摘要
目的 了解北京地区孕妇胎膜早破的发生情况及分娩方式与妊娠结局的关系.方法 采用多中心、分层（三级综合与专科医院、二级医院）的方法,收集北京妇产医院、友谊医院、大兴妇幼保健院、通州妇幼保健院4家医院2011年1-12月全年分娩孕妇的临床资料,共18 534例,进行回顾性分析.结果 ①18 534例孕妇中,胎膜早破的发生率为24.30％ （4 504/18 534）,足月胎膜早破的发生率为21.10％（3 910/18 534）,未足月胎膜早破的发生率为3.20％（594/18 534）;早产的发生率为6.17％（1 144/18 534）,其中胎膜早破早产547例,占早产的47.81％;足月分娩17 390例,其中胎膜早破3 957例（22.75％）.②分娩方式中,总的剖宫产率为48.50％（8 989/18 534）;无胎膜早破孕妇的剖宫产率为52.66％（7 388/14 030）;胎膜早破孕妇的剖宫产率为35.55％（1 601/4 504）,剖宫产分娩的1 601例孕妇产后出血率为13.12％（210/1 601）,而阴道分娩组的产后出血率仅为4.17％（121/2 903）（χ^2=121.361,P=0.000）;剖宫产产妇的住院天数平均为（5.3±2.9）d,阴道分娩产妇为（4.3±2.3）d（t=-12.136,P=0.000）.结论 北京地区胎膜早破发生率较高,胎膜早破易诱发早产,但未导致新生儿窒息和感染率增加.阴道分娩是胎膜早破孕妇的主要分娩方式,剖宫产不能降低新生儿窒息率,却增加了产后出血风险和住院时间.
Objective To investigate the incidence and pregnancy outcomes of premature rupture of membranes （PROM） in pregnant women in Beijing.Methods A retrospective multicenter study of 18 534 cases delivered in Beijing Obstetrics and Gynecology Hospital,Beijing Friendship Hospital,Daxing MCH Hospital and Tongzhou MCH Hospital from January 2011 to December 2011,was conducted.Results Among 18 534 cases,PROM occurred in 4 504 cases （24.30%）,including 3 910 cases of in term PROM （21.10%） and 594 cases of preterm PROM （3.20%）.The incidence of premature delivery was 6.17% （1 144/18 534）,and among 1 144 cases of premature delivery 547 cases were PROM （47.81%）;the incidence of PROM was 22.75% （3 957/17 390） in term delivery.The overall cesarean section （CS） rate was 48.50% （8 989/18 534） and that in pregnant women with PROM was 35.55% （1 601/4 504）,but the CS rate in pregnant women without PROM was 52.66% （7 388/14 030）.The rate of postpartum hemorrhage was 13.12% （210/1 601）in CS cases and 4.17% （121/2 903） in vaginal delivery cases （χ^2=121.361,P=0.000）.The mean hospital stay for PROM was （5.3±2.9） d in CS cases and （4.3±2.3） d in vaginal delivery cases （t =-12.136,P =0.000）.Conclusions Without severe maternal or fetal complications,the incidence of PROM is relatively high in Beijing region and PROM may not increase the maternal or fetal complications.Vaginal delivery is the main mode of delivery for PROM.Cesarean section may not cause less neonatal complications,but may lead to more postpartum hemorrhage and longer hospital stay.
出处
《中华全科医师杂志》
2015年第11期854-857,共4页
Chinese Journal of General Practitioners
关键词
胎膜早破
分娩
横断面研究
妊娠结局
Fetal membranes,premature rupture
Parturition
Cross-sectional studies
Pregnancy outcome
