Chua S, Arulkumaran S, Sailesh Kumar S, Selamat N, Ratnam S S
Department of Obstetrics and Gynaecology, National University Hospital, Singapore.
J Obstet Gynaecol (Tokyo 1995). 1995 Aug;21(4):367-72. doi: 10.1111/j.1447-0756.1995.tb01024.x.
To assess the infectious morbidity associated with prelabour rupture of membranes (PROM) to delivery interval, and the incidence of maternal and neonatal infection in a population managed by either immediate stimulation or by overnight conservatism.
A retrospective study of 117 women admitted with PROM to the labour ward in the National University Hospital, Singapore, in the period between June 1990 and May 1991, and who were managed by immediate stimulation or by stimulation after overnight conservatism. Statistical analysis was performed using Chi-square and Student's t-test.
More than one third of infants whose mothers had ruptured membranes for > 48 hrs had signs of neonatal infection, compared with an incidence of 8.8% and 8.9%, respectively for those with an interval of < 12 hrs and 12-24 hrs between PROM to delivery. Group B streptococcal infection was a major cause of neonatal infectious morbidity. Clinical evidence of maternal infection occurred in 3 of the 117 women; these patients had an interval between rupture of membranes and delivery of between 24-76 hrs.
Prolongation of PROM to delivery interval for > 48 hrs increases the incidence of infection. Conservative policy of management of PROM at term should aim to deliver the babies < 48 hrs after PROM. The difference in maternal and neonatal infection rates were not significant in the group treated with a policy of overnight conservatism compared with the group in whom labour was stimulated immediately on admission.
评估胎膜早破（PROM）至分娩间隔与感染性发病率之间的关系，以及在采取即刻引产或过夜保守治疗的人群中孕产妇和新生儿感染的发生率。
对1990年6月至1991年5月期间入住新加坡国立大学医院产科病房的117例胎膜早破患者进行回顾性研究，这些患者接受了即刻引产或过夜保守治疗后引产。采用卡方检验和学生t检验进行统计分析。
母亲胎膜破裂超过48小时的婴儿中，超过三分之一有新生儿感染迹象，而胎膜早破至分娩间隔<12小时和12 - 24小时的婴儿感染发生率分别为8.8%和8.9%。B族链球菌感染是新生儿感染性发病的主要原因。117例女性中有3例出现孕产妇感染的临床证据；这些患者的胎膜破裂至分娩间隔为24 - 76小时。
胎膜早破至分娩间隔延长超过48小时会增加感染发生率。足月胎膜早破的保守治疗策略应旨在胎膜早破后<48小时内分娩。与入院时即刻引产的组相比，过夜保守治疗组的孕产妇和新生儿感染率差异不显著。
