李春红

【摘要】 目的：探讨针对足月单胎胎膜早破孕妇的最佳引产时机。方法：选取2018年4月-2019年4月在笔者所在医院产科分娩的78例足月单胎胎膜早破孕妇进行分析，按不同时间时机分为A组（破膜2 h后引产）和B组（破膜12 h后引产），比较两组引产效果。结果：A组剖宫产率低于B组，阴道顺产率高于B组，差异均有统计学意义（P<0.05），两组产钳助产率比较差异无统计学意义（P>0.05）;A组母婴并发症发生率（7.69%）低于B组（48.72%），差异有统计学意义（P<0.05）;两组产后出血发生率比较差异无统计学意义（P>0.05）。结论：破膜后2 h对足月单胎胎膜早破孕妇进行引产，是最佳时机。

【关键词】 胎膜早破 引产时机 并发症 产后出血

doi：10.14033/j.cnki.cfmr.2020.27.057 文献标识码 B 文章编号 1674-6805（2020）27-0-03

[Abstract] Objective： To explore the best time of induction of labor for pregnant women with PROM. Method： From April 2018 to April 2019， 78 pregnant women with premature rupture of membranes at full-term single birth in the obstetrics department of the author's hospital were selected for analysis， they were divided into group A （induced labor 2 h after rupture of membrane） and group B （induced labor 12 h after rupture of membrane） according to different time and opportunity， and the effects of labor induction were compared between the two groups. Result： The cesarean section rate in group A was lower than that in group B， and the vaginal vaginal delivery rate was higher than that in group B， the differences were statistically significant （P<0.05）. There was no statistically significant difference in the forceps delivery rate between the two groups （P>0.05）. The incidence of maternal and infant complications in group A （7.69%） was lower than that in group B （48.72%）， the difference was statistically significant （P<0.05）. There was no significant difference in the incidence of postpartum hemorrhage between the two groups （P>0.05）. Conclusion： The best time to induce labor to the pregnant women with PROM is 2 hours after PROM.

[Key words] Premature rupture of membranes Timing of labor induction Complications Postpartum hemorrhage

First-authors address： Xiamen Hospital of Traditional Chinese Medicine， Xiamen 361000， China

胎膜早破是一種常见的妊娠期并发症，指的是产程发动前发生胎膜自然破裂，临床表现为阵发性阴道流液，量可多可少。据临床统计，在所有孕妇中，发生足月胎膜早破的概率大概占10%左右，而发生未足月胎膜早破的概率则最高不超过3.5%。胎膜早破可能造成不良围产儿结局，并且会造成较高的母体产褥病率[1]。对于发生胎膜早破的孕妇，其终止妊娠时间直接关系到母婴的安全[2]。本研究选取2018年4月-2019年4月在笔者所在医院产科分娩的78例足月单胎胎膜早破孕妇进行临床研究，分析不同引产时机下的母儿结局，详细报告如下。

1 资料与方法

1.1 一般资料

选取2018年4月-2019年4月在笔者所在医院产科分娩的78例足月单胎胎膜早破孕妇入组为本次研究对象。纳入标准：孕妇突感有液体自阴道流出，不可控制，量可随体位改变增加;腹压增大时发现羊水从阴道处流出;肛诊检查时上推胎头或按压宫底时观察有液体自阴道流出;pH检测为弱碱性;症状不明显时进行阴道液涂片，涂片干燥后镜检显微镜下能发现羊齿状结晶体。……