Obstetric Department, University Hospital Carlos Haya, Arroyo De Los Ángeles Av., 29011 Málaga, Spain.
Arch Gynecol Obstet. 2012 Aug;286(2):347-52. doi: 10.1007/s00404-012-2299-1. Epub 2012 Mar 29.
This paper shows temporal trends of latency period and perinatal survival after preterm premature rupture of membranes at or before 28 weeks (very early PPROM).
We have studied retrospectively medical records of all cases of very early PPROM attended in our Obstetric Department from January 1, 2000 to December 31, 2010.
A total of 327 cases of very early PPROM were attended, representing 0.4 % of all deliveries, 3.68 % of all preterm births and 15 % of cases all of PPROM. The mean gestational age at delivery was 27 weeks (range 20-34). The mean duration of latency period for the total of 327 cases was 12.1 days (range 0-83, SD 13.3), with a clear trend to its increase from 2005 (p < 0.05). The mean duration of latency period was largest in 2010 (p < 0.05). For the whole period 2000-2010, perinatal deaths reached 30.6 % of all cases, with a clear trend to decrease as gestational age at diagnosis increased, and over the years of study. We have also found a high rate of obstetric complications and a high rate of cesarean deliveries.
The upward trend in the duration of latency period in all groups over the years of study and the encouraging perinatal survival observed, even in previable PPROM, are incentives to follow expectant/conservative management in these cases.
本文展示了在 28 周（极早产）或之前发生的胎膜早破的潜伏期和围产儿存活率的时间趋势。
我们回顾性地研究了 2000 年 1 月 1 日至 2010 年 12 月 31 日期间在我们妇产科就诊的所有极早产胎膜早破病例的医疗记录。
共 327 例极早产胎膜早破病例，占总分娩数的 0.4%，所有早产的 3.68%，所有胎膜早破病例的 15%。分娩时的平均孕龄为 27 周（范围 20-34）。327 例的潜伏期平均持续时间为 12.1 天（范围 0-83，SD 13.3），潜伏期有明显的延长趋势，从 2005 年开始（p < 0.05）。2010 年潜伏期的平均持续时间最长（p < 0.05）。在 2000 年至 2010 年期间，所有病例中围产儿死亡达到 30.6%，随着诊断时的孕龄增加和研究年份的增加，围产儿死亡率呈下降趋势。我们还发现了较高的产科并发症发生率和剖宫产率。
在研究期间，所有组别的潜伏期持续时间呈上升趋势，围产儿存活率令人鼓舞，即使是在极早产胎膜早破的情况下，也鼓励对这些病例进行期待/保守治疗。
