[足月时胎膜早破且宫颈条件不佳：立即引产还是延迟引产？]
[Premature rupture of membranes at term on unfavourable cervix: immediate or delayed induction?].
作者信息
Zelli P, Boussat B, Reynaud J-C, Pons J-C, Sergent F
机构信息
Service de gynécologie et obstétrique, clinique universitaire de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble, C.S. 10217, 38043 Grenoble cedex 9, France.
出版信息
J Gynecol Obstet Biol Reprod (Paris). 2013 Nov;42(7):671-7. doi: 10.1016/j.jgyn.2013.03.004. Epub 2013 Jun 12.
OBJECTIVES
To define the optimal delay before inducing labor in the management of premature rupture of the membranes (PRM) at term with unfavourable cervix in order to reduce the risk of caesarean section as well as the risk of maternal and foetal infection.
MATERIALS AND METHODS
Retrospective study of three homogeneous groups carried out over on a period of 4years in two centres. All the patients were included after premature rupture of membranes at term with unfavourable cervix (Bishop score<6). We defined three expected delays after PRM at term: less than 7h (group 1), between 7 and 12h (group 2) and more than 12h (group 3). We have assessed the obstetrical, maternal and foetal consequences for each group.
RESULTS
Sixty patients were allocated in group 1, 49 in group 2 and 46 in group 3. There was no significant difference in the rate of caesarean between the three groups but it was lower in group 2: 6.1% versus 18.3% in group 1 and 21.7% in group 3. No statistical difference was observed concerning maternal or foetal infections.
CONCLUSION
In PRM at term, neither our study nor literature data allow us to conclude about the optimal delay before inducing labor.
目的
确定足月胎膜早破（PRM）且宫颈条件不佳时引产的最佳延迟时间，以降低剖宫产风险以及母婴感染风险。
材料与方法
在两个中心对三个同质组进行了为期4年的回顾性研究。所有患者均为足月胎膜早破且宫颈条件不佳（Bishop评分<6）后纳入研究。我们定义了足月胎膜早破后的三个预期延迟时间：少于7小时（第1组）、7至12小时（第2组）和超过12小时（第3组）。我们评估了每组的产科、母体和胎儿结局。
结果
第1组分配了60例患者，第2组49例，第3组46例。三组之间剖宫产率无显著差异，但第2组较低：6.1%，而第1组为18.3%，第3组为21.7%。在母体或胎儿感染方面未观察到统计学差异。
结论
在足月胎膜早破中，无论是我们的研究还是文献数据都无法让我们得出引产的最佳延迟时间。
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