Clinical Analysis Of 302 Cases With Premature Delivery

Objective A preterm birth is one that occurs full 28 weeks to less 37 weeks (196-258 days) of gestation.The preterm birth mobidity is about 5%-15%. An infants born at less than 37weeks of gestation are at risk for morbidity and mortality heighten due to organs and immuature function prematurity. 15 precent of premature infant will death within neonatal period, 8 precent of premature infant who is survival can make ingering effects of dysgnosia and nervous system. It reports that premature delivery is the leading cause of 75% perinatal morbidity and mortality, besides the fatal malformation. Development of the intensive care have obviously decrease the mortality rate of premature infant and improved the exist state of prematue infant, but the incidence rate of premature delivery still have no obviously decrease. Premature delivery still is one of important causes to the perinatal death. Hence, understanding the related factors and the cause of premature delivery is necessary. It is very important to prevention and treatment actively. This study is to discuss the related risk factors of premature delivery,the cause of premature delivery and maternal and fetal prognosis.Methods: We analyzed retrospectively the 302 cases of premature delivery from January, 1999 to December, 2006 (premature delivery group) and 302 cases of full-term delivery that we drownrandom at the same time (control group). We compared premature delivery during 28 weeks to less 32weeks,32 weeks to less 34 weeks and 34 weeks to less 37 weeks and analyzed the outcome of premature infants in different weeks of gestation. Contrasting analysis was performed about the influence of tocolysis and nontocolysis therapy on the pregnant women and fetus with premature delivery from preterm premature rupture of membrane (PPROM) in 34 gestational weeks.Results: The incidence of preterm delivery is 3.8% of all births in the past 8 years in our hospital. The main causes of premature delivery is premature rupture of the membranes and it is 40.07% among all cases, the second is placental facters 15.23%, sequentiaei in order are Double pregnancy 9.93%,Abnormal fetal position 8.94%,Intrahepatic cholestasis of pregnancy 4.97%,Hepertencive disorder complicating pregnancy 4.97%,others 0.99%and premature delivery with unknown causes 14.90%. There is a significant difference between tow groups in premature rupture of membrane,placental facters,Abnormal fetal position,Double pregnancy,Intrahepatic cholestasis of pregnancy P<0.05, There is no significant difference between tow groups in hepertencive disorder complicating pregnancy P>0.05.Crvicovaginitis is 39.74% among all the related risk factors of premature delivery, pregnancy with Crvicovaginitis or≥35 yearsold,recurrent abortion and premature delivery history,low society layer,low income and no antenatal care,midrange or serious anaemia in gestation period has more incidence rate of premature delivery, there is a significant difference between two groups P<0.05. There is no significant difference between two groups in pregnancy of≤18岁,antepartum hemorrhage P>0.05.Incidence rate of asphyxia of neonatal,death of neonatal,low birth weight infant in premature delivery group is higher than control group, there is a significant difference between the two groups P<0.05. The more decrease the gestational age, the more incidence rate ofllow birth weight infant,asphyxia of neonata and mortality the perinatal. There is no significantly different of the incidence of cesarean section and vaginato assist delivery between the groups of preterm and full-term delivery, but incidence of postpartum hemorrhage in premature delivery group is higher than control group, there is a significant difference between the two groups P<0.01.Tocolysis management including prenatal glucocorticoid combined with antibiotics and suppress antofuterine contraction could effectively lower the low birth weight infant,neonatal scleredema,hyaline membrane disease,asphyxia of neonata and the perinatal mortality in the patients with premature delivery from PPROM in 34 gestational weeks.Conclusion: The related risk factors of premature deliveryincluding: Crvicovaginitis,≥35 years old,recurrent abortion and premature delivery history,low society layer,low income and no antenatal care,midrange or serious anaemia in gestation period. premature rupture of the membranes and placental facters,Double pregnancy,Abnormal fetal position,Intrahepatic cholestasis of pregnancy,Hepertencive disorder complicating pregnancy,others and premature delivery with unknown causes are main main causes of pre- mature delivery. Premature delivery can increase the incidence rate of asphyxia of neonatal,death of neonatal,low birth weight infant. Premature delivery can not increase the incidence of cesarean section and vaginato assist delivery,but increase the incidence of postpartum hemorrhage. Tocolysis management including prenatal glucoco- rticoid combined with antibiotics and suppress antofuterine contrac- tion could effectively lower the perinatal mortality in the patients with premature delivery from PPROM in 34 gestational weeks.