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由于顾虑胎膜早破或破膜过久(PROM)而致母婴感染,临床采取择期分娩常带来早产的新问题。积极干预反可增加母婴感染率和死亡率。故目前在破膜过久处理上趋向于保守。 Kappy等随访188例PROM患者,其中对孕28～34周者进行保守处理:每天全血计数、查心肺体征、子宫触痛程度和胎心率,每4小时测量体温。如发生感染,给以氨苄青霉素和庆大霉素。若胎龄超过37周,宫颈成熟则引产。若宫颈不成熟则积极监护。用此法仅1例婴儿发生败血症(B型β-溶血性链球菌)。Fayez等对早破膜病例进行前瞻性研究,观察组:74例,胎龄<34周,保守观察直至自然分娩或达34周,除非有败血症才进行干预。引产组:53例,胎龄≥34周,在破膜
Due to concerns of premature rupture of membranes or rupture of membranes (PROM) and maternal and child infections, clinical elective delivery often brings new problems of premature birth. Positive intervention can increase mother-infant infection and death rates. It is too long in the rupture of membranes tends to be conservative. Kappy and other 188 cases of follow-up PROM patients, including pregnant 28 to 34 weeks for conservative treatment: daily blood count, check cardiopulmonary signs, uterine tenderness and fetal heart rate, body temperature measured every 4 hours. In case of infection, give ampicillin and gentamicin. If the gestational age more than 37 weeks, the cervix is mature abortion. If the cervix is not mature, then active guardianship. Only one case of infant sepsis (type B beta-hemolytic streptococcus) was used in this method. Fayez and other prospective study of rupture of membranes cases, the observation group: 74 cases, gestational age <34 weeks, conservative observation until spontaneous delivery or up to 34 weeks, unless there is sepsis intervention. Induction group: 53 cases, gestational age ≥34 weeks, in the rupture of membranes