在妊娠23周以下可能发生膜破裂后的新生儿结局
Agnes Grill1, Fanny Mikula2, Sophie Jansen1
1Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
European journal of pediatrics
|July 25, 2025
概括
对于23周前的早产性膜破裂 (pPROM),破裂时的妊娠年龄和分娩时间显著影响婴儿的生存和健康结果. 咨询应考虑这些关键预测因素,以获得更好的患者指导.
科学领域:
- 新生儿科学 新生儿科学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 周围生理学 周围生理学
背景情况:
- 在怀孕23周之前治疗早产前膜破裂 (pPROM) 的咨询是具有挑战性的,因为数据有限,结果不尽相同.
- 现有的关于在pPROM后出生在生存极限的婴儿的结局数据很少,这使临床决策复杂化.
研究的目的:
- 提供有关早产婴儿的结果的机构特定数据,这些婴儿在怀孕23周之前出生后出生.
- 在这个高风险人群中确定生存和严重的短期发病率的关键预测因素.
- 为了改善对孕妇的咨询,经历pPROM在或接近生存能力的极限.
主要方法:
- 追溯队列研究分析了2009-2022年的数据.
- 纳入标准:怀孕23周+0周以下的早产婴儿接受活跃的新生儿护理.
- 主要结局:生存率和没有严重短期发病率的生存率 (IVH III,PVHI,cPVL,ROP).
主要成果:
- 总体生存率为69.7%;在109名分析患者中,没有严重发病的生存率为51.4%.
- 随着出生时妊娠年龄的增加,生存率和无发病率的生存率都显著改善.
- 在pPROM时更高的妊娠年龄和更长的延迟到分娩是没有严重发病率的生存的重要预测因素. 新生儿早发性败血症发生在18.3%的病例中.
结论:
- 在pPROM<23+0周妊娠后出生的婴儿的机构特异性数据对临床实践至关重要.
- 在pPROM时的妊娠年龄和到分娩的潜伏时间是早产婴儿生存和完整生存的关键预测因素.
- 这些发现增强了为患有接近生命限度的pPROM孕妇提供咨询的能力.
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