成功治疗中晚期早产胎膜早破1例报告及文献复习

A. Jha, Xiao Li, Shui-wang Zhang, Hui Li
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引用次数: 0

摘要

发生在妊娠早期小于23 - 24周(胎儿生存能力之前)的胎膜早破,早期早产的风险较高,因此预后较差,新生儿生存机会较差,幸存者中严重的、长期的新生儿发病率较高。在这种情况下,在诊断时没有明显的宫内感染证据,通常提供终止妊娠或妊娠管理的治疗方式,通常优先选择前者。当制定的准管理,这是非常罕见的,自发的重新密封膜发生的结果是模棱两可的正常妊娠。本案就是这种罕见情况的一个例子。一名25岁的蒙古人,怀孕20周时发生自发性早产胎膜早破。经过8天的准产治疗,患者羊水渗漏停止,妊娠37周可继续妊娠至足月,胎母结局正常。感染的风险随着潜伏期的延长而增加,但在本病例中,潜伏期延长了16周以上,没有感染的证据,足月胎母结局正常。这是本院第一例此类病例,值得报道。希望本文能揭示自发性早产胎膜早破经适当的预期治疗后再密封的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Successful Management of Preterm Premature Rupture of Membrane in Second Trimester: A Case Report and Literature Review
The preterm premature rupture of membranes occurring in early pregnancy at less than 23 - 24 weeks (prior to fetal viability), has higher risk for early preterm delivery, and therefore, the poorer the prognosis with poor chance of neonatal survival and a high rate of severe, long-term neonatal morbidity among survivors. In such cases in absence of overt evidence of intrauterine infection at the time of diagnosis termination of pregnancy or expectant management is generally offered modality of treatment, the prior being commonly preffered. When expectant management is instituted, it is very rare that spontaneous resealing of the membranes occurs with the outcome that is equivocal to normal pregnancy. The presented case is an example of this rare happening. A 25-year-old, mangolian, primigravida at 20 weeks of pregnancy had spontaneous preterm premature rupture of membranes. After 8 days of expectant management, she had cessation of amniotic fluid leak and could continue pregnancy till term with normal feto-maternal outcome at 37 weeks of pregnancy. The risk of infection increases with prolongation of latency period but in this case, the latency period was prolonged for more than 16 weeks and there was no evidence of infection, with normal feto-maternal outcome at term. This is the first case of its kind happened in our hospital and deserves to be reported. It is expected that this article will reveal the possibility of resealing of spontaneous preterm premature rupture of membrane with proper expectant management.
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