Relationship Between The Latency Of Premature Rupture Of Membranes With Pregnancy Outcome

Objective:To explor the effect of different gestational weeks and latency period on pregnancy outcome in premature rupture of membrane and the optimal timing of clinical intervention.Methods:A retrospective study was conducted on clinical data of1594(between28～41+6weeks), healthy singleton pregnant women with PROM and neonatal information, who admitted to our hospital from January1,2009to June30,2012.According to the different clinical treatment and different gestational weeks all subjects were divided into4groups:(1)28-31+6gestational weeks;(2)32～33+6gestational week;(3)34～36+6gestational weeks;(4)37～41+6gestational weeks. According to the different latencies, each gestational age group were further divided into two groups:intervention group (<72hours) and control group (>72hours) in group (1) and group (2); and<12h versus>12h in group (3); and<6h versus>6h in group (4). Analysis the relationship between different groups of pregnant women with different latency and the maternal and neonatal outcomes.Results:In28～31+6weeks of gestation group, neonatal mortality and bronchopulmonary dysplasia were significantly higher in group of latent period within72h than that in group of latent period over72h. But the neonatal hyperbilirubinemia was higher in group of latent period over72h than that in group of latent period within72h. There was statistically significant (P<0.05). In32～33+6weeks group, there was no statistic difference of maternal and neonatal outcomes between the group of latent period over72h and the group of within72h. In34-36+6weeks group, there was no statistic difference of maternal and neonatal outcomes between the group of latent period over12h and the group of within12h. in37～41+6weeks group, antepartum fever, puerperal morbidity, the rate of cesarean section and early neonatal bacterial infections were higher in group of latent period over6h than that in group of latent period within6h. There was statistically significant (P<0.05).Conclusion:The patients with PPROM at28～31+6gestational weeks, the suitable measures to treat are promoting fetal lung maturation, preventing infection, tocolysis to prolong latency period if there were no contraindications and termination the pregnancy at the right time. The patients with PPROM at32～33+6gestational weeks, the suitable measures are promoting fetal lung maturation, preventing infection, tocolysis, extending the gestational week until34weeks and termination of pregnancy. To the patients with PPROM at34～36+6gestational weeks induction of labor is recommended in12hours after the rupture of membrane. To the patients with PROM at37～41+6gestational weeks induction of labor is recommended in6hours after the rupture of membrane.