羊膜腔穿刺术在胎膜早破早产管理中的应用：一项回顾性队列分析。
Amniocentesis in the management of preterm premature rupture of the membranes: a retrospective cohort analysis.
作者信息
Porreco Richard P, Heyborne Kent D, Shapiro Howard
机构信息
Presbyterian/St Luke's Medical Center, Obstetrix Medical Group of Colorado, Denver, Colorado 80218, USA.
出版信息
J Matern Fetal Neonatal Med. 2008 Aug;21(8):573-9. doi: 10.1080/14767050802178011.
OBJECTIVE
This retrospective analysis determined the utility of amniocentesis in the management of preterm premature rupture of the membranes (PPROM).
STUDY DESIGN
Consecutive patients with PPROM were managed with and without amniocentesis. Both groups received antibiotics and corticosteroids; tocolytics were withheld. Patients were induced if clinical or amniotic fluid (AF) proven chorioamnionitis occurred or gestational age goals were reached. Primary endpoints were individual and composite neonatal morbidity (CNM).
RESULTS
One hundred forty-seven maternal patients were managed with amniocentesis (AC) and 146 were managed without amniocentesis (NAC). CNM was significantly reduced in the group managed with AC (OR 2.94, 95% CI 1.68-5.15, NAC vs. AC). NAC patients had similar rates of neonatal sepsis as well as CNM to those patients in the AC group with positive AF Gram stains and/or cultures.
CONCLUSIONS
Patients with PPROM who are managed with AC have significantly less CNM than NAC patients.
目的
本回顾性分析确定了羊膜腔穿刺术在早产胎膜早破（PPROM）管理中的效用。
研究设计
连续纳入的PPROM患者分别接受或不接受羊膜腔穿刺术治疗。两组均接受抗生素和糖皮质激素治疗；未使用宫缩抑制剂。如果发生临床或羊水（AF）证实的绒毛膜羊膜炎或达到孕周目标，则对患者进行引产。主要终点是个体和复合新生儿发病率（CNM）。
结果
147例产妇接受了羊膜腔穿刺术（AC）治疗，146例未接受羊膜腔穿刺术（NAC）治疗。接受AC治疗的组中CNM显著降低（OR 2.94，95%CI 1.68 - 5.15，NAC组与AC组相比）。NAC组患者的新生儿败血症发生率以及CNM与AF革兰氏染色和/或培养结果为阳性的AC组患者相似。
结论
接受AC治疗的PPROM患者的CNM明显低于NAC组患者。
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