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尼日利亚西南部一家三级医疗机构胎膜早破的管理结果

MANAGEMENT OUTCOME OF PREMATURE RUPTURE OF MEMBRANES IN A TERTIARY HEALTH FACILITY IN SOUTH WESTERN NIGERIA.

作者信息

Suleiman B K, Bello O O, Tijani A M, Oluwasola T A O

机构信息

Department of Obstetrics and Gynaecology, Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Nigeria.

Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria.

出版信息

Ann Ib Postgrad Med. 2021 Jun;19(1):63-69.

Abstract

BACKGROUND

Pre-labour Rupture of Membranes (PROM) contributes immensely to the potential risk of maternal morbidity and mortality.

OBJECTIVE

To explore the incidence and management outcome of PROM at Ladoke Akintola University of Technology Teaching Hospital (LTH), Ogbomoso, Nigeria.

METHODS

A retrospective study of 61 cases of PROM managed at LTH, Ogbomoso over a 3-year period. Information on the socio-demographics and obstetrics characteristics, management instituted, and outcomes were obtained using a structured proforma. Data were analysed using SPSS version 20. Level of statistical significance was set at <0.05 and 95% confidence interval.

RESULTS

The incidence of PROM was 4.1% with a perinatal mortality rate of 0.18 per 1000 deliveries. Twenty (33%) were pre-term while 41 (67%) were term PROM with 10% of the perinatal death occurring among those with preterm PROM. The mean age of the women was 36.9 (SD=2.1) years and median parity of 1(range 1-5) children. There was a significant association between the women's gestational age at which PROM occurred with the latency period (p< 0.001). Fetal birth weight, APGAR score and Neonatal Intensive Care Unit (NICU) admission were all significantly associated with the gestational age at which PROM occurred (p<0.05). There was a significant difference between the intervention instituted and mode of delivery (p=0.009).

CONCLUSION

The incidence of PROM at term was high and conservative/ expectant management was effective. The latency period and fetal outcomes such as birth weight, apgar score and NICU admission were determined by the gestational age at which PROM occurred.

摘要

背景

胎膜早破(PROM)极大地增加了孕产妇发病和死亡的潜在风险。

目的

探讨尼日利亚奥贡博索拉多克·阿金托拉科技大学教学医院(LTH)胎膜早破的发生率及管理结果。

方法

对奥贡博索LTH在3年期间管理的61例胎膜早破病例进行回顾性研究。使用结构化表格获取社会人口统计学和产科特征、所采取的管理措施及结果等信息。数据采用SPSS 20版进行分析。统计学显著性水平设定为<0.05和95%置信区间。

结果

胎膜早破的发生率为4.1%,围产儿死亡率为每1000例分娩0.18例。20例(33%)为早产,41例(67%)为足月胎膜早破,10%的围产儿死亡发生在早产胎膜早破者中。女性的平均年龄为36.9(标准差=2.1)岁,中位产次为1(范围1 - 5)个孩子。胎膜早破发生时的孕周与潜伏期之间存在显著关联(p<0.001)。胎儿出生体重、阿氏评分和新生儿重症监护病房(NICU)入院情况均与胎膜早破发生时的孕周显著相关(p<0.05)。所采取的干预措施与分娩方式之间存在显著差异(p = 0.009)。

结论

足月胎膜早破的发生率较高且保守/期待治疗有效。潜伏期以及胎儿结局如出生体重、阿氏评分和NICU入院情况由胎膜早破发生时的孕周决定。

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本文引用的文献

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Maternal and fetal outcomes in term premature rupture of membrane.足月胎膜早破的母婴结局
World J Emerg Med. 2016;7(2):147-52. doi: 10.5847/wjem.j.1920-8642.2016.02.011.
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Prelabour Rupture of Membranes: Mode of Delivery and Outcome.胎膜早破:分娩方式与结局
Open Access Maced J Med Sci. 2015 Jun 15;3(2):237-40. doi: 10.3889/oamjms.2015.037. Epub 2015 Apr 24.
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Practice Bulletin No. 160: Premature Rupture of Membranes.实践通报第 160 号:胎膜早破。
Obstet Gynecol. 2016 Jan;127(1):e39-e51. doi: 10.1097/AOG.0000000000001266.

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