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目的:观察分析未足月胎膜早破(PPROM)对自发性早产(SPB)母婴结局的影响。方法:选择单胎SPB 495例,将孕28~33~(+6)周SPB 170例分为伴胎膜早破(PROM)组(A1组)100例,不伴PROM组(A2组)70例;孕34~36~(+6)周SPB 325例分为伴PROM组(B1组)190例,不伴PROM组(B2组)135例。收集所有入组病例及其新生儿临床资料进行汇总分析,比较孕28~33~(+6)周SPB A1组与A2组、孕34~36~(+6)周SPB B1组与B2组的母婴结局。结果:(1)A1组剖宫产、临床绒毛膜羊膜炎、产后出血、产褥感染、新生儿肺炎等发生率,显著或非常显著高于A2组(P<0.05,P<0.01),新生儿呼吸窘迫综合征(NRDS)发生率显著低于A2组(P<0.05);两组新生儿窒息发生率和围生儿病死率比较,差异不显著(P>0.05)。(2)B1组临床绒毛膜羊膜炎、产后出血、新生儿肺炎等发生率,显著或非常显著高于B2组(P<0.05,P<0.01);两组剖宫产、产褥感染、新生儿窒息、NRDS等发生率及围生儿病死率比较,均差异不显著(P>0.05)。结论:PPROM可导致SPB母婴不良结局,增加临床绒毛膜羊膜炎、产后出血及新生儿肺炎等发生风险。
Objective: To investigate the effect of PPROM on spontaneous preterm (SPB) maternal and infant outcomes. Methods: A total of 495 singletonic SPB patients were selected and 170 cases of SPB between 28 and 33 (+6) weeks were divided into PROM group (A1 group), 100 cases without PROM group (A2 group), 70 cases For example, among the 34 ~ 36 ~ (+6) weeks of pregnancy, 325 cases were divided into 190 cases with PROM group (B1 group) and 135 cases without PROM group (B2 group). The clinical data of all the patients and their newborns were collected and analyzed. The results of SPB group A1 and group A2 at 28 ~ 33 ~ (+6) weeks pregnant and that of group B2 at 34 ~ 36 ~ (+6) Baby ending. Results: (1) The incidence of cesarean section, clinical chorioamnionitis, postpartum hemorrhage, puerperal infection and neonatal pneumonia in group A1 were significantly or very significantly higher than those in group A2 (P <0.05, P <0.01) The incidence of neonatal respiratory distress syndrome (NRDS) was significantly lower than that of A2 group (P <0.05). There was no significant difference in neonatal asphyxia and perinatal morbidity between the two groups (P> 0.05). (2) The incidence of clinical chorioamnionitis, postpartum hemorrhage and neonatal pneumonia in B1 group was significantly higher than that in B2 group (P <0.05, P <0.01). The incidences of cesarean section, puerperal infection, Children asphyxia, NRDS and other perinatal morbidity and mortality were not significantly different (P> 0.05). Conclusion: PPROM can lead to maternal and fetal adverse outcomes of SPB and increase the risk of clinical chorioamnionitis, postpartum hemorrhage and neonatal pneumonia.