早产胎膜早破患者的母胎结局研究

Niki Shah, Vipul S. Patel, Anisa Shaikh
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摘要

背景:早产胎膜早破(PPROM)是指怀孕 28-37 周的孕妇在分娩前胎膜破裂。早产胎膜早破与孕产妇和新生儿的严重发病率或死亡率相关。本研究旨在评估 PPROM 的风险因素、病因及其对三级医院孕产妇的影响:方法:在阿赫姆达巴德 SMS 医院妇产科进行了一项横断面研究。研究对象包括 50 名妊娠 28-37 周、患有先兆流产(PPROM)的孕妇,她们都接受了详细的病史询问和检查。对每位患者进行了随访直至分娩,并记录了胎儿和产妇的结局:结果:PPROM 是一种常见的妊娠并发症。80%的孕妇年龄在 20-29 岁之间,70%的孕妇没有预约,76%的孕妇来自低 SE 级,68%的孕妇孕龄在 34-36 周之间。阴道分娩占 58%。患有先兆流产的母亲所生的婴儿体重多在 2-2.5 公斤之间(48%)。34名产妇没有罹患早产儿先兆流产的风险因素。导致早产儿猝死的最常见病因是感染,占 16%,胎位不正占 10%。大多数患有先兆流产的母亲没有并发症。17(34%)名婴儿因早产、呼吸窘迫、出生窒息和败血症而需要入住新生儿重症监护室。RDS 是最常见的新生儿并发症。本研究中有 2 名新生儿死于 RDS 和早产:有效的早产儿窒息治疗包括评估保守治疗策略的风险和优势。在可能的情况下,药物治疗应侧重于在孕期预防性使用抗生素和类固醇,以降低胎儿和母亲的发病率和死亡率。一旦出现绒毛膜羊膜炎的迹象,应考虑终止妊娠。
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A study on feto-maternal outcome in patients with preterm premature rupture of membranes
Background: Preterm premature rupture of membranes (PPROM) is rupture of fetal membranes prior to labor in pregnancies between 28-37 weeks. PPROM is associated with significant maternal and neonatal morbidity or mortality. The present study was conducted to evaluate risk factor and etiology of PPROM and its fetomaternal effect in tertiary care hospital. Methods: A cross-sectional study was conducted in the department of obstetrics and gynaecology, SMS Hospital, Ahemdabad. From August 2023 to February 2024.The study included 50 pregnant women between 28-37 weeks gestation with PPROM were subjected to detailed history and examination. Each patient was followed till her delivery and fetomaternal outcome was recorded. Results: PPROM is a fair complication of pregnancy. 80% were belongs to 20-29 age, 70% were unbooked, 76% from low SE-class, 68% with gestational age of 34-36 weeks. Vaginal delivery was common 58%. The babies born to mothers with PPROM more in weight of 2-2.5 kg (48%). 34 had no risk factors to develop PPROM. Most common etiology for PPROM infection 16% and malpresentation 10%. Most of the mothers with PPROM had no complications. 17 (34%) babies required NICU admissions for complaints of premturity, respiratory distress, birth asphyxia, and sepsis. RDS was most common neonatal complication. 2 neonatal deaths in this study due to RDS and prematurity. Conclusions: Effective PPROM Mx involves evaluating the risks and advantage of conservative Mx strategies. Whenever possible, Rx should be focused towards prophylactic use of antibiotics and steroids during pregnancy can reduce fetal and mother morbidity and mortality. Termination of pregnancy should be considered at the 1st sign of chorioamnionitis.  
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