Cox S M, Leveno K J
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical School, Dallas, USA.
Obstet Gynecol. 1995 Dec;86(6):875-9. doi: 10.1016/0029-7844(95)00303-9.
To determine maternal and neonatal outcomes in pregnancies complicated by preterm rupture of membranes (PROM) at 30-34 weeks' gestation.
A randomized controlled trial was conducted to study the benefits of expectant management in women hospitalized for PROM at 30-34 weeks' gestation. During this investigation, no tocolytics, corticosteroids, or prophylactic antibiotics were used.
Sixty-eight women with PROM were managed expectantly and 61 were delivered intentionally. The mean gestational age at study entry was 31.7 weeks in both the expectant management and intentional delivery groups (P > .05). The mean gestational ages at delivery were similar (32.0 and 31.7 weeks, respectively). Other indices of pregnancy outcome (ie, birth weight, intraventricular hemorrhage, necrotizing enterocolitis, sepsis, respiratory distress syndrome, and perinatal death) were not significantly improved by expectant management. However, there was a significant increase in the incidence of chorioamnionitis and antepartum hospitalization in the women managed expectantly.
There were no clinically significant neonatal advantages to expectant management of ruptured membranes at 30-34 weeks. Antepartum hospitalization was decreased by 2.5 days in those women randomized to intentional delivery.
确定妊娠30 - 34周合并胎膜早破（PROM）的孕产妇和新生儿结局。
进行了一项随机对照试验，以研究对妊娠30 - 34周因胎膜早破住院的妇女进行期待治疗的益处。在这项研究中，未使用宫缩抑制剂、皮质类固醇或预防性抗生素。
68例胎膜早破妇女接受期待治疗，61例进行了引产。期待治疗组和引产组入组时的平均孕周均为31.7周（P > 0.05）。分娩时的平均孕周相似（分别为32.0周和31.7周）。期待治疗并未显著改善其他妊娠结局指标（即出生体重、脑室内出血、坏死性小肠结肠炎、败血症、呼吸窘迫综合征和围产期死亡）。然而，期待治疗的妇女绒毛膜羊膜炎和产前住院的发生率显著增加。
对妊娠30 - 34周胎膜早破进行期待治疗在临床上对新生儿并无显著优势。随机分配接受引产的妇女产前住院时间减少了2.5天。
