Fortunato S J, Welt S I, Eggleston M K, Bryant E C
Department of Obstetrics and Gynecology, Wright State University, Dayton, Ohio.
J Reprod Med. 1994 Jan;39(1):13-6.
Premature rupture of the membranes (PROM) in the previable gestation is frequently associated with fetal or neonatal death. Passive expectant management is successful in only a small minority of cases. Women presenting with PROM at < or = 27 weeks' gestation were treated with tocolysis and prophylactic antibiotics and delivered electively for lung maturity. The corrected perinatal survival was > 92%. The mean latency phase was 21.6 days (+/- 18.12 SD). Twenty-one percent of patients presented in labor; the mean latency phase for this subgroup was 14.4 (+/- 8.54) days. Nineteen patients (79%) had a latency phase > 7 days, and 14 (58%) had a latency phase > 14 days. Thirty-nine percent of infants required < 48 hours of mechanical ventilation. Six infants were delivered with intraventricular hemorrhage; in all cases it was grade 1 or 2. There were three (12.5%) postpartum infections and three septic neonates. Active expectant management using tocolysis and prophylactic antibiotics was associated with a prolonged latency phase, low infectious morbidity and good neonatal outcome.
孕28周前胎膜早破（PROM）常与胎儿或新生儿死亡相关。被动期待治疗仅在少数病例中成功。妊娠≤27周出现胎膜早破的孕妇接受了宫缩抑制治疗和预防性抗生素治疗，并择期分娩以促进肺成熟。校正后的围产期存活率>92%。平均潜伏期为21.6天（±18.12标准差）。21%的患者出现临产；该亚组的平均潜伏期为14.4（±8.54）天。19例（79%）患者的潜伏期>7天，14例（58%）患者的潜伏期>14天。39%的婴儿需要机械通气<48小时。6例婴儿分娩时发生脑室内出血；所有病例均为1级或2级。有3例（12.5%）产后感染和3例新生儿败血症。使用宫缩抑制和预防性抗生素的积极期待治疗与延长潜伏期、低感染发病率和良好的新生儿结局相关。
