Ramsey Patrick S, Lieman Joelle M, Brumfield Cynthia G, Carlo Waldemar
Division of Maternal-Fetal Medicine, Department of Obstetrics/Gynecology, 458 Old Hillman Building, 619 19th St South, Birmingham, AL, USA.
Am J Obstet Gynecol. 2005 Apr;192(4):1162-6. doi: 10.1016/j.ajog.2004.11.035.
To compare morbidities of neonates born to women who developed chorioamnionitis after premature preterm rupture of membranes versus those who did not.
We reviewed outcomes in singleton pregnancies with confirmed premature preterm rupture of membranes at 24 weeks or beyond that resulted in delivery less than 37 weeks. Management of premature preterm rupture of membranes included the use of antibiotics, betamethasone if less than 32 weeks, and expectant management with induction at 34 weeks or greater. Composite neonatal major and minor morbidity rates were compared between pregnancies complicated by chorioamnionitis and those that were not.
From August 1998 to August 2000, 430 cases of premature preterm rupture of membranes were identified among 6003 deliveries (7.2%). Thirteen percent of women (56/430) with premature preterm rupture of membranes developed chorioamnionitis. The incidence of chorioamnionitis increased significantly with decreasing gestational age. The composite neonatal major morbidity rate was significantly higher in neonates whose mothers developed chorioamnionitis (55%) versus those who did not (18%, P < .0001). In a multiple logistic regression model, chorioamnionitis ( P < .0001), infant gender ( P = .007), latency ( P = .03), and gestational age at delivery ( P < .0001) were significantly associated with composite neonatal morbidity.
Neonatal morbidities are significantly higher among pregnancies with premature preterm rupture of membranes complicated by chorioamnionitis when compared with pregnancies that were not.
比较胎膜早破后发生绒毛膜羊膜炎的孕妇所分娩新生儿与未发生绒毛膜羊膜炎的孕妇所分娩新生儿的发病率。
我们回顾了单胎妊娠且确诊为孕24周及以后发生胎膜早破并在孕37周前分娩的结局。胎膜早破的处理包括使用抗生素，孕周小于32周时使用倍他米松，以及在孕34周及以后进行期待治疗并引产。比较了合并绒毛膜羊膜炎的妊娠和未合并绒毛膜羊膜炎的妊娠中新生儿主要和次要合并症的综合发生率。
1998年8月至2000年8月，在6003例分娩中确诊430例胎膜早破（7.2%）。13%的胎膜早破孕妇（56/430）发生了绒毛膜羊膜炎。绒毛膜羊膜炎的发生率随孕周的降低而显著增加。母亲发生绒毛膜羊膜炎的新生儿的综合主要发病率（55%）显著高于未发生绒毛膜羊膜炎的新生儿（18%，P <.0001）。在多因素logistic回归模型中，绒毛膜羊膜炎（P <.0001）、婴儿性别（P =.007）、潜伏期（P =.03）和分娩时的孕周（P <.0001）与新生儿综合发病率显著相关。
与未合并绒毛膜羊膜炎的妊娠相比，合并绒毛膜羊膜炎的胎膜早破妊娠中新生儿发病率显著更高。
