PREMATURE RUPTURE OF THE MEMBRANES - EFFECT OF PENICILLIN PROPHYLAXIS AND LONG-TERM OUTCOME OF THE CHILDREN
PREMATURE RUPTURE OF THE MEMBRANES - EFFECT OF PENICILLIN PROPHYLAXIS AND LONG-TERM OUTCOME OF THE CHILDREN
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DOI：
10.1055/s-2007-994661
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发表时间：
1992-01-01
影响因子：
2
通讯作者：
YLIKORKALA, O
中科院分区：
文献类型：
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作者：
KURKI, T;HALLMAN, M;YLIKORKALA, O
为了评估青霉素预防胎膜早破（PROM）妇女的价值和胎膜早破后出生的儿童的长期结局，我们研究了221名患有这种疾病的妇女。青霉素（5亩两次，间隔6小时）静脉注射给50名妇女和安慰剂的51名妇女，而76个可比的患者没有青霉素或安慰剂治疗。胎膜早破至分娩的时间间隔为14小时至56天。安慰剂组患者绒毛膜炎发生率（14%）高于青霉素组（2%）（p < 0.05）。安慰剂组有1例产褥期肠炎，青霉素组无1例。安慰剂预防组有1例新生儿（1.7%）发生败血症，而青霉素组无一例发生败血症。未接受青霉素或安慰剂治疗的胎膜早破孕妇的结局与安慰剂组相当。此外，我们还比较了159名胎膜早破母亲（超过12小时，平均5.6天，范围14至1344小时）与43名胎膜早破后5小时内出生的类似胎龄儿童的身体和心理发育。胎膜早破和分娩之间的时间间隔较长可能与肺部后遗症无关，但胎膜早破后不久出生的婴儿（8/43，18.6%）比胎膜早破后较长时间出生的婴儿（7/159，4.4%）更容易患脑瘫（p < 0.05）。我们的结论是，在胎膜早破的情况下，青霉素预防降低孕产妇和新生儿感染的发病率，胎膜早破和分娩之间的长时间间隔不会损害这些孩子的长期结果。
To assess the value of prophylaxis with penicillin in women with premature rupture of membranes (PROM) and the long-term outcome of children born after prolonged PROM, we studied 221 women with this condition. Penicillin (5 mu twice, 6 hours apart) was given intravenously to 50 women and placebo to 51 women, whereas 76 comparable patients were treated without penicillin or placebo. The time interval between PROM and delivery ranged from 14 hours to 56 days. Chorioamnionitis occurred more frequently (p < 0.05) among patients with placebo (14%) than among those treated with penicillin (2%). One puerperal endometritis appeared in the placebo group compared with none in the penicillin group. One newborn (1.7%) born to a mother with placebo prophylaxis developed septicemia, compared with none in the penicillin group.The outcomes of pregnancies complicated with PROM treated without penicillin or placebo were comparable with those in the placebo group. In addition, we compared somatic and psychomotor development of 159 children born to mothers with prolonged PROM (more than 12 hours; mean, 5.6 days; range, 14 to 1344 hours) with those of 43 children born at similar gestational age within 5 hours after PROM. No pulmonary sequelae could be linked to the long time period between PROM and delivery, but infants born soon after PROM more often (p < 0.05) had cerebral palsy (8 of 43, 18.6%) than did infants born after prolonged PROM (7 of 159; 4.4%). We conclude that, in cases with PROM, penicillin prophylaxis decreases maternal and neonatal infectious morbidity and that the long interval between PROM and delivery does not impair the long-term outcome for these children.