611例胎膜早破临床回顾性分析

发布时间：2018-05-01 14:44

本文选题：胎膜早破 + 危险因子　；参考：《山西医科大学》2014年硕士论文

【摘要】：目的：临产前发生胎膜破裂，称为胎膜早破(premature rupture of membrane，PROM）。是妊娠中晚期发病率较高的并发症。发生率国外报道为5%-15%，国内为2.7%-7%。妊娠满37周后的胎膜早破发生率为10%；妊娠不满37周的胎膜早破发生率为2.0-3.5%。孕周越小，围产儿预后越差，胎膜早破可引起早产、胎盘早剥、脐带脱垂、羊水过少、胎儿窘迫和新生儿呼吸窘迫综合征，孕产妇及胎儿感染率和围产儿病死率显著升高。本研究旨在分析胎膜早破的高危因素、分娩方式及对妊娠结局的影响。方法：回顾性分析2011年1月至2012年12月在山西医科大学第一医院住院分娩的611例胎膜早破孕妇的相关临床资料并复习国内外相关文献报道。结果：1.本院胎膜早破的发生率为15.1%，其中未足月胎膜早破的发生率为2.6%，足月胎膜早破的发生率为12.5%。2.导致胎膜早破的高危因素主要为生殖道感染、宫腔操作史、宫腔内压力增加（巨大儿、双胎与多胎妊娠、羊水过多）、妊娠期高血压疾病等。3.未足月胎膜早破的剖宫产率高于足月胎膜早破(P＜0.05)。4.本研究胎膜早破剖宫产指征中，，难产占首位，胎儿窘迫占第二位。5.未足月胎膜早破剖宫产率较高的原因为早产儿的肺发育不成熟，更容易发生胎儿窘迫，而选择剖宫产终止妊娠。与足月胎膜早破相比，双胎及多胎妊娠在未足月胎膜早破中的发生率较高。6.胎膜早破给母体带来的不良影响主要包括绒毛膜羊膜炎、胎盘早剥、产后出血。7.未足月胎膜早破的胎儿窘迫及新生儿窒息的发生率高于足月胎膜早破(P＜0.05)。结论：胎膜早破可对母婴造成不良影响，应重视胎膜早破的高危因素，加强孕前和孕期保健，降低胎膜早破的发生率，并对不同孕周胎膜早破患者加强临床监护，给予正确处理，减少母婴并发症。
[Abstract]:Objective : Premature rupture of membranes , called premature rupture of membrane ( PROM ) , occurs in the presence of premature rupture of membranes . The incidence rate was 5 % -15 % in foreign countries , 2.7 % -7 % in China , and 10 % in premature rupture of pregnancy after 37 weeks of gestation .
The incidence of premature rupture of fetal membranes was 2.0 - 3.5 % at 37 weeks of gestation . The less pregnant weeks , the poorer the perinatal prognosis , premature rupture of the membranes could lead to preterm labor , placental abruption , umbilical cord prolapse , oligohydramnios , fetal distress and neonatal respiratory distress syndrome , maternal and fetal infection rates , and perinatal mortality . This study was intended to analyze the high risk factors , modes of delivery and the effects on the outcome of pregnancy .

Methods : The clinical data of 611 cases of premature rupture of fetal membranes from January 2011 to December 2012 in the first hospital of Shanxi Medical University were analyzed retrospectively .

Results : 1 . The incidence of premature rupture of fetal membranes was 15.1 % , the rate of premature rupture of fetal membranes was 2.6 % , and the rate of premature rupture of fetal membranes was 12.5 % .

Conclusion : Premature rupture of membranes can affect the mother - to - child health , and should pay attention to the high risk factors of PROM , strengthen maternal and pregnancy health care , reduce the incidence of PROM , and strengthen clinical monitoring for patients with PROM .

【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.433

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