Seneviratne H R, de Silva G D, de Silva M V, Rudra T
Department of Obstetrics and Gynaecology, Faculty of Medicine, Colombo.
Ceylon Med J. 1998 Mar;43(1):11-5.
To compare the obstetric performance, perinatal outcome and risk of neonatal infection in labour following spontaneous (SROM) and artificial (AROM) rupture of membranes.
Prospective, non-randomised, comparative study during a one-month period in 1995. The study was approved by the ethics committee of the Faculty of Medicine, University of Colombo.
University Obstetrics Unit at De Soysa Hospital for Women, Colombo.
324 women who were in early established labour after 37 weeks of gestation. 151 of these had SROM and 173 AROM. The AROM and SROM groups among primigravidae and multigravidae were considered separately.
Oxytocin use in multigravidae was significantly higher in the AROM group than in the SROM group (p < 0.001). The emergency caesarean section (LSCS) rate in primigravidae was significantly higher in the AROM group than the SROM group (p < 0.001). A significantly larger number of primigravid AROM women had abnormal fetal heart rate changes on auscultation (p < 0.05) and cardiotopographic (CTG) patterns (p < 0.001) when compared with primigravid SROM women. Choreoamnionitis and funisitis were commoner in the AROM group although the difference was not statistically significant.
AROM appears to be associated with a higher chance of fetal distress particularly in primigravidae. Both AROM and SROM are associated with a potential risk of infection at intrauterine sites.
比较自然破膜（SROM）和人工破膜（AROM）后分娩时的产科表现、围产期结局及新生儿感染风险。
1995年为期1个月的前瞻性、非随机对照研究。该研究经科伦坡大学医学院伦理委员会批准。
科伦坡德索伊萨妇女医院大学产科病房。
324例孕37周后进入产程早期的妇女。其中151例为自然破膜，173例为人工破膜。初产妇和经产妇中的人工破膜组和自然破膜组分别进行分析。
经产妇中，人工破膜组催产素使用率显著高于自然破膜组（p<0.001）。初产妇中，人工破膜组急诊剖宫产（LSCS）率显著高于自然破膜组（p<0.001）。与初产妇自然破膜组相比，初产妇人工破膜组听诊时出现异常胎心变化（p<0.05）及心电图（CTG）异常（p<0.001）的人数显著更多。人工破膜组绒毛膜羊膜炎和脐带炎更为常见，尽管差异无统计学意义。
人工破膜似乎与胎儿窘迫的较高发生率相关，尤其是在初产妇中。人工破膜和自然破膜均与宫内感染的潜在风险相关。
