胎膜早破與難產(chǎn)、羊膜腔感染的關(guān)系及處理方法

高玉瓊

[摘要] 目的 了解胎膜早破發(fā)生難產(chǎn)、羊膜腔感染的發(fā)生率極其原因。方法 分析我院100例胎膜早破孕婦中發(fā)生難產(chǎn)、羊膜腔感染的原因和類型,隨機(jī)抽取同時(shí)期無(wú)胎膜早破的健康孕婦100例作對(duì)照。結(jié)果 觀察組100例胎膜早破孕婦中,發(fā)生難產(chǎn)、羊膜腔感染的有48例,發(fā)生率為48%,其中發(fā)生難產(chǎn)并發(fā)羊膜腔感染9例,發(fā)生難產(chǎn)35例,發(fā)生羊膜腔感染4例。對(duì)照組100例孕婦中發(fā)生難產(chǎn)、羊膜腔感染的有19例,發(fā)生率為19%,其中發(fā)生難產(chǎn)并發(fā)羊膜腔感染 3 例,發(fā)生難產(chǎn)14例,發(fā)生羊膜腔感染 2 例。 結(jié)論 應(yīng)進(jìn)一步重視胎膜早破 ,加強(qiáng)圍生期衛(wèi)生宣教與指導(dǎo),妊娠后期減少性生活次數(shù),積極治療與預(yù)防下生殖道感染,避免突然增加腹壓,補(bǔ)充足量的維生素、鈣、鋅、銅等營(yíng)養(yǎng)素,宮頸內(nèi)口松弛者,于妊娠14-16周行宮頸環(huán)扎術(shù)并臥床休息。對(duì)已經(jīng)出現(xiàn)胎膜早破的孕婦加強(qiáng)臨床觀察,一旦有胎膜早破或合并羊膜腔感染者,要及時(shí)處理,并作好新生兒復(fù)蘇準(zhǔn)備,以減少母兒并發(fā)癥的發(fā)生。

[關(guān)鍵詞] 胎膜早破;難產(chǎn);合并;產(chǎn)褥感染;邊遠(yuǎn)貧困地區(qū)

[中圖分類號(hào)] R714.4[文獻(xiàn)標(biāo)識(shí)碼] A[文章編號(hào)] 1004-8650(2009)05-07-03

The Relationship among Premature Rupture of Membranes and Dystocia, Amniotic Cavity Infection and Processing Method

GAO Yu-qiong

(People's Hospital of Abazhou, Maerkang, Sichuan, 614000)

[Abstract] Objective To probe into the incidence and cause of dystocia and amniotic cavity infection in premature rupture of membranes.Methods We analyzed the cause and type of dystocia and amniotic cavity infection in 100 women with premature rupture of membranes. 100 healthy pregnant women during the same period were randomly chose as control group.Results In observation group, 48 cases (48%) had dystocia and amniotic cavity infection (35 had dystocia, 4 had amniotic cavity infection, 9 had both of them). In control group, 19 cases (19%) had dystocia and amniotic cavity infection (14 had dystocia, 2 had amniotic cavity infection, 3 had both of them). Conclusion We should pay more attention to premature rupture of membranes, strengthen hygiene education and instruction during perinatal period. Pregnant women should decrease the frequency of sexual life, active prevent and treat genital tract infection, avoid a sudden increase of abdominal pressure, and replenish enough vitamin, calcium, zinc and so on. For patients with cervical relaxation, cervical cerclage should perform in the 14-16 weeks. For those with premature rupture of membranes, we should strengthen clinical observation and give timely treatment, so as to make preparation for neonatal resuscitation and reduce the incidence of complications.

[Key words] Premature rupture of membranes; Dystocia; Combination; Puerperal infection; Remote and poor areas

全國(guó)統(tǒng)編教材《婦產(chǎn)科學(xué)》第六版述胎膜早破即為臨產(chǎn)前胎膜破裂[1],妊娠滿37周后的胎膜早破發(fā)生率為10%,妊娠不滿37周的胎膜早破發(fā)生率為2.0%-3.0%。胎膜早破可引起早產(chǎn)、臍帶脫垂及母兒感染等一系列產(chǎn)科并發(fā)癥狀,是孕產(chǎn)婦感染、早產(chǎn)、圍生兒死亡的重要原因之一,占分娩總數(shù)的10%-12%。

1臨床資料

1.1一般資料

收集1990年1月-2000年1月,在我院住院分娩的100例胎膜早破或合并羊膜腔感染的病例作為觀察組,年齡19-35歲,平均年齡27歲,孕周32-42周,平均孕周為37周。……