| Objective: Discussion on premature rupture of membranes ofdifferent gestational age of termination of pregnancy,termination ofpregnancy indications and reasonable choice to terminate way.Thus, Toimprove the perinatal infant prognosis.Comprehensive considerationmaternal and perinatal elements,as far as possible causes the benefits tomaximize.Method: Discuss on clinical data about383cases of women inpremature rupture of membranes in a retrospective way.And thereasonable group discussions and statistical processing.To make theclinical data for reasonable group discussions and statistical processing.Research1:Patients are divided into several groups by the occurringdifferent gestational age of premature rupture of membranes,which aregroup A (28weeks≤gestational age≤32weeks,64cases),group B (32weeks＜gestational age≤34weeks,64cases),group C (34weeks＜gestational age≤36weeks,104cases) and group D (gestational age＞36weeks,151cases).Research2:Patients are divided into several groups by theterminating gestational age,which are group I (28weeks≤gestational age≤32weeks,49cases),group II (32weeks＜gestational age≤34weeks,61cases),group III (34weeks＜gestational age≤36weeks,107cases) group IV (gestational age＞36weeks,166cases).Results： Research1:1.383cases of premature rupture of membranes aredivided into several groups by the occurring different gestational age ofpremature rupture of membranes,the comparations of age and the time ofgravidity among groups show no significant statistical difference.（P＞0.05）2.The newborns used breathing machine, neonatal respiratorydistress syndrome, neonatal infection, intracranial hemorrhage at28-32weeks PROM have the highest rate of death,the differences arestatistically significant.（P＜0.05）3.Overall,as the extension of expectedtreatment time, the incidence of infection are increased.4.For PROM at28+1-34weeks, to extend gestational age by giving appropriate expectedtreatment,the incidence of neonatal respiratory distress syndrome willdrop remarkable.Research2:1.The termination of pregnancy is mainly caused byfetus factor in group I and II.Taking up40.8%and39.3%respectively.The termination of pregnancy is mainly caused by about togive birth in group IIIand IV.Taking up42.1%and63.9%respectively.2.As the age of termination of pregnancy grows,the ratio ofabout to give birth increase gradually, while the fetus and maternalfactors reduce gradually.3. As the age of termination of pregnancygrows,the ratio of cesarean section increased gradually,the ratio ofvaginal delivery reduce gradually.The ratio of cesarean section was71.7%and the ratio of vaginal delivery was as low as28.3%.4. Cesareansection can reduce the incidence of intracerebral haemorrhage obviouslyin group I and II.（P＜0.05) Cesarean section and vaginal delivery interms of intracranial hemorrhage show no significant statistical differencein group IIIand IV.（P＞0.05）Other groups in different delivery way fornewborns disease show no statistical difference.Conclusion：1.The much earlier the premature rupture of membranes develops, the more serious the neonatal prognosis.Accordingto the main reason of premature rupture of membranes,gestation periodshould give positive and effective preventive measures.2.Expectedtreatment can be adopted to prolong the gestational age to32weeks inless than32weeks at the situation of monitoring the indicators ofmaternal and fetus exactly.By doing these can reduce neonatal morbidityand mortality.3.To the32+1-34weeks of PROM,if there is no signs ofinfection,we can extend gestational age properly.If there is any signs ofinfection, we can terminate the pregnancy timely.4.More than34weeksof PROM, don’t give expected treatment. We can accord to the actualsituation for waiting for the onset of labor or use oxytocin induced laborto launch.5.The choice of the ways of premature rupture of membranesfor termination of pregnancy,The present study indicate that differenttermination pregnancy ways had no significant difference to neonatalprognosis. In the clinical work we should accord to the actual situation,weigh the pros and cons, choice individual termination pregnancy wayafter full of communication. |
