Objective To explore the influence of the time of induction delivery for full-term or near-term pregnant women with premature rupture of membranes ( PROM ) on modes of delivery and on maternal and infant complications. Methods A retrospective study was conducted on the data of 682 cases of full and near-reran ( gestational age ≥ 35 weeks ) pregnant women with PROM, single fetal head position and without other complications, delivered in Miyun County Maternal and Child Health Hospital between September 2006 and September 2010. All subjects were divided into four groups: 382 in group A with spontaneous labor within 12 h after PROM; 106 in group B with spontaneous labor between 12 h to 24 h after PROM; 91 in group C with oxytocin induction between 12 h to 24 h after PROM; 103 in group D with oxytocin induction after 24 h after PROM. The maternal and neonatal complications and delivery modes of four groups were compared. Results The cesarean section rate of group C ( 26.37％ ) and group D ( 27.19％ ) were higher than that of group A ( 9.16％ )and group B ( 13.20％ ), and the difference was statistically significant ( P ＜ 0.05 ). But the difference in cesarean section rate between group C and group D was not significant ( P ＞ 0.05 ). The rate of intrauterine infection ( 21.36％ ), puerperalmorbidity ( 18.45％ ) and perinatal morbidity ( 22.33％ ) in group D was higher than that in group A ( 0.79％, 1.05％, 4.19％ ), group B ( 2.83％, 2.83％,5.66％ ) and group C ( 5.50％, 5.50％, 7.69％ ) respectively. The differences were statistically significant ( P ＜ 0.01 ). The difference was not statistically significant in the rate of postpartum hemorrhage ( P ＞ 0.05 ). Conclusion For full-term or near-term pregnant women,they should wait for spontaneous delivery within 12 h after PROM. For those without spontaneous labor 12-24 h after PROM, induction labor should be carried out actively in order to reduce the incidence of cesarean delivery and maternal and neonatal complications.%目的 探讨足月及近足月胎膜早破孕妇不同引产时机对分娩方式和母婴并发症的影响.方法 对2006年9月～2010年9月在密云县妇幼保健院分娩的682例足月及近足月(孕周≥35周)、单胎头位且无其他合并症的胎膜早破孕妇的临床资料进行回顾性分析.按自然临产和引产干预时间不同分为4组:A组为破膜12h内自然临产者382例;B组为破膜12～24h自然临产者106例;C组为破膜12～24h未临产行缩宫素引产者91例;D组为破膜>24h未临产行缩宫素引产者103例.比较各组孕妇的分娩方式及母婴并发症.结果 A组、B组、C组、D组剖宫产率分别为9.16%、13.20%、26.37%、27.19%,C组、D组剖宫产率均高于A组、B组,有统计学意义(P<0.05);D组、C组剖宫产率比较无统计学意义(P>0.05);D组宫内感染率(21.36%)、产褥病率(18.45%)、围产儿病率(22.33%)均高于A组(0.79%、1.05%、4.19%)、B组(2.83%、2.83%、5.66%)和C组(5.50%、5.50%、7.69%),差异有统计学意义(P<0.01),产后出血率各组之间比较差异无统计学意义(P>0.05).结论 在足月及近足月胎膜早破孕妇中,破膜12h内以期待为主,破膜12～24h未能自然临产者,应积极引产,以降低剖宫产及母婴并发症的发生率.
展开▼
