全球精选文摘 - 自然发作后“胎膜早破”是剖宫产的危险因素之一

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自然发作后“胎膜早破”是剖宫产的危险因素之一

“Early rupture of membranes” after the spontaneous onset of labor as a risk factor for cesarean delivery

Lee SM, Lee KA, Lee JH 2010/7/30 15:42:55

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Eur J Obstet Gynecol Reprod Biol, 2010,

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Objective:
The objective of this study was to examine if patients with “early rupture of membranes (ROM)” after spontaneous onset of labor are at increased risk of cesarean section.

Study Design:
The rate of cesarean section was examined in 447 term singleton nulliparas who were admitted after the spontaneous onset of labor. The cases were divided into 2 groups: (1) “early ROM”, defined as ROM at a cervical dilatation <4cm (n=109); and (2) “late ROM”, ROM at a cervical dilatation ≥4cm (n=338).

Results:
(1) “Early ROM” occurred in 24.4% of the cases and the overall cesarean section rate was 5.6%; (2) there were no significant differences in the clinical characteristics including prepregnancy BMI, proportion of complicated pregnancies, total duration of labor, proportion of regional anesthesia, gestational age at delivery, and birthweight between the two groups of cases. However gravidas with “early ROM” were of advanced maternal age and had less cervical dilation on admission, shorter duration of 1st stage of labor, and more frequent use of oxytocin augmentation; (3) patients with “early ROM” had a threefold higher rate (11.9% vs. 3.6%) of cesarean section and a fourfold higher rate (11.9% vs. 3.0%) of cesarean section due to failure of progress than did those with “late ROM” (p<0.005 for each); (3) 92% (23/25) of cesarean sections were performed due to failure to progress; and (4) there was no significant difference in the rate of histologic chorioamnionitis between the two groups of cases.

Conclusion:
“Early ROM” after the spontaneous onset of labor is a risk factor for cesarean section in term singleton nulliparas.

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疾病资源中心

高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

直肠癌术后5个月，体检发现肝占位1个月——上海中山医院病例

贾户亮

复旦大学中山医院肝癌研究所

患者，女性，51岁，5个月前因直肠癌于外院行手术治疗，术后病理证实为直肠溃疡型低分化腺癌。术前检查发现肝脏多发实质占位，术前行化疗1次，术后行化疗4次，具体用药不详。病程中无发热、腹胀、腹痛、恶心、呕吐等症状。既往否认乙型肝炎病史，否认糖尿病病史。无特殊职业接触史，无家族遗传性病史。

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