ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT CỤC THAI KỲ Ở THAI 24-34 TUẦN ỐI VỠ NON TẠI BỆNH VIỆN PHỤ SẢN THÀNH PHỐ CẦN THƠ NĂM 2023-2024

Abstract

Background: Premature rupture of membranes is the rupture of the amniotic membrane during- labor, with no uterine contraction, about 12% in pregnancy and 8% in term pregnancy. This is a common complication in pregnancy, especially in preterm prelabour rupture of membranes (before 37 weeks, especially 32 weeks, about 1% before 31 weeks. Objectives: Describe the clinical, subclinical and outcome of pregnancy in preterm prelabour rupture of the membranes in Can Tho Hospital of Gynecological and Obstetrics. Materials and methods: Pregnant women hospitalised and born at Can Tho Hospital of Gynecological and Obstetric from 04/2023 đến 04/2024. Results: Clinical characteristics: The reason for hospital admission is abnormal vaginal discharge, accounting for 50.3%. The average gestational age is 29.84 ± 2.98 weeks (ranging from 24 to 34 weeks). Characteristics of premature rupture of membranes: leaking amniotic fluid accounts for 89.72%, with clear white fluid accounting for 98.72%; the density of the amniotic fluid is thin in 90.70% of cases; the average amount is 73.66% and a large amount is 20.80%. The average time from membrane rupture to hospital admission is 79 ± 64.77 minutes (ranging from 9 to 480 minutes). Paraclinical features: anemia (Hb below 11g/dl) accounts for 20.96%; average white blood cell count is 14.24 ± 4.22 (10.3 - 23.4 x10^9/L), with 23.98% having white blood cells above 15,000/mm^3. Pregnancy outcomes in patients with premature rupture of membranes over preterm infants: 65.83% had adequate doses of corticosteroids before birth. Of the 78 cases of premature rupture of membranes over preterm infants, 50 required emergency cesarean delivery, accounting for 64.10%; vaginal deliveries accounted for 35.90%; the reason for emergency cesarean was fetal distress during labor, accounting for 48.43%; previous cesarean scars with rupture accounted for 23.51%, labor arrest accounted for 8.77%; and 5.66% of cases involved breech presentation. The average birth weight of the infants was 2213.49 ± 324.34 grams (ranging from 760 grams to 2900 grams); normal Apgar scores accounted for 61.51% and abnormal Apgar scores accounted for 38.49%, which is the proportion of neonates requiring resuscitation primarily due to respiratory distress. Resuscitation cases were managed with NCPAP breathing treatment. Conclusion: Cases of preterm rupture of membranes are prone to increase.