Stancu Samantha Mc Kenzie, Ash Liran Kobi, Smeding Cynthia, Alwan Maisa Abdullah
Homerton University Hospital, NHS Foundation Trust, London, United Kingdom.
Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Open Access Maced J Med Sci. 2019 Apr 14;7(7):1124-1128. doi: 10.3889/oamjms.2019.250. eCollection 2019 Apr 15.
Preterm premature rupture of membranes (P-PROM) exerts a tremendous influence on pregnancy prognosis. Additionally, it is a major public health concern, as the cause of up to 40% of all preterm births.
The objective of this study was to identify predictors of Caesarean Delivery in singleton pregnancies complicated by P-PROM.
This is a retrospective observational study of all consecutive singleton P-PROM deliveries (24-37 weeks) over an 18 months at a tertiary referral centre. Pertinent data was collected comprising demographics, obstetric history, pregnancy-associated pathology and delivery from electronic patient records. Univariate statistical analysis comprised Odds Ratio, 95% Confidence interval and Chi-square test with subsequent -value with statistical significance set at < 0.05.
A total of 240 women delivered singletons following P-PROM over an 18-month period. Maternal age ranged between 12-41 years with an average age of 28 ± 6.27 years. Vaginal delivery (VD) was the predominant mode of delivery, accounting for 52.9% (n = 127) of deliveries. The following parameters were identified as predictors of Caesarean Section (CS) in P-PROM: vaginal infection ( = 0.04), previous CS ( < 0.0001), primiparity ( = 0.004), gravidity > 5 ( = 0.009), university education ( = 0.0006) and prenatal care ( < 0.0001).
The advantage of CS over vaginal delivery is expedited delivery of the distressed fetus, while that of vaginal delivery entails avoiding postoperative morbidity. However, large multicentric randomised-controlled studies are needed to elucidate this dilemma definitively.
胎膜早破（P-PROM）对妊娠预后有巨大影响。此外，它是一个重大的公共卫生问题，因为它是所有早产原因的40%。
本研究的目的是确定单胎妊娠合并P-PROM剖宫产的预测因素。
这是一项对某三级转诊中心18个月内所有连续单胎P-PROM分娩（24-37周）的回顾性观察研究。从电子病历中收集相关数据，包括人口统计学、产科病史、妊娠相关病理和分娩情况。单因素统计分析包括比值比、95%置信区间和卡方检验，随后的P值设定为具有统计学意义（P<0.05）。
在18个月期间，共有240名妇女在P-PROM后分娩单胎。产妇年龄在12-41岁之间，平均年龄为28±6.27岁。阴道分娩（VD）是主要的分娩方式，占分娩总数的52.9%（n = 127）。以下参数被确定为P-PROM剖宫产（CS）的预测因素：阴道感染（P = 0.04）、既往剖宫产史（P<0.0001）、初产妇（P = 0.004）、妊娠次数>5次（P = 0.009）、大学学历（P = 0.0006）和产前检查（P<0.0001）。
剖宫产相对于阴道分娩的优势在于能迅速娩出窘迫胎儿，而阴道分娩的优势在于避免术后发病。然而，需要大型多中心随机对照研究来明确解决这一困境。
