Clinical Analysis Of 200 Cases Of Preterm Premature Rupture Of Membranes

Objective: By investigating the prevalence,high risk factors and pregnancy outcome of PROM(preterm premature rupture of membranes),this study aims to strengthen the understanding of this kind of disease and reduce its incidence,thereby improving maternal and fetal outcomes.Methods: We conducted a retrospective study of 200 cases of PROM recorded in Ma’an shan Maternity and Child Health Hospital between 1 January 2019 and 31 December 2019.The study population was classified into three groups according to gestational age: group A,28.0-33.9(moderate preterm PROM,n = 32);group B,34.0-36.9 weeks(late preterm PROM,n = 168)and group C,(randomly selected patients of PROM of term hospitalized at the same time,n=192).Through the collection of clinical data of patients,the high-risk factors of preterm premature rupture of membranes,expectant treatment,delivery methods and maternal and infant outcomes were analyzed and compared.Results:(1)There were no statistically significant differences in the age,primiparity,and menstrual delivery among the three groups(P>0.05);(2)The single factor analysis of high-risk factors included reproductive tract infections,gestational diabetes,multiple births,fetal position errors and cervical incompetence(P<0.05),showed statistical significance.History of induced abortion,gestational diabetes,and reproductive tract infection were key risk factors for PPROM.(3)There was a statistically significant difference in the normal delivery rate among the three groups(P<0.05),and no significant difference in the rate of vaginal delivery and cesarean section(P>0.05).With the increase in gestational age,vaginal delivery rate increased,and the rate of birth attendance and the rate of cesarean section both decreased.The indications for cesarean section of PPROM were most common in breech presentation and scarred uterus,and scarred uterus was most common in TPROM group cesarean section.(4)The comparison of intrauterine infection among the three groups was statistically significant(P<0.05).The rates of postpartum hemorrhage,placental abruption,and puerperal morbidity were not statistically significant(P>0.05).Group A had the highest intrauterine infection rate,while group B was higher than group C;(5)There were statistically significant differences in neonatal weight,NRDS,and neonatal sepsis rate among the three groups(P<0.05),but there was no significant difference in asphyxia rate(P>0.05).The neonatal respiratory distress syndrome and neonatal sepsis rate in group A were significantly higher than that in group B and group C.(6)There was a statistically significant difference in the incidence of intrauterine infection in the PPROM group with a membrane rupture time of ≤48 hours and >48 hours(P<0.05).There was no significant difference in the incidence of placental abruption,postpartum hemorrhage,and puerperal morbidity(P>0.05).There was no significant difference in NRDS,asphyxia and sepsis(P>0.05).Conclusion:(1)Single-factor analysis showed genital tract infection,gestational diabetes,multiple births,and incorrect fetal position are the risk factors for PPROM.The screening of genital tract infection,gestational diabetes,and cervical incompetence during pregnancy should be highly valued,and early detection and treatment should be administered.(2)For PPROM with a gestational age of less than 34 weeks,fetus have the highest probability of developing intrauterine infection and neonatal NRDS and sepsis.Expectant treatments such as promoting fetal lung maturity,preventing infection,and inhibiting contraction should be given to reduce maternal and infant complications and improve maternal and child outcome.