Clinical study on spontaneous premature rupture of fetal membranes

의학과/석사[한글] CLINICAL STUDY ON SPONTANEOUS PREMATURE RUPTURE OF FETAL MEMBRANES Sang Hur, M.D. Department of Medical Science, The Graduate School, Yonsei University (Directed by Professor Hyun Mo Kwak, M.D., Associate Professor Sang Whan Song, M.D.) The premature rupture of fetal membranes (S.P.R.M.) is defined as spontaneous rupture of fetal membranes before the onset of labor. The S.P.R.M. is a cause of perinatal death and morbidity as well as a cause of meternal morbidity. Spontaneous labor develops in most cases within 24 hours after S.P.R.M.: however, S.P.R.M. developing before the 36 week of gestation and prolonged lag period near term pregnancy remains an obstetric problem in terms of prevention of perinatal and maternal morbidity. Five hundred sixty seven cases of S.P.R.M. who were admitted to Severance Hospital during the last 7 years were analyzed clinically to gather data for improving obstetric results in the future. The results are as follows: 1. The incidence of S.P.R.M. was 9.70%. 2. Toxemia and incompetent internal os of cervix were the most common diseases in S.P.R.M. before the 36th week of gestation and toxemia was the most prevalent underlying complication in S.P.R.M. developing after the 36th week of gestation. 3. Antepartal anemia was present in 15.12% of S.P.R.M. cases and in 25.39% of cases rupturing before the 36th week of gestation. 4. S.P.R.M. developed in 31.31% of the cases between 0:0.1 a.m. to 6:00 a.m. 5. Abnormal fetal presentation was present in 10.58% and breech presentation, transverse lie and compound presentation were present in 8.94%, 1.09% and 0.55% respectively. 6. Seasonally, S.P.R.M. was most prevalent in the summer, as 32.27%. 7. Twin pregnancy rate was 2.29% among S.P.R.M. 8. The cesarean section rate was 10.05%. 9. By and large, maternal postpartum morbidity was higher than general maternity cases, and the longer lag period the higher the maternal postpartum morbidity. 10. Fetal distress developed more frequently in cases of S.P.R.M. given oxytocin than in those not given oxytocin. 11. The perinatal mortality rate was 6.30%. [영문] The premature rupture of fetal membranes (S.P.R.M.) is defined as spontaneous rupture of fetal membranes before the onset of labor. The S.P.R.M. is a cause of perinatal death and morbidity as well as a cause of meternal morbidity. Spontaneous labor develops in most cases within 24 hours after S.P.R.M.: however, S.P.R.M. developing before the 36 week of gestation and prolonged lag period near term pregnancy remains an obstetric problem in terms of prevention of perinatal and maternal morbidity. Five hundred sixty seven cases of S.P.R.M. who were admitted to Severance Hospital during the last 7 years were analyzed clinically to gather data for improving obstetric results in the future. The results are as follows: 1. The incidence of S.P.R.M. was 9.70%. 2. Toxemia and incompetent internal os of cervix were the most common diseases in S.P.R.M. before the 36th week of gestation and toxemia was the most prevalent underlying complication in S.P.R.M. developing after the 36th week of gestation. 3. Antepartal anemia was present in 15.12% of S.P.R.M. cases and in 25.39% of cases rupturing before the 36th week of gestation. 4. S.P.R.M. developed in 31.31% of the cases between 0:0.1 a.m. to 6:00 a.m. 5. Abnormal fetal presentation was present in 10.58% and breech presentation, transverse lie and compound presentation were present in 8.94%, 1.09% and 0.55% respectively. 6. Seasonally, S.P.R.M. was most prevalent in the summer, as 32.27%. 7. Twin pregnancy rate was 2.29% among S.P.R.M. 8. The cesarean section rate was 10.05%. 9. By and large, maternal postpartum morbidity was higher than general maternity cases, and the longer lag period the higher the maternal postpartum morbidity. 10. Fetal distress developed more frequently in cases of S.P.R.M. given oxytocin than in those not given oxytocin. 11. The perinatal mortality rate was 6.30%.restrictio