Investigation On Risk Factors And Pregnancy Outcome Of Premature Rupture Of Second Pregnancy Maternal

Objective This study aims to explore the risk factors of PROM(Premature rupture of membranes)with secondary pregnancy,termination the way of pregnancy,termination of pregnancy indications of secondary pregnancy,and effects of secondary pregnancy premature rupture of membranes on pregnancy outcome,to provide guidance for the prevention and treatment of secondary pregnancy premature rupture of membranes,improve perinatal maternal and child safety,to make mothers and infants benefit maximized.Methods 1.Adopt case control study collected of secondary pregnancy maternal informations from December 2015 to December 2016 in a top three hospital in Qingdao according to the diagnostic and inclusion criteria of stroke,selected 179 cases of gestational age ? 28 weeks of the second pregnancy premature rupture of membranes as an observation group,and select the normal delivery of 179 cases of second pregnancy full-term fetal membranes were not broken as a control group and compare with the observation group.2.The observation group Would divided into two groups according to gestational age,group A1: PROM less than 37 weeks,group A2: PROM time over 37 weeks,and compare the two groups,and the full-term PROM were compared with the control group(group B)to analyze the effect of PROM on pregnancy outcome.3.The group A and group B was separately divided into?24 hours group?>24 hours group according to the time of rupture of membranes from childbirth,to study the effect of rupture of membranes on the duration of pregnancy outcome.Adopted to SPSS19.0 statistical software to statistically analyze.Results 1.Analysis of risk factors of premature rupture of membranes in second pregnancy maternal(1)Univariate analysis showed that there were about eleven factors related to the secondary pregnancy PROM,as below:reproductive tract infections(?~2=37.042,P=0.000),age(t=5.801,P=0.000),education degree(?~2=16.454,P=0.000),anemia(?~2=4.447,P<0.05),progestational body mass index(?~2=3.872,P<0.05),cervical incompetence(?~2=5.398,P=0.000),cephalopelvic relation and fetal position(?~2=10.186,P<0.05),family history(?~2=4.361,P<0.05),scarred uterus(?~2=13.358,P=0.000),the history of induced abortion and odinopoeia(?~2=8.433,P<0.05),abruptio placentaea(?~2=4.757,P<0.05);(2)However,by entering these factors into logistic regression analysis,it was revealed that there were seven significant factors for secondary pregnancy premature rupture of membranes including reproductive tract infections(OR=5.942,95%CI: 3.007-11.743),age(OR=1.195,95%CI: 1.120-1.275),progestational,body mass index(OR=2.224,95%CI: 1.189-4.160),the history of induced abortion and odinopoeia(OR=4.558,95%CI:1.364-15.229),education degree(OR=2.735,95%CI: 1.535-4.872),scarred uterus(OR=2.041,95%CI: 1.014-4.111),cephalopelvic relation and fetal position(OR=2.677,95%CI: 1.489-4.813).2.Analysis of pregnancy outcome(1)The cesarean rate of group A2 was much higher than that group A1 and group B(P<0.05),cesarean section main indications: fetal distress in uterus,scarred uterus,abnormal fetal position and so on.(2)The incidence rate of chorioamnionitis,neonatal respiratory distress syndrome,asphyxia neonatorum,neonatal death of group A1 was much higher than that group A2(P<0.05).(3)The incidence rate of chorioamnionitis,intrauterine infection,neonate pneumonia of group A2 was much higher than that group B(P<0.05).(4)Rupture of membranes from childbirth have two groups,among the two groups there are obvious relation about postpartum hemorrhage,chorioamnionitis,neonatal respiratory distress syndrome,neonatal hyperbilirubinemia,neonate pneumonia and neonatal death(P<0.05),Among the two groups there are not obvious relation about puerperal infection Intrauterine infection and neonatal asphyxia(P>0.05).Conclusions 1.The main factors causing the premature rupture of membranes incluging: reproductive tract infections,progestational body mass index,the history of induced abortion and odinopoeia,education degree,age,scarred uterus and cephalopelvic relation and fetal position.2.Secondary pregnancy PROM can lead to serious harm of materal and newborn.3.Cesarean section main indications: fetal distress in uterus and scarred uterus.4.The incidence rate of chorioamnionitis and postpartum hemorrhage would increase when the membranes rupture from childbirth for long time.