Body G, Forveille F, Lemseffer J, Kone M, Pierre F, Lansac J, Soutoul J H, Berger C
Département de Gynécologie-Obstétrique et de la Reproduction, CHU Bretonneau, Tours.
J Gynecol Obstet Biol Reprod (Paris). 1991;20(1):93-100.
The authors studied the outcome of pregnancies after spontaneous rupture of the membranes before 28 weeks of amenorrhoea in a series of 28 women. The mean time of the rupture was at 25 1/2 weeks. The duration of the time of rupture was a mean of 10 days and deliveries occurred between the 19th and the 32nd weeks. In 5 cases with an average term of 22 1/2 weeks the pregnancy was terminated. Caesarean operation was carried out in 4 cases and spontaneous vaginal delivery occurred between the 26th and 30th weeks of amenorrhoea in 19 cases. Chorio-amnionitis was the most common maternal complication (32.1%). Maternal morbidity was high (82%) without important sequelae. Thirty infants were born out of these 28 pregnancies (two sets of twins). 33% of the infants were stillborn, 46.6% died in the neonatal period, all of these from respiratory complications. 20% of the children are still alive, and all of these weighed at least 1,000 grams and were born after 28 weeks. A child that was born at 27 weeks amenorrhoea has serious neurological deficits. Having studied the bibliography on the subject and their own personal experience the authors suggest a routine to carry out in these cases. Although the prognosis is poor, the totality of these factors could encourage obstetrical teams to be conservative so long as they watch very carefully under well defined conditions.
作者对28名妊娠28周前胎膜自然破裂的孕妇的妊娠结局进行了研究。胎膜破裂的平均时间为25.5周。胎膜破裂的持续时间平均为10天，分娩发生在第19至32周之间。5例平均孕周为22.5周的孕妇终止了妊娠。4例行剖宫产，19例在闭经第26至30周之间自然阴道分娩。绒毛膜羊膜炎是最常见的母体并发症（32.1%）。母体发病率高（82%），但无严重后遗症。这28次妊娠中有30名婴儿出生（两组双胞胎）。33%的婴儿为死产，46.6%在新生儿期死亡，均死于呼吸并发症。20%的儿童仍然存活，且均体重至少1000克，在28周后出生。一名在闭经27周时出生的儿童有严重的神经功能缺陷。在研究了该主题的文献及自身经验后，作者提出了在这些情况下应遵循的常规做法。尽管预后不佳，但只要在明确的条件下密切观察，所有这些因素可能会促使产科团队采取保守态度。
