未足月双胎胎膜早破46例临床分析

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1、未足月双胎胎膜早破46例临床分析［摘要］目的讨论双胎未足月胎膜早破（PPROM）的临床特点和妊娠结局。方法回顾性分析双胎PPROM（研究组）46例及同期随机选择的单胎PPROM（对照组）60例，比较两组胎膜早破的发生孕周、并发症合并症发生率、期待疗法、新生儿预后等情况。结果研究组早产儿的体重明显低于对照组，研究组早产儿的窒息率、呼吸窘迫综合征（RDS）等新生儿并发症均高于对照组（P<0.05或P<0.01）;研究组破膜前32.6%新生儿有较明显宫缩，对照组破膜前18.3%新生儿有明显宫缩（P<0.05）o研究组早产率（95.8%）明显高于对照组（31.7%XP<0.01）6结论双胎妊娠是导

2、致PPROM的高危因素；双胎合并PPROM的临床处理棘手，早产发生率显著升高，并且新生儿预后差，应积极预防。［关键词］双胎妊娠；未足月胎膜早破；早产［中图分类号］R724［文献标识码］A［文章编号］1673-7210(2012)01(b)-071-03Clinicalanalysisof46casesofpretermprematureruptureofmembranesoftwinsLIJiaSULiTANGHuirongTheMaternalandChildHealthCareHospitalofJinjiangDistrictinChengduCity,SichuanProvince

3、,Chengdu610000,China[Abstract]ObjectiveTodiscusstheclinicalcharacterandtheresultsofpretermprematureruptureofmembranesPPROMoftwins.Methods46casesofPPROMoftwins(studygroup)and60casesofPPROMofsingletonschosenrandomlyatthesametime(controlgroup)werereviewedretrospective!y.Theratioofruptureofmembranes,t

4、heperiodofthepregnancy,therateofcomplications,temporizationandtheprognosisofneonateswerecomparedbetweenthetwogroups.ResultsTheweightofneonatesinthestudygroupwasmuchlowerthanthecontrolgroup,andtheratioofchokeandcomplicationssuchasrespiratorydistresssyndrome(RDS)ofneonatesinthestudygroupwereallsigni

5、ficantlyhigherthanthecontrolgroup(P<0.05orP<0.01)・Theuterinecontractionappearedbeforemembranesrupturedamong32.6%ofneonatesinthestudygroupand18.3%ofneonatesinthecontrolgroup(P<0.05).Theratioofprematurebirthwas95.8%inthestudygroup,higherthanthecontrolgroup(31.7%)(P<0.01)・ConelusionThetwinspregnancyi

6、stheriskfactorofcausingPPROM;theclinicaltreatmentoftwinspregnancycombinedwithPPROMisdifficult,theradioofprematurebirthissignificantlyincreasedandtheprognosisofneonatesisbad,therefore,aggressivepreventionshouldbetaken・[Keywords]Twinspregnancy;Pretermprematureruptureofmembranes;Prematurebirth双胎妊娠的发生

7、率随着促排卵药物的应用及辅助生育技术的广泛开展而逐渐增加。双胎妊娠的风险大大高于单胎妊娠，双胎妊娠比单胎妊娠发生早产和胎膜早破（PROM）的几率大，孕期其他合并症并发症发生高于单胎，与新生儿并发症关系更为密切。有资料研究表明，未足月胎膜早破（PPROM）在双胎妊娠的发生率为30.77%[1]，由于双胎胎儿体重较小，所以易发生新生儿窒息、败血症、新生儿呼吸窘迫综合征（RDS）以及围生期新生儿死亡。特别是PPROM发生的越早