Nava Flores Jorge, Enríquez Miranda Ma Cecilia, Hernández-Valencia Marcelino
Hospital de Ginecología y Obstetricia No. 3, Centro Médico Nacional La Raza, Unidad de Investigación Médica en Enfermedades Endocrinas, Centro Médico Nacional S-XXI, IMSS, México D.F.
Ginecol Obstet Mex. 2003 Jul;71:343-8.
Premature rupture of the membranes (PROM) occurs in a third of the childbirths preterm, this represents 8% of all pregnancies, with same morbidity and mortality in developing and developed countries, PROM is the more common cause of neonatal morbidity and mortality, making this obstetric complication a worldwide problem of health, since it contributes to the economic problem for the cost risen in medical attention for both, mothers and live birth. PROM is considered a mutifactorial entity. This study was carried out in the Hospital de Ginecología y Obstetricia of the Centro Médico "La Raza" in Mexico City, where women entered in serial form with pregnancies from 27 to 34 weeks of gestation and spontaneous PROM, without any other pathology. 120 patients were included, with 26.8 +/- 5.9 year-old age. The gestational age with more frequency of PROM were from 30 to 33 weeks, 22.5% of the patients had 4 days with PROM, 6 of this cases arrived up to 13 days with this complication at delivery. 2.5% of the patients presented deciduitis, with adequated response to the use of antibiotics. When analyzing the hospital stay, a stay was observed from 4 to 7 days (5.26 +/- 1.96 M +/- SD), with a total cost for maternal stay of 2 millions 445,650 pesos. Those babies born had an average of 23 days of hospital stay and the total cot of the days of stay was 4 millions 963,978 pesos. Other costs were the attention of maternal and pediatrics specialty, the obstetric resolution of the pregnancy, obstetric ultrasonography and crystallographies. Thus, the total costs of the attention of this complication in these patients with PROM was of 10 millions 296,988 pesos. The international reference is the American dollar that was in 10 pesos for dollar to the moment of this study. The maternal morbidity is low to that described in previous studies, but in spite of the exhaustive efforts on the prevention, prediction, diagnosis and treatment, the premature rate due to PROM has not diminished, however the rate of neonatal survival has been increased and the morbidity has diminished.
胎膜早破（PROM）发生在三分之一的早产分娩中，占所有妊娠的8%，在发展中国家和发达国家具有相同的发病率和死亡率。PROM是新生儿发病和死亡的最常见原因，使这种产科并发症成为一个全球性的健康问题，因为它会因母亲和活产儿医疗护理费用的增加而导致经济问题。PROM被认为是一种多因素疾病。本研究在墨西哥城“拉扎”医疗中心的妇产科医院进行，研究对象为孕周27至34周且发生自发性PROM、无任何其他病理情况的连续妊娠妇女。共纳入120例患者，年龄为26.8±5.9岁。发生PROM频率最高的孕周为30至33周，22.5%的患者胎膜早破4天，其中6例在分娩时该并发症持续长达13天。2.5%的患者出现蜕膜炎，使用抗生素后反应良好。分析住院时间时，观察到住院时间为4至7天（5.26±1.96天，平均值±标准差），产妇住院总费用为2445650比索。那些出生的婴儿平均住院23天，住院总费用为4963978比索。其他费用包括产妇和儿科专科护理、妊娠的产科处理、产科超声检查和晶体检查。因此，这些胎膜早破患者该并发症的护理总费用为10296988比索。本研究进行时，国际参考货币是美元，汇率为1美元等于10比索。产妇发病率低于先前研究中描述的情况，但尽管在预防、预测、诊断和治疗方面做出了详尽努力，因胎膜早破导致的早产率并未降低，不过新生儿存活率有所提高，发病率有所降低。
