Clinical Analysis In Preterm Premature Rupture Of Membranes In134Patients

Objective To investigate the risk factors of pregnancy pretermpremature rupture of membranes(PPROM)， the clinical methods， thepregnancy outcome and the suitable time and way of childbirth.Methods One：We collect134patients of PPROM from Jan．2009to Feb．2013．to analysis the proportion of every possible risk factor. Two：we separate the134patients and their150babies in terms of gestational ageto three groups for comparing the suitable clinical methods，the pregnancyoutcome and the suitable time and way of childbirth:Group A with gestationless than31weeks greater than6day，group B from32weeks to34weeksgreater than6day and group C from35weeks to36weeks greater than6days．Results (1)The risk factors of PPROM are as： conditions ofinfection,intrauterine operation history,the high pressure ofintrauterine,abnormal fetal position,complication of pregnancy,injuries orsexual contact before rupture of membranes，laxation of ceryical internalopening and so on.(2)The proportion of group A and B of using tocolyticsand fetal lung maturation agent more than group C and the difference had statistical significance(P<0．05). The average tocolysis time of groupA andgroup B is longer than group C,while the proportion of childbirth within24hours is less than, and the difference had statistical significance(P<0．05).(3) The proportion of cesarean for fetal distress.of group A ishigher than group B and C,while for social factor is less than. In addition,The proportion of cesarean for cephalopelvic disproportion of group A and Bis less than group C.All of the differences have statistical significance(P<0．05).(4) The proportion of group A of chorioamnionitis,incisionalwound, neonate asphyxia, RDS，pneumonia of newborn and neonatal deathis more than group Band C and the difference had statistical significance(P<0．05).Conclusion (1) It is important to take actions to reducing theproportion of PPROM after knowing the risk factors.(2) It is better to useantibiotic of all PPROM,besides,tocolytics and fetal lung maturation agentshould be used before the gestation of34weeks.(3)The shorter gestationalweek,the proportion of fetal distress is more,while the longer gestationalweek,the proportion of cephalopelvic disproportion is more. So we shouldchoose the suitable way of childbirth.(4) The shorter gestational week,theproportion of chorioamnionitis,incisional wound, neonate asphyxia, RDS，pneumonia of newborn and neonatal death is more,so we should improvethe treatment level in perinatal period and take steps to care for prematureinfants.