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目的观察未足月胎膜早破(preterm premature rupture of membranes,PPROM)孕妇羊水过少对妊娠结局的影响。方法 PPROM孕妇256例,根据破膜后残余宫内的羊水指数(amniotic fluid index,AFI)值分为AFI≤5cm组84例,AFI>5cm组172例,比较2组破膜时间<48h、48h~7d、>7d的临产率,分娩方式,羊水污染、胎儿宫内感染、胎儿宫内窘迫及新生儿窒息发生率。结果 AFI≤5cm组剖宫产率为83.3%,破膜时间<48h临产率65.5%,羊水污染发生率为57.1%,新生儿窒息发生率为14.3%,胎儿宫内感染发生率为30.9%,晚期减速发生率为23.4%,重度变异减速发生率为38.1%;AFI>5cm组剖宫产率为29.7%,破膜时间<48h临产率18.0%,羊水污染发生率为17.5%,新生儿窒息发生率为1.1%,胎儿宫内感染发生率为3.5%,晚期减速发生率为3.5%,重度变异减速发生率为5.8%,2组比较差异均有统计学意义(P<0.05)。结论 PPROM严重威胁母婴安全,AFI可作为监测母婴安全和指导治疗的指标。
Objective To observe the effect of oligohydramnios on pregnancy outcome in preterm premature rupture of membranes (PPROM). Methods 256 cases of PPROM pregnant women were divided into AFI≤5cm group (84 cases) and AFI> 5cm group (172 cases) according to residual intrauterine amniotic fluid index (AFI) ~ 7d,> 7d of the rate of labor, mode of delivery, amniotic fluid contamination, intrauterine infection, fetal distress and neonatal asphyxia incidence. Results Cesarean section rate was 83.3% in AFI≤5cm group, 65.5% in rupture time <48h, 57.1% in amniotic fluid contamination, 14.3% in neonatal asphyxia, 30.9% in intrauterine infection, The rate of late deceleration was 23.4% and that of severe degeneration was 38.1%. The rate of cesarean section was 29.7% in AFI> 5cm, the rate of spontaneous rupture was 48%, the incidence of amniotic fluid contamination was 17.5%, neonatal asphyxia (1.1%), intrauterine infection (3.5%), late deceleration (3.5%) and severe deceleration (5.8%). There were significant differences between the two groups (P <0.05). Conclusion PPROM poses a serious threat to mother-infant safety. AFI can be used as an indicator to monitor mother-infant safety and guide treatment.