Dinsmoor Mara J, Bachman Rebecca, Haney Elaine I, Goldstein Marci, Mackendrick William
Department of Obstetrics and Gynecology, Evanston Hospital, Evanston Northwestern Healthcare, Evanston, IL, USA.
Am J Obstet Gynecol. 2004 Jan;190(1):183-7. doi: 10.1016/s0002-9378(03)00926-8.
This study was undertaken to assess contemporary outcomes in pregnancies managed expectantly after extremely preterm premature (< or =24 weeks) premature rupture of the membranes (EPPROM).
We queried antepartum and ultrasound databases for patients with EPPROM. Data on pregnancy outcome and short-term neonatal outcomes were collected.
Forty-six patients with EPPROM were studied. Patients were hospitalized at 24 weeks' gestation and given antibiotics and antenatal steroids. Median gestational age at PPROM was 22.0 weeks (range 16.9-24 weeks); 43 (93%) elected expectant management, 2 of whom later had an intrauterine fetal death. Median latency period to delivery was 13 days (range 0-96 days), with mean gestational age at delivery of 25.8+/-3.4 weeks. Overall survival was 47% (27 of 57 infants), after a median hospital stay of 71 days (range 17-209 days). Ten (37%) of the survivors have serious sequelae.
Although significant pregnancy prolongation after previable PPROM occurs in many cases, neonatal outcomes remain poor.
本研究旨在评估极早早产（孕周≤24周）胎膜早破（EPPROM）后期待治疗的当代妊娠结局。
我们查询了产前和超声数据库中EPPROM患者的信息。收集了妊娠结局和短期新生儿结局的数据。
对46例EPPROM患者进行了研究。患者在妊娠24周时住院，并给予抗生素和产前类固醇。PPROM时的中位孕周为22.0周（范围16.9 - 24周）；43例（93%）选择期待治疗，其中2例后来发生了宫内胎儿死亡。分娩的中位潜伏期为13天（范围0 - 96天），分娩时的平均孕周为25.8±3.4周。在中位住院71天（范围17 - 209天）后，总体生存率为47%（57例婴儿中的27例）。10例（37%）幸存者有严重后遗症。
尽管许多病例中发生了可存活孕周前PPROM后妊娠显著延长，但新生儿结局仍然很差。
