|
Abstract: Objective：To study the precise timing of labor induction in GDM women with term premature rupture of membranes and its infuence on maternal and neonatal outcomes. Methods：A retrospective analysis was performed on 585 pregnant women with premature rupture of membranes at term without other comorbidities and complications except GDM in Nanjing Maternal and Child Health Hospital between June 2017 and July 2021，which were divided into three groups according to the interval time(P-O)between preterm rupture of membranes and initiation of oxytocin induction：group A(2~6 h)，group B(6~9 h)，group C(9~12 h). The general clinical data，maternal and neonatal outcomes of the cases in the three groups were statistically analyzed. Results：①The time from premature rupture of membranes to delivery(P-D)increased with the delay of induction of labor initiation(P-O)(Ptrend ＜ 0.05)，with the shortest P-D time in group A(P ＜ 0.05). ②The incidence of cesarean delivery，interpartum fever，chorioamnionitis，and intrauterine distress increased with the prolongation of P-O(Ptrend ＜ 0.05)，of which the incidence was the lowest in group A(P ＜ 0.05)；no statistical difference was found in the incidence of uterine contraction weakness，postpartum hemorrhage，and puerperal disease in the three groups. ③The incidence of cesarean delivery due to uterine atony increased with the delay of P-O in the three groups(Ptrend ＜ 0.05). ④ The incidence of neonatal sepsis and neonatal intracranial hemorrhage in group A was significantly lower than that in group C(P trend＜0.05)，incidence were significantly lower than those in group C(P ＜ 0.05). Conclusion：In pregnant women with GDM and PROM at term，to exclude other complications and contraindications to vaginal delivery，the choice of oxytocin induction of labor within 2~6 h can both reduce the use of clinical antimicrobials and significantly reduce the incidence of adverse maternal and neonatal outcomes.
|