Neonatal outcome and two-year follow-up after expectant management of second trimester rupture of membranes
Neonatal outcome and two-year follow-up after expectant management of second trimester rupture of membranes
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DOI：
10.1016/j.ijgo.2007.12.007
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发表时间：
2008-06-01
影响因子：
3.8
通讯作者：
Lang, Uwe
中科院分区：
文献类型：
--
作者：
Pristauz, Gunda;Bauer, Margit;Lang, Uwe
目的：评价中期妊娠合并早产胎膜早破(PPROM)的新生儿结局及2年随访。方法：回顾分析妊娠14+0~24+6周妊娠合并胎膜早破87例(单胎56例，双胞胎6例，三胞胎1例)的产科及新生儿资料。患者在怀孕24周后接受抗生素和类固醇治疗，以促进胎儿肺成熟。对胎盘进行组织病理学检查。存活的婴儿在2岁时进行了随访。结果：胎膜早破至分娩的中位潜伏期为4d。56例独生子女存活率为45%(25/56)，13例在医院死亡。出院婴儿存活率为23%(12/56)。在组织学上，存活的婴儿中有42%(5/12)出现绒毛膜羊膜炎，而在医院死亡的婴儿中，这一比例为92%(12/13)。在12名存活的婴儿中，50%在2岁时神经学和发育结果正常。结论：胎龄、出生体重和组织学绒毛膜羊膜炎对妊娠合并胎膜早破的预后有重要意义。存活的婴儿有50%的机会在2岁时达到适当的健康状态。(C)2008年国际妇产科联合会。爱思唯尔爱尔兰有限公司出版。版权所有。
Objective: To assess neonatal outcome and 2-year follow-up of pregnancies complicated by second trimester preterm premature rupture of membranes (PPROM). Methods: A retrospective review of obstetric and neonatal records for 87 pregnancies (56 singletons, 6 twins, 1 triplet) with PPROM between 14 + 0 and 24 + 6 weeks of gestation. Patients received antibiotics and steroids for fetal lung maturity once they reached 24 weeks of gestation. Placentas were examined histopathologically. Surviving infants were followed-up at 2 years of age. Results: Median latency from PPROM to delivery was 4 days. Survival rate of 56 singletons was 45% (25/56); and 13 died in hospital. Survival rate of infants discharged from hospital was 23% (12/56). Chorioamnionitis was seen histologically in 42% (5/12) of surviving infants compared with 92% (12/13) of those that died in hospital. Of the 12 surviving infants, 50% had a normal neurological and developmental outcome at 2 years of age. Conclusion: Gestational age, birth weight, and histologic chorioamnionitis have prognostic importance in pregnancies complicated by PPROM. Surviving infants have a 50% chance of achieving an adequate health status at 2 years of age. (C) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.