ĐẶC ĐIỂM VÀ THÁI ĐỘ XỬ TRÍ ỐI VỠ NON Ở TUỔI THAI TỪ 28 TUẦN 0 NGÀY ĐẾN 33 TUẦN 6 NGÀY TẠI KHOA ĐẺ BỆNH VIỆN PHỤ SẢN HÀ NỘI NĂM 2022

Abstract

Objective: To describe the clinical characteristics, paraclinical features, and management attitudes towards preterm rupture of membranes (PROM) from 28 weeks 0 days to 33 weeks 6 days of gestation at the Delivery Department, Hanoi Obstetrics and Gynecology Hospital in 2022. Subjects and Methods: A cross-sectional descriptive study was conducted on 110 pregnant women with PROM from 28 weeks 0 days to 33 weeks 6 days of gestation at the Delivery Department, Hanoi Obstetrics and Gynecology Hospital from January 1, 2022, to December 31, 2022. Results: The mean age of pregnant women was 29.48 ± 5.78, with the majority being in the reproductive age group. The rate of genital tract infections was 13.64%, history of preterm birth and preterm PROM accounted for 12.72%, and multiple pregnancies, and multiple gestations accounted for 7.27%. Cases of PROM with gestational ages at the time of rupture ranging from 32 to under 34 weeks accounted for 70%, while those from 30 to under 32 weeks accounted for 17.3%. Evaluation of amniotic fluid status by ultrasound upon admission revealed normal fluid in 64.1% of cases, oligohydramnios in 25.7%, and absent amniotic fluid in 10.2%. The first tests showed increased neutrophilic leukocytes in 41.8% of cases, neutrophilic leukocytosis and elevated C-reactive protein (CRP) in 16.4%, and elevated CRP in 7.3%. The majority of cases initially received expectant management, accounting for 74.5%, followed by labor at 16.4%, C-sections at 16.4%, and the least common being induction of labor at 0.9%. Among cases receiving conservative treatment, 48.78% were treated with antibiotics and corticosteroid therapy, 40.24% received combined antibiotic, tocolytic, and corticosteroid therapy. Conclusion: The majority of pregnant women with PROM belonged to the gestational age group from 32 to under 34 weeks, accounting for 70%. Upon admission, oligohydramnios was present in 25.7% of cases, and absent amniotic fluid in 10.2%. The rate of conservative treatment to maintain pregnancy was 74.5%.