Suzuki Shunji
Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, 5-11-12 Tateishi, Katsushika-ku, Tokyo 124-0012, Japan.
ISRN Obstet Gynecol. 2012;2012:856971. doi: 10.5402/2012/856971. Epub 2012 May 28.
The purpose of this paper was to examine the obstetric and neonatal outcomes of preterm singleton pregnancies complicated by placental abruption following preterm premature rupture of membranes (p-PROM) compared with those without p-PROM. We reviewed the obstetric records of 95 singleton deliveries complicated by placental abruption at 22-36 weeks' gestation. The incidence of placental abruption in singleton pregnancies with p-PROM was 4.7%, and the crude odds ratio of placental abruption for women following p-PROM was 6.50 (P < 0.01). Of the 95 cases of placental abruption in preterm singleton deliveries, 64 cases (67.4%) occurred without p-PROM and 31 cases (32.6%) occurred following p-PROM. The incidence of histological chorioamnionitis stage III in the patients following p-PROM was significantly higher than that in the patients without p-PROM (P = 0.02). The rate of emergency Cesarean deliveries associated with nonreassuring fetal status (NRFS) in the patients following p-PROM was significantly lower than that in the patients without p-PROM. However, there were no significant differences in the maternal and neonatal outcomes between the patients with and without p-PROM. Although p-PROM may be one of important risk factors for placental abruption associated with chorioamnionitis, it may not influence the perinatal outcomes in preterm placental abruption.
本文旨在研究胎膜早破（p-PROM）后早产单胎妊娠并发胎盘早剥的产科及新生儿结局，并与未发生p-PROM的情况进行比较。我们回顾了95例妊娠22-36周并发胎盘早剥的单胎分娩的产科记录。发生p-PROM的单胎妊娠中胎盘早剥的发生率为4.7%，p-PROM后发生胎盘早剥的女性的粗比值比为6.50（P<0.01）。在95例早产单胎分娩胎盘早剥病例中，64例（67.4%）发生在未发生p-PROM时，31例（32.6%）发生在p-PROM后。p-PROM患者中III期组织学绒毛膜羊膜炎的发生率显著高于未发生p-PROM的患者（P=0.02）。p-PROM患者中因胎儿窘迫（NRFS）而行急诊剖宫产的比例显著低于未发生p-PROM的患者。然而，发生和未发生p-PROM的患者在母婴结局方面无显著差异。虽然p-PROM可能是与绒毛膜羊膜炎相关的胎盘早剥的重要危险因素之一，但它可能不会影响早产胎盘早剥的围产期结局。
