Clinical Analysis on 147 Cases of Preterm Premature Rupture of Membrane

Objective:To investigate the impacts of management and delivery methods for preterm premature rupture of membrane (PPROM) on the maternal and neonatal outcomes. Methods:The clinical data of 147 pregnant women who experienced PPROM during 28-36+6 weeks were analyzed retrospectively. These cases were divided into 2 groups according to the pregnancy weeks:the group of 28-34+6 weeks and the group of 35-36+6 weeks. The relationships between different delivery methods and neonatal outcomes,as well as between intrauterine infection and the time from membrane rupture to delivery were analyzed. Results:There were no significant differences of cesarean section rates between the 2 groups (P0.05). The incidences of various neonatal complications in the 28-34+6 group were significantly higher than the 35-36+6 group (P0.01),while the birth weights and Apgar scores were much lower than the 35-36+6 group (P0.01). And the lasting time of neonates hospitalization in the 28-34+6 group was obviously longer than the 35-36+6 group (P0.01). The proportion of intrauterine infection in cases with ≥48 h after PPROM was markedly higher than those within 48 h (P0.01). Prolonged gestational age for the 35-36+6 group didn't lead to significant improvements in neonatal outcomes (P 0.05). Conclusion:Expectant management is suitable for patients experienced PPROM during 28-34 +6 weeks with the depth of amnitotic fluid 2 cm and no infections. Termination of pregnancy should be operated when PPROM happens during 35-36 +6 weeks. Vaginal delivery should be selected if there are no definite cesarean section indications,while cesarean section should be performed with operative indications and infections.