通讯作者: 罗青清, luoqq822@126.com

DOI：10.12201/bmr.202504.00048

Clinical characteristics of premature rupture of membranes complicated with histological chorioamnionitis

• 摘要：目的：分析胎膜早破（Premature rupture of membrane, PROM）并发组织学绒毛膜羊膜炎（Histologic Chorioamnionitis, HCA）的临床特征，为此类孕妇及其新生儿的临床管理提供思路。方法：回顾性分析2021年01月-2021年12月在西南医科大学附属医院分娩并行胎盘胎膜病理学检查的PROM孕妇病例共202例，根据组织病理学结果将孕妇分为HCA组和对照组（151例 vs. 51例），比较分析两组孕妇产前因素及短期母胎妊娠结局。结果：HCA组羊水污染率（19.6%28/151 vs. 6.0%3/51）、白细胞（White Blood Cell, WBC）总数（10.26 vs. 9.72 *109//L)、中性粒细胞（neutrophile granulocyte, NEU）数量（8.14 vs. 7.74*109//L）及血清淀粉样蛋白（Serum Amyloid A, SAA）水平（2.99 vs. 1.76 mg/L）显著高于对照组（P＜0.05）；HCA组新生儿早发型败血症发生率明显高于对照组（49.7%75/151 vs. 25.5%13/51, P＜0.05）。结论：PROM并发HCA时，新生儿发生早发型败血症风险明显增加，应加强对此类新生儿的筛查并尽早干预治疗。羊水污染以及母体感染指标增高与HCA发生相关，具有预测HCA发生的潜在价值。

  关键词： 组织学绒毛膜羊膜炎; 胎膜早破; 母儿结局

   

  Abstract: Abstract: Objective: To analyze the clinical features of premature rupture of membranes (PROM) complicated with histologic chorioamnionitis (HCA), and to provide insights for clinical management of such pregnant women and their newborns. Methods: A total of 202 cases of PROM pregnant women who gave birth in the Affiliated Hospital of Southwest Medical University from January 2021 to December 2021 were retrospectively analyzed. According to the histopathological results, the pregnant women were divided into HCA group and control group (151 cases vs. 51 cases), and the prenatal factors and short-term maternal-fetal pregnancy outcomes of the two groups were compared and analyzed. Results: The amniotic fluid contamination rate (19.6% 28/151 vs. 6.0% 3/51), white blood cell (WBC) count (10.26 vs. 9.72 *109//L), neutrophil (Neu) count (8.14 vs. 7.74*109//L) and serum amyloid A (SAA) levels (2.99 vs. 1.76 mg/L) in HCA group were significantly higher than those in control group (P<0.05). There was a higher?incidence of early neonatal septicemia in HCA group than in control group (49.7% 75/151 vs. 25.5% 13/51, P<0.05). Conclusion: The risk of early-onset sepsis in neonates with PROM complicated with HCA significantly increases. It is necessary to strengthen the screening and early intervention in such cases. Amniotic fluid contamination and increased maternal infection indicators are associated with the occurrence of HCA, which may serve as potential indicators of HCA.

  Key words: Histological chorioamnionitis; Premature rupture of membranes; Mother-child outcome.

  提交时间：2025-04-16

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• 序号	提交日期	编号	操作
  1	2025-03-31	bmr.202504.00048V1	下载

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