Analysis Of Preterm Premature Rupture Of Membranes On The Outcome Of The Premterm Infants

Objective: To explore the differences among different amniotomy tims andgestational ages that preterm premature rupture of membranes （PPROM） impact onneonatal outcomes, to guide clinical management of PPROM and preterm infants,and reduce their incidence of complications and mortality.Method:1. Taken in May2011to March2012in our hospital delivery158cases met theinclusion criteria data in preterm infants were according to the design of the study willbe divided into: GroupⅠ, complicated with premature rupture of membranes inpreterm infants of101cases; GroupⅡ,without premature rupture of membranes inpreterm infants of57cases. Retrospectively analyzed the mode of delivery andoutcome of preterm children, infection indicators between GroupⅠ and GroupⅡ.2. According to the time of its rupture of membranes, GroupⅠ is divided into fourgroups: the amniotomy time <24h group,60cases; the amniotomy24-48h group,14cases; the amniotomy time48-72h group,10cases; the amniotomy time≥72h group,17cases. Analysis of differences in premature rupture of membranes time impact onthe outcome of preterm infants and related indicators of infection.3. According to the gestational age size, GroupⅠ is divided into four groups:gestational age <32w group,25cases; gestational age32-33⁺⁶ w group,25cases;gestational age34-35⁺⁶ w group,76cases; gestational age≥36w group,76cases.Analysis of differences in gestational age impact on the outcome of preterm infantsand related indicators of infection.Results:1. The incidence rate of Neonatal Pneumonia and Intra-amniotic Infection of GroupⅠare higher than in the GroupⅡ, the difference between the two groups is significant（P<0.05）. And the differences of WBC, N, NE, and CRP between two groups’mothers are all significant （P <0.05）. 2.4different sets of the amniotomy time in Neonatal Pneumonia and NRDSincidence of comparison, the difference were significant （P<0.05）. Compared with theamniotomy time <24h group, the incidence of Neonatal Pneumonia andIntra-amniotic Infection was significantly lower than in48-72h group and≥72hgroup, the differences were significant （P<0.05）. Compared with the amniotomy time24-48h group, the incidence of Neonatal Pneumonia and Intra-amniotic Infection wassignificantly lower than in the amniotomy time48-72h group and≥72h group, thedifference were significant （P <0.05）.3.4different sets of gestational age preterm infants in Neonatal Pneumonia, NRDS,Hyperbilirubinemia incidence of comparison, the differences were significant （P<0.05）. The incidence rate of pneumonia in gestational age <32w group,32-33⁺⁶ wgroup was significantly higher than in the gestational age≥36W group, the incidencerate of NRDS in gestational age <32w group,32-33⁺⁶w group was significantly higherthan in the gestational age of34-35⁺⁶w group and gestational age≥36W group, theincidence rate of Hyperbilirubinemia in gestational age32-33⁺⁶w group wassignificantly lower than in the gestational age of34-35⁺⁶ w group and gestationalage≥36w group, the differences were significant （P <0.05）.Conclusion:1. The incidence of Neonatal Pneumonia and Intra-amniotic Infection weresignificantly increased in preterm infants combined PPROM, especially when theamniotomy time≥48h, gestational age <34w.2. Different approaches should be taken due to gestational age and the amniotomytime: gestational age <34w, can actively look forward to therapy to promote fetal lungmaturity if there has no obvious signs of infection; gestational age34w-36w, shouldtermination of pregnancy within48hours; gestational age≥36w, delivery time andmanner can be based on the principle of full-term PROM; all is to reduce thecomplications of preterm infants with a variety of morbidity and mortality.3. The WBC, N, NE, and CRP were significantly higher in PPROM patients, whoseamniotomy time>12h with the preventive use of antibiotics can reduce the incidenceof severe intrauterine infection and septicemia.