未足月胎膜早破母婴结局的临床资料分析

目的探讨未足月胎膜早破（PPROM）的母婴预后。方法回顾性分析我院2004年1月-2008年12月收治的PPROM单胎妊娠的537例孕产妇的临床资料。结果孕23-32＋6周PPROM患者的死产率为83.3%,新生儿死亡率为63.3%,围产存活新生儿发病率与孕33-36＋6周的PPROM患者相比,两组差异具有统计学意义（均为P〈0.01）。PPROM患者的围产儿结局与破膜孕周密切相关。结论孕23-32＋6周PPROM的早产儿预后较差,在保守治疗期间应根据具体情况适时终止妊娠,而孕33-36＋6周PPROM患者建议在积极期待治疗期间及时分娩,以减少早产儿并发症。

Relationship between Preterm Premature Rupture of Membrane and Maternal-Neonatal Outcomes at Different Gestational Weeks

Objective To study the maternal and fatal outcomes and the selection of the optimal time of delivery after preterm premature rupture of membranes （PPROM）. Methods Maternal and fetal outcomes of 537 singleton pregnancies complicated with preterm rupture of amniotic membranes from January 2004 to December 2008 were retrospectively analyzed. Results The incidence of stillbirth was 83.3% in gestational age of 23-32 ＋6 weeks in pregnant women complicated with PPROM. The neonatal mortality was 63.3%,and the morbidity of perinatal survival was significantly different from the group of 33-36＋6 weeks （all P0.01）. Perinatal outcome was closely related to the gestation age of amniotic membrane rupture. Conclusion Prognosis of pregnant women with PPROM at 23-32＋6 weeks of gestation was poor. Termination of pregnancy should be considered according to the conditions of patients. Alternatively,patients with PPROM at 33-36＋6 weeks of gestation having the favorable outcomes for neonates should receive delivery with aggressive expectant management to reduce the neonatal complications.