity departments in France and other European countries are currently using this new tool routinely. Several observation studies have shown the potential interest of pulse oximetry. Randomized controlled trials will soon be able to conclude on the real benefits that can be expected from pulse oximetry during therm labor in normally grown fetuses. Other clinical situations such as meconium-stained amniotic fluid, preterm labor or fetal growth retardation remain to be explored.