三级医院低危妊娠胎膜早破母胎结局的前瞻性观察研究

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引用次数: 0

摘要

背景:羊水在妊娠中起着多种重要作用,如维持体内平衡、防止创伤、感染,并促进分娩时宫颈扩张。因此,如果胎膜提前破裂,随之而来的后果可能对胎儿和母亲都是有害的。早破膜(PROM)的病因尚不清楚,并发症多种多样。然而,及时诊断和早期管理可以帮助限制不良后果并确保安全分娩。方法:这项前瞻性观察研究在阿萨姆邦提斯普尔一家三级医院的妇产科进行,为期1年(2021-2022)。根据纳入和排除标准,在所有到门诊或产房就诊的患者中,有94例被纳入研究。这些妇女的数据被输入到一份形式表格中,研究是在经过适当的伦理许可后进行的。结果:住院发病率为1.3%,以初产妇为主。多数病例病因不明,但社会经济阶层较低的女性发生早PROM的机会较多。68%的产妇选择剖宫产。最常见的产妇发病因素为发热,占7.4%。大多数婴儿的APGAR得分都很好。20.2%的婴儿需要入住新生儿重症监护病房。未见产妇或围产期死亡。结论:胎膜早破是一种难以理解的疾病,即使在没有其他产科并发症的情况下,也与孕产妇和围产期发病率和死亡率的高风险相关。及时的管理和适当的干预可以大大改善这两种结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Hospital Based Prospective Observational Study on the Maternal and Fetal Outcome in Premature Rupture of Membranes in low-risk Pregnancies at a Tertiary Care Hospital
Background: Amniotic fluid plays multiple important roles in pregnancy like homeostasis, protection fromtrauma, infection, and also facilitates cervical dilation in labour. Therefore, if the fetal membranes are rupturedbefore time, the consequences that follow can be detrimental to the fetus as well as the mother. The etiology ofpremature rupture of membranes (PROM) is still largely unclear and the complications are manifold. Howeverprompt diagnosis and early management can help limit the adverse consequences and ensure a safe delivery.Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynecology, ina tertiary care hospital in Tezpur, Assam, over a period of 1 year (2021-2022). Out of all the patients who attendedthe OPD or emergency labour room, 94 cases were included in the study as per the inclusion and exclusion criteria.The data of these women was entered into a proforma and the study was done after due ethical clearance.Results: Hospital incidence was 1.3%, with more women being primigravidae. Majority of cases had unknown etiology butwomen from lower socioeconomic class showed more chances of PROM. Caesarean section was the mode of delivery in 68%cases. Most common maternal morbidity factor was fever at 7.4%. Most babies had a good APGAR score. 20.2% of babiesrequired admission to NICU. No maternal or perinatal mortality was seen.Conclusion: PROM is an enigmatic condition associated with high risk of maternal and perinatal morbidity andmortality, even in the absence of other obstetric complications. Timely management and appropriate interventioncan greatly improve both outcomes.
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