Study On The Relationship Between Preterm Premature Rupture Of Membranes And Histologic Chorioamnionitis

Objective:Collect data of pregnant women with PPROM?Preterm premature rupture of membranes?,including basic personal data,pregnancy-related data,neonatal data and laboratory data?blood routine test,CRP,PCT?.Analyze which of these data are associated with PPROM complicated with HCA?Histologic chorioamnionitis?.Methods:A total of 55 pregnant women with PPROM who were hospitalized and delivered in our hospital from April 2016 to December 2019 were selected and divided into HCA group?32 people?and control group?23 people?.The criteria for grouping were whether the placental pathology diagnosed HCA.All clinical data of pregnant women in the two groups were analyzed in this study:?1?basic personal data:age,pre-pregnancy BMI,weight gain during pregnancy,low educational background,hospitalization days;?2?obstetric data:number of births,gestational age at rupture of membrane,latent period of membrane rupture?time of membrane rupture to fetal delivery?,cesarean section rate,morbidity of some related pregnancycomplications?GDM,oligoamnios,placental abruption,umbilical cord prolapse,placental membrane adhesion,puerperal infection,postpartum hemorrhage,breech position,positive culture of vaginal secretions?;?3?neonatal data:neonatal birth weight,neonatal asphyxia rate?APGAR?7 points?,NICU transfer rate;?4?laboratory test results:maternal blood routine?WBC,NC,LC,HB,PC,plateletcrit,and calculate the values of NLR,PLR,PWR?,CRP,PCT.SPSS 25.0 software was used for statistical analysis.Results:1.Basic personal data between the two groups is as follows:age?33.16±4.92years old vs.32.57±5.29years old?,hospitalization days?7?5,8?days vs.6?4,8?days?,pre-pregnancy BMI?24.54±3.80kg/m²vs.21.4?19.14,27.5?kg/m²?,weight gain during pregnancy?10.92±4.33kg vs.11.89±5.36kg?,proportion of primary parturient women?62.5%vs.69.6%?and low educational background?21.9%vs.30.4%?.The difference between the two groups was not statistically significant?P>0.05?.2.Latent period of membrane rupture of HCA group obviously higher than the control group,the difference was statistically significant?44?8.75,83.25?h vs.12.5?6,29?h,P=0.010?.There was no significant difference in the two groups?P>0.05?,including rupture in gestational age(35⁺⁴(33⁺³,36⁺¹)weeks vs.36(34⁺⁵,36⁺³)weeks),birth gestational age(35⁺⁴(33⁺⁶,36⁺²)weeks vs.35⁺⁵(34⁺⁶,36⁺³)weeks),cesarean section rate?68.8%vs.47.8%?,morbidity of pregnancy complications?GDM31.25%vs.17.39%, oligohydramnios 21.88%vs.21.74%,placental abruption3.13%vs.8.7%,umbilical cord prolapse3.13%vs.4.35%,placental membrane adhesion21.88%vs.13.04%,puerperal infection6.25%vs.8.7%,postpartum hemorrhage6.25%vs.4.35%,breech9.38%vs 13.04%,positive culture rate of vaginal secretions25%vs.30.43%?.3.The mean or median neonatal birth weight?2469.84±524.82g vs.2770?2550,2950?g?,neonatal asphyxia rate?3.13%vs.4.35%?and NICU transfer rate?21.9%vs.13.0%?showed no significant difference between the two groups?P>0.05?.4.The mean or median of laboratory test results for the HCA and control groups was as follows,PC232.53±68.75×10⁹/L vs.193.04±64.16×10⁹/L,PLR133.36?112.18,156.69?vs.108.02?92.51,144.87?,WBC10.10±3.17×10⁹/L vs.9.18±2.58×10⁹/L,NC7.22?5.70,9.67?×10⁹/L vs.6.8±2.34×10⁹/L,LC1.545?1.365,2.11?×10⁹/L vs.1.67±0.49×10⁹/L,HB115±11.48g/L vs.118.57 12.68g/L,plateletcrit0.24±0.052%vs.0.2±0.06%,NLR4.22?3.42,5.61?vs.3.99?2.93,5.26?,PWR24.40?19.23,27.66?vs.21.50±9.05,CRP6.8?3.785,7.663?mg/L vs.7.663?4.65,7.663?mg/L,PCT0.064?0.047,0.081?ug/L vs.0.062?0.048,0.0807?ug/L.In the HCA group,PC and PLR were significantly higher than those in the control group?P=0.035,P=0.044?,with statistically significant differences.The ROC curves of PC,PLR and PC combined with PLR were plotted to obtain AUC,which were 066,0.66 and0.67.Predictive value of PC and PLR for HCA is limited.There was no significant difference in WBC,NC,LC,HB,PC,plateletcrit,NLR,PLR,PWR,CRP and PCT?P>0.05?.Conclusions:1.In pregnant women with PPROM,the longer the latent period of membrane rupture,the higher the incidence of HCA;2.Predictive value of PC and PLR for PPROM complicated with HCA is limited.As a whole variable,PC and PLR did not improve the predictive value of HCA.