足月胎膜破裂常规治疗与积极治疗的比较

Farah Khan, N. Shah, Shabana Kanwal, Nusrat Shah, F. Naz, Urooj Naz
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摘要

目的:比较产程前胎膜破裂(PROM)的常规治疗与积极治疗的效果。地点和时间:本研究于2022年3月至2022年6月在卡拉奇家庭医生不孕不育和产科中心进行。材料与方法:我们进行了一项随机对照试验,对74名登记的足月妊娠和37周以上妊娠胎膜破裂的患者进行了随机对照试验,这些患者经最后一次正常月经或日期扫描证实。两组随机分为自然分娩组和前列素积极治疗组。37例分娩前胎膜破裂患者按照科室政策检查后留置自然分娩,37例妇女积极治疗后穹窿植入前列素。测量的主要结果:关注的结果是干预与非干预在各组胎膜早破和开始分娩之间的时间跨度。次要结局包括对常规措施或积极治疗均无反应并需要剖腹产的患者。结果:干预组从破膜到临产的时间较保守组短(6.40h比5.03h)。试验组和对照组正常分娩或剖宫产率相同(27例)。Vs. 25分)。两组患者并发症发生率无统计学差异。(p值=0.967)结论:我们的研究结果显示,保守治疗与主动治疗的预后无差异。然而,干预组主动管理的患者较早分娩,与自发管理的患者相匹配。关键词:足月妊娠,胎膜早破,阴道自然分娩,紧急剖宫产学校规定的学习注册号为JSMU/IRB/2022/-601。
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Comparison of Conventional Treatment of Prom (Pre Labor Rupture of Membranes) with Active Treatment in Term Patients
Objectives: To compare outcome of conventional treatment of Pre labor rupture of membranes (PROM) with active treatment in term patients. Place and Duration: This study was Conducted in Family Medics Infertility and Maternity Centre Karachi from March 2022 till June 2022. Materials & Methods: We conducted a randomized control trial on 74 registered patients who presented to the labor room with term pregnancy and with the ruptured membranes at thirty-seven weeks or more gestation verified from the last normal menstrual period or a dating scan. Two groups were randomized as either spontaneous labor or active management by Prostin.37 patients presented in Prelabour rupture of membranes were examined as per departmental policy and left for spontaneous labor and 37 women were actively managed by inserting Prostin in the posterior fornix. Main Outcomes Measured: The outcome of interest was intervention vs .non intervention regarding timespan between PROM and initiation of labour in respective groups. Secondary outcome included patients who did not respond to either conventional measures or active treatment and required caesarian section. Results: The time duration between rupture membrane and initiation of labour was less in intervention group as compared to conservative group (6.40hrs vs. 5.03hrs).The rates with respect to normal delivery or caesarian section were same in test and control groups (27 pts. vs. 25 pts.). There was no statistically significant difference regarding complication in both the arms in study. (P-value=0.967) Conclusion: The results of our study showed that there are no differences in outcomes of conservative management of PROM with that of active management. However, patients managed actively in intervention group delivered earlier as matched with patients with spontaneous management. Keywords: Term pregnancy, PROM, Spontaneous vaginal delivery, Emergency Cesarean section. The Registration number of the study specified by the university is JSMU/IRB/2022/-601.
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