Poma P A
Department of Obstetrics and Gynecology, Loyola University, Chicago, Illinois, USA.
J Natl Med Assoc. 1996 Jan;88(1):27-32.
The management of patients with premature rupture of membranes has changed markedly in the past several years. The basis for this is a combination of a better understanding of newborn physiology, improved neonatal care, refinements in antibiotic therapy, and the widespread use of maternal and fetal monitoring. The best outcome for both mother and infant undoubtedly reflects data based on a combination of factors, among which are gestational age survival, evidence of fetal distress, presence or absence of labor and sepsis, and of course, the cervical condition as it is related to labor-readiness. An important recent advance is the recognition that an active observation management program is associated with less morbidity and mortality than the classic management course of delivery within 12 hours of membrane rupture. The fact that preterm premature rupture of membranes tends to recur in subsequent pregnancies offers an opportunity for prevention. Moreover, advances in perinatal and neonatal care will continue to improve the outcomes of these women and their children.
在过去几年中，胎膜早破患者的管理发生了显著变化。其依据是对新生儿生理学有了更好的理解、新生儿护理得到改善、抗生素治疗更加精细以及母婴监测的广泛应用。母婴的最佳结局无疑反映了基于多种因素的数据，其中包括孕周存活率、胎儿窘迫的证据、是否临产和感染，当然还有与临产准备相关的宫颈状况。最近一项重要进展是认识到，与胎膜破裂后12小时内进行经典分娩管理流程相比，积极观察管理方案的发病率和死亡率更低。胎膜早破在后续妊娠中往往会复发，这为预防提供了机会。此外，围产期和新生儿护理的进步将继续改善这些妇女及其子女的结局。
