Retrospective Analysis Of Risk Factors And Perinatal Outcomes Of Premature Rupture Of Membranes

BackgroundPremature rupture of membranes(PROM)is more common in obstetrics.The occurrence of PROM can cause maternal and neonatal infection,and also cause premature delivery,umbilical cord prolapse and compression,fetal hypoxia and other adverse pregnancy outcomes.Because of its many influencing factors,it is still in research,how to reduce its occurrence is still a clinical problem to be solved.ObjectiveBy studying the risk factors and perinatal outcomes of PROM patients,and analyzing the correlation between PROM residual amniotic fluid and perinatal outcomes,the purpose is to improve the understanding,strengthen health education in maternal and child health care work,regular prenatal examination and early treatment for high-risk pregnant women,so as to reduce the occurrence of PROM.MethodsA total of 516 pregnant women with PROM were selected from 7,052 patients who were hospitalized and delivered in the Second People’s Hospital of Anyang during the period from January 2017 to October 2019.According to the gestational age,they were divided into preterm premature rupture of membranes(PPROM)group(77 cases)and PROM of term(TPROM)group(439 cases)according to the gestational week when PROM occurred.The risk factors and perinatal outcomes of the two groups were analyzed statistically,and the independent risk factors of PPROM were selected by logistic regression analysis;According to the residual amniotic fluid volume after PROM,they were divided into normal amniotic fluid volume group(369 cases)and abnormal amniotic fluid volume group(147 cases).Results(1)The risk factors of PROM pregnant women were: multiple uterine cavity operation history(25.65%),elderly women(19.86%),abnormal fetal position(13.55%),genital tract infection(8.17%);Multivariate logistic regression analysis showed that the potential risk factors of PPROM were: history of uterine operation,reproductive tract infection,gestational diabetes mellitus,abnormal fetal position,macrosomia,hypertensive disorder complicating pregnancy,twin pregnancy,polyhydramnios,etc.P < 0.05).(2)There was no significant difference between PPROM group and TPROM group(P > 0.05);The distribution rate of double fetus in PPROM group was significantly higher than that in TPROM group(P < 0.05).There was no significant difference in the incidence of chorioamnionitis and postpartum hemorrhage between PPROM group and TPROM group(P > 0.05).The proportion of pregnant women with membrane rupture to termination time ≥24h and the number of pregnant women with amniotic fluid pollution was significantly higher than that in TPROM group(P < 0.05);There was no significant difference in the delivery mode,puerperal infection and postpartum hemorrhage between PPROM group and TPROM group(P > 0.05).(3)The incidence of cesarean section and postpartum uterine infection in the group with abnormal amniotic fluid volume was significantly higher than that in the group with normal amniotic fluid volume(P < 0.05).In PPROM group,the incidence of postpartum uterine infection,neonatal asphyxia,neonatal pneumonia,fetal distress,neonatal transfer to NICU and other adverse perinatal outcomes in abnormal amniotic fluid volume group were higher than those in normal amniotic fluid volume group(P < 0.05).The incidence of neonatal conversion to NICU in abnormal amniotic fluid volume group was significantly higher than that in normal amniotic fluid volume group(P < 0.05);There was no significant difference in the incidence of neonatal asphyxia,neonatal pneumonia and fetal distress between the two groups(P > 0.05).Conclusion(1)The main risk factors of PROM were multiple intrauterine operation history,old age of pregnant women,abnormal fetal position and reproductive tract infection.(2)Multiple intrauterine operation history,reproductive tract infection,abnormal fetal position,increased intrauterine pressure,gestational diabetes mellitus,gestational hypertension are the potential risk factors of PPROM.(3)Twin pregnancy is more prone to PPROM than singleton pregnancy.(4)Abnormal amniotic fluid volume increased the rate of cesarean section and the incidence of postpartum uterine infection;PPROM is expected to increase the chance of abnormal amniotic fluid and increase the incidence of amniotic fluid contamination;Abnormal amniotic fluid volume increased the adverse outcomes of PPROM.