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目的:探讨足月及近足月胎膜早破孕妇不同计划分娩时机对分娩方式和母婴并发症的影响。方法:对852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。按自然临产和计划分娩干预时间不同分为4组:A组为破膜12 h内自然临产424例,B组为破膜12～24 h自然临产146例,C组为期待至12 h未临产行缩宫素计划分娩131例,D组为破膜期待至24 h未临产行缩宫素计划分娩151例。比较各组孕妇的分娩方式及母婴并发症。结果:①A、B、C、D组剖宫产率分别为8.96%、8.90%、25.95%、27.15%,C、D组剖宫产率均高于A、B组差异有统计学意义(P<0.05),D、C组剖宫产率比较差异无统计学意义(P>0.05)。②D组宫内感染率(17.21%)、产褥病率(15.23%)、围产儿病率(21.85%)均高于A(0.94%、1.41%、4.09%)、B(2.84%、2.73%、5.47%)和C组(5.34%、5.50%、7.60%),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<12 h以期待为主,破膜12～24 h未能自然临产者应积极计划分娩,以降低剖宫产及母婴并发症的发生率。
Objective: To investigate the effects of different delivery schedules on delivery mode and maternal and infant complications in pregnant women with full-term and near-term premature rupture of membranes. Methods: The clinical data of 852 pregnant women with full - term and nearly full - term (gestational age ≥35 weeks) and single fetus with no other comorbidities were retrospectively analyzed. Divided into 4 groups according to the time of spontaneous abortion and scheduled labor intervention: group A was spontaneous abortion in 424 cases in 12 hours after rupture of membranes; in group B, 146 cases were spontaneous abortion in 12-24 hours after rupture of membrane; Line oxytocin 131 cases of childbirth plan, D group is expected to membrane rupture until 24 h without labor oxytocin planned delivery 151 cases. The mode of delivery and maternal and infant complications of pregnant women in each group were compared. Results: ①The cesarean section rates in groups A, B, C and D were 8.96%, 8.90%, 25.95% and 27.15% respectively, and the cesarean section rates in groups C and D were significantly higher than those in group A and B (P <0.05). There was no significant difference in cesarean section rates between D and C groups (P> 0.05). The intrauterine infection rate (17.21%), the rate of puerperal disease (15.23%) and perinatal morbidity (21.85%) in group D were significantly higher than those in group A (0.94%, 1.41%, 4.09% , 5.47% respectively) and group C (5.34%, 5.50%, 7.60%). The difference was statistically significant (P <0.01). There was no significant difference in the rate of postpartum hemorrhage between the groups (P> 0.05). Conclusion: In preterm premature rupture of membranes and premature rupture of membranes in pregnant women, rupture of membrane <12 h to look forward to the main rupture of membranes 12 to 24 h failed to spontaneous labor should plan actively to reduce cesarean section and maternal and child The incidence of complications.