Ernest J M, Givner L B
Department of Obstetrics and Gynecology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27157.
Am J Obstet Gynecol. 1994 Feb;170(2):516-21. doi: 10.1016/s0002-9378(94)70220-9.
Preterm premature rupture of the fetal membranes is common and frequently results in infectious complications. A prospective, randomized, controlled trial of penicillin versus placebo in preterm premature rupture of membranes is reported. The aim of the study was to determine if prophylactic antibiotics after preterm premature rupture of membranes would reduce infectious complications in the mother or neonate.
Patients with preterm premature rupture of membranes between 21 and 37 weeks' gestation were randomized into a penicillin group that received 1 million units of benzylpenicillin intravenously every 4 hours followed by 250 mg of potassium phenoxymethyl penicillin (Pen-Vee K, Wyeth-Ayerst) orally twice daily or a placebo group before delivery. Latency period, infectious complications, and neonatal outcomes were studied.
Patients with preterm premature rupture of membranes who received prophylactic penicillin had fewer infectious complications, including intraamniotic infection and postpartum endometritis (4 vs 11, p < 0.03), without adverse effects on the mother or fetus.
Prophylactic penicillin in patients with preterm premature rupture of membranes reduces maternal infectious complications without adversely affecting the mother or newborn.
胎膜早破早产很常见，且常导致感染性并发症。本文报道了一项关于青霉素与安慰剂用于胎膜早破早产的前瞻性、随机、对照试验。该研究的目的是确定胎膜早破早产之后使用预防性抗生素是否会减少母亲或新生儿的感染性并发症。
妊娠21至37周的胎膜早破早产患者被随机分为青霉素组，每4小时静脉注射100万单位苄星青霉素，随后每日口服两次250毫克苯氧甲基青霉素钾（青霉素V钾片，惠氏-艾尔斯特公司生产），或在分娩前分为安慰剂组。对潜伏期、感染性并发症和新生儿结局进行了研究。
接受预防性青霉素治疗的胎膜早破早产患者感染性并发症较少，包括羊膜腔内感染和产后子宫内膜炎（4例对11例，p<0.03），对母亲或胎儿无不良影响。
胎膜早破早产患者使用预防性青霉素可减少母亲的感染性并发症，且对母亲或新生儿无不良影响。
