Analysis Of Clinical Data Of 200 Patients With Premature Rupture Of Membrane Of Term

Background and objectivePremature rupture of membrane is defined as rupture of membrane prior the term. Premature rupture of membrane is a complication commonly occurred in pregnancy, counting 5 percent to 10 percent of the total labor. In recent years, the rate of dystocia has been developed while caul early broken. The rate of PROM which occurs In pregnancies of less than 37 weeks of gestation is 2 percent to 3.5 percent, while The rate of PROM which occurs In pregnancies of after 37 weeks of gestation is 10 percent.When PROM happens, aboat 90 percent of the pregnant woman with PROM will delivery during 24 hours, but 90 percent of the pregnant woman of preterm premature rupture of membranes (PPROM) will delivery in a week.PROM can cause serious complicating diseases on mother and baby. For example:chorioamnionitis, dystocia, postpartum hemorrhage, premature delivery, fetal distress, neonatal asphyxia, infectious diseases and so on. It is very important that appropriate management with PROM to decrease the complications in both mothers and neonates.This study retrospectively analyzed the cases materials of 200 cases PROM with single head position term and that of 200 cases with single head position term of health pregnancy, comparatively analyzed the pregnant age, the gestational age, the weight of neonates, Apgar Score, delivery mode, the rate of dystocia, the labor time, the cause of dystocia and mothers and their children complications. To explore the relationship between dystocia and PROM, maternal and child complications, and its treatment to guide the clinical practice.Material and methodsThis study collected 200 cases of PROM of term cases delivered from June 2011 to December 2011 in The Third Affiliated Hospital of Zhengzhou University, those cases were arranged to be the observation group, and compare with 200 healthy cases of full term of without PROM selected by random, those cases were arranged to be the compared group. The two groups were both primipara, single fetus and without the obstetrical complication and other complications. The clinical data of the pregnancy women were reviewed retrospectively. The clinical data Included age, gestational weeks, the weight of neonatus, Apgar Score, delivery mode, the rate of dystocia, the labor time, the cause of dystocia and mothers and their children complications.Results1 Comparison of clinical informationThe age, gestational age and gestational weeks and parity, new birth weight between the two groups was not statistically different, P>0.05.2 The delivery pattern between PROM of term group and Control groupIn PROM of term group,there were 85 cases taking spontaneous labor, accounting for 42.5%,7 cases taking transvaginal assisted labor, accounting for 3.5%,108 cases taking cesarean section, accounting for 54.0%; while in the compared group, there are 131 cases taking spontaneous labor, accounting for 65.5 %,8 cases taking transvaginal assisted labor, accounting for 4%,61 cases taking cesarean section, accounting for 30.5%;PROM of term group cesarean section rate is significantly higher than control group (P<0.05). PROM of term group spontaneous labor rate is significantly lower than control group (P< 0.05).There was no significant difference in the rate of transvaginal assisted labor between the two groups.3 The dystocia between PROM of term group and Control groupIn PROM of term group, the total cases of dystocia is 77, accounting for 38.5%, in the total cases of dystocia, there was 32 cases of pelvic disproportion,23 cases of occiput transverse presentation,17 cases of occiput posterior presentation,3 cases of sincipital presentation,2 cases of anteriorasynelitism; while in the compared group, the total cases of dystocia is 40, accounting for 20.0%, in the total cases of dystocia, there was 17 cases of pelvic disproportion,12 cases of occiput transverse presentation, 7 cases of occiput posterior presentation,2 cases of sincipital presentation,2 cases of anteriorasynelitism; There was significant difference in the numbers of dystocia, pelvic disproportion, occiput transverse presentation, sincipital presentation and anteriorasynelitism between the two groups.4 The labor time between PROM of term group and Control groupThere was no significant difference in the Mean Time of total stage of labor, first stage of labor and second stage of labor between the two groups.5 The prenatal complications between PROM of term group and Control groupThe complications in both mothers and neonates of the PROM of term group were mainly fetal distress, neonatal asphyxia, puerperal infection and postpartum hemorrhage, Their incidences in turns were 14%,6.0%,2.5%,0.5%, but the compared group for 6.5%,2.0%,1.0%,0.5%. There was statistical difference between and neonatal asphyxia hemorrhage incidence of two groups by comparing them with y2, but no statistical difference between puerperal infection and postpartum hemorrhage incidence of two groups by comparing them with x2. Conclusions1. The full term PROM may be one of the cause of dystocia, and it may be one of the reasons of cesarean rate rise up.2. The most common cause of dystocia are pelvic disproportion, occiput transverse presentation and occiput posterior presentation.3. The full term PROM can cause great harm to mother and child, and it may be oen cause of marked increase in the rate of fetal distress and neonate asphyxia.