摘要
目的:分析宫颈锥切术后妊娠期间胎膜早破(PROM)发生影响因素。方法:选择2016年3月-2020年9月于广东医科大学附属医院产科行宫颈锥切术后孕妇192例临床资料,其中PROM组52例、无PROM组140例,PROM孕妇中未足月PROM组13例、足月PROM组39例,记录孕妇年龄、孕期体质指数(BMI)、锥切手术方式等,于孕20~24周经阴道超声测量子宫颈长度(CL)。结果:PROM组年龄、孕前BMI、锥切方式为冷刀锥切术(CKC)及锥切术后6~12个月的比例均大于无PROM组,CL小于无PROM组(均P<0.05),PROM组与无PROM组经产妇、辅助生殖助孕、宫颈病变类型等无差异(P>0.05);年龄增加、孕前BMI增加、CKC手术及锥切术后6~12个月是发生PROM的独立危险因素(P<0.05),CL增加是PROM的独立保护因素(P<0.05);未足月PROM组年龄、CKC及锥切术后6~12个月的比例均大于足月PROM组,CL小于足月PROM组(均P<0.05),未足月PROM组与足月PROM组孕前BMI、经产妇、辅助生殖助孕、宫颈病变类型等无差异(P>0.05);CL增加是未足月PROM的独立保护因素(P<0.05);年龄、孕前BMI、CL预测PROM的最佳截断值为36岁、25.4kg/m^(2)、25.1mm,CL预测未足月胎膜早破的最佳截断值为23.6mm。结论:高龄、孕前肥胖及孕中期CL过短是宫颈锥切术后妊娠期间PROM发生的风险因素。
Objective: To analyze the factors influencing premature rupture of membranes(PROM) of pregnant women after conization of cervix. Methods: From March 2016 to September 2020, 192 pregnant women who had undergone conization of cervix were selected as the research objects, which included 52 cases with PROM in study group and 140 cases without PROM in control group. Among women in the study group, there were 13 cases with preterm premature rupture of membranes(PPROM) in group A and 39 cases with PROM after full term in group B. The age, the body mass index(BMI) during pregnancy, and the surgery method of conization of cervix of these women were recorded. The length of cervix(CL) of these women during 20-24 gestational weeks was measured by transvaginal ultrasound. Results: The age, the BMI value before pregnancy, the proportions of conization of cervix by cold knife conical(CKC) and pregnancy within 6-12 months after conization of cervix of the women in the study group were significantly higher than those of the women in the control group, the CL value of the women in the study group was significantly less than that of the women in the control group(all P<0.05). There were no significant differences in the proportions of pluripara and the pregnancy by assisted reproduction, and the types of cervical lesions of the women between the study group and the control group(P>0.05). The Age, the BMI value before pregnancy, surgery by CKC, and pregnancy within 6-12 months after surgery were the independent risk factors of PROM occurrence(P<0.05), and the CL was the independent protective factor of PROM occurrence(P<0.05). The age, and the proportions of surgery by CKC and pregnancy within 6-12months after surgery of the women in group A were significantly higher than those of the women in group B,but the CL value of the women in group A was significantly lower than that of the women in group B(all P<0.05).There were no significant differences in the BMI value before pregnancy,the proportions of pluripara and the pregnancy by as
作者
钟俊
黄思毅
郭玉峰
王青
ZHONG Jun;HUANG Siyi;GUO Yufeng;WANG Qing(Affiliated Hospital of Guangdong Medical University,Zhanjiang,Guangdong Province,524023;Yiling District Maternal and Child Health Care Hospital,Yichang,Hubei Province)
出处
《中国计划生育学杂志》
2022年第7期1689-1693,共5页
Chinese Journal of Family Planning
关键词
宫颈锥切术
胎膜早破
影响因素
Conization of cervix
Premature rupture of membranes
Influencing factors
