A nationwide study of obstetric management and outcomes in premature rupture of membrane at term: Report from the Perinatology Committee, Japan Society of Obstetrics and Gynecology, 2017?2018
A nationwide study of obstetric management and outcomes in premature rupture of membrane at term: Report from the Perinatology Committee, Japan Society of Obstetrics and Gynecology, 2017?2018
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一项关于足月胎膜早破的产科管理和结果的全国性研究：日本妇产科学会围产期委员会的报告，2017 年至 2018 年
DOI：
10.1111/jog.15450
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发表时间：
2022
影响因子：
1.6
通讯作者：
Kanayama Naohiro
中科院分区：
文献类型：
--
作者：
Oda Tomoaki;Mitsuda Nobuaki;Miyakoshi Kei;Makino Shintaro;Ishii Keisuke;Kurasawa Kentaro;Kubo Takahiko;Shimoya Koichiro;Ikeda Tomoaki;Kanayama Naohiro
目的这项全国性的研究旨在探讨足月胎膜早破（PROM）的实际管理及其与孕产妇和新生儿结局的关系。方法我们对2016年参加日本妇产科学会日本围产期登记网络的415家机构进行了问卷调查。患者为足月胎膜早破后期待阴道分娩的妇女，无临床绒毛膜炎。我们根据胎膜早破后期待治疗的持续时间（24、24和48小时内）将设施分为三组。此外，我们使用日本围产期登记网络数据库2016分析了围产期结局与管理方案之间的关系。结果在415家机构中，有346家（83.4%）完成并返回了调查。在231个具有管理协议的设施中，167个设施（72.3%）从PROM到分娩的间隔为3天是可以接受的。149家机构（64.5%）回答称，他们没有进行机械性宫颈扩张，90家（39.0%）使用催产素作为子宫收缩剂，无论宫颈成熟与否。211家医院（91.3%）制定了对B组链球菌阳性患者使用抗生素的政策。新生儿出生时的结果和剖宫产和产后发热的频率并没有显着差异three groups.ConclusionsMost设施在日本围产期登记网络管理妇女在足月分娩后3天内关注细菌感染胎膜早破。与胎膜早破后立即引产相比，胎膜早破后48小时内的期待治疗并没有增加产后发热的风险。
AimThis nationwide study aimed to investigate the practical management of term premature rupture of membrane (PROM) and its relationship with maternal and neonatal outcomes.MethodsWe conducted a questionnaire survey of 415 facilities participating in the Japan Perinatal Registry Network of the Japan Society of Obstetrics and Gynecology in 2016. The patients were women expecting vaginal birth after PROM at term without clinical chorioamnionitis. We classified the facilities into three groups based on duration of the expectant management after PROM (within 24, 24, and 48 h). Furthermore, we analyzed the association between perinatal outcomes and management protocol using the Japan Perinatal Registry Network Database 2016.ResultsOf 415 facilities, 346 (83.4%) completed and returned the survey. Among 231 facilities with management protocols, an interval of 3 days from PROM to delivery was acceptable in 167 facilities (72.3%). One hundred forty‐nine facilities (64.5%) responded that they did not perform mechanical cervical dilation, and 90 (39.0%) used oxytocin as a uterotonic irrespective of cervical maturation. The number of hospitals that had a policy to administer antibiotics to Group B streptococcus‐positive patients was 211 (91.3%). Neonatal outcomes at birth and the frequency of cesarean section and postpartum fever did not differ among the three groups.ConclusionsMost facilities in the Japan Perinatal Registry Network managed women at term to delivery within 3 days after PROM with attention to bacterial infection. Expectant management up to 48 h after PROM did not increase the risk of postpartum fever, compared to labor induction immediately after PROM.