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      什么是胎膜早破

      【导读】胎膜早破是指妊娠中晚期或临产前胎膜破裂,羊水自阴道突然流出的情况。了解了什么是胎膜早破之后,孕妈妈们还得知道,胎膜早破对于母体和胎儿都是非常危险的,严重的可能会造成新生儿病死。因此,一旦发现有胎膜早破的情况,应立即进行治疗。

      胎膜早破是围生期最常见的并发症,对孕妇、产妇、胎儿和新生儿来说,胎膜早破是极其容易造成严重不良后果的。

      胎膜早破指的就是妊娠中晚期或临产前胎膜破裂,羊水自阴道突然流出。如果怀孕的周数小于37周,那么这种情况下的胎膜早破又称为早产,也即我们常说的未足月。

      羊膜腔压力增高,支原体感染,胎儿先露部与骨盆入口衔接不好,孕妇缺乏铜、锌微量元素等情况,都可能是造成胎膜早破的原因。

      无论对于孕妇本身还是胎儿来说,胎膜早破都是有危险的。胎膜早破可导致早产率升高,围生儿病死率增加,宫内感染率及产褥感染率均升高。

      胎膜早破是指临产前胎膜自然破裂,一般来说,孕妇可以从以下方面入手,判断自己是否有胎膜早破的症状。

      1、孕妇可以自己判断是否有如下情况:有或没有各种原因突然阴道排液,且排液的量可多可少。排液的话通常为持续性,但持续的时间各不相同,开始时,排液量多,随后逐渐减少。少数为间歇性排液。阴道的排液通常与孕妇体位的变动、活动与否有关。

      2、医生诊疗判断方法:孕妇仰卧位,可能见到阴道口有液体流出,也可能无任何液体流出;如无液体流出,肛查时上托阴道后穹隆、上推胎头、按压宫底或孕妇变动体位可有液体由阴道口流出,注意这些辅助操作后可能仍不见液体流出。所流出的液体通常稀薄,可能混有胎粪或胎脂。

      以上“胎膜早破的症状”分别是孕妇自身及医生方面给出的答案。

      胎膜早破对于孕妇和宝宝都是非常不利的,它是指孕妇在临产前胎膜自然破裂了。为了更好地避免悲剧的发生,我们要先来了解胎膜早破的原因,以对症下药。

      胎膜早破的原因:

      1、感染:胎膜早破导致宫腔感染是传统的胎膜早破和感染的因果关系,医学上早已普遍认识到感染和胎膜早破互为因果关系,而且感染是胎膜早破的最重要原因。

      2、胎膜发育不良:除胎膜本身的因素外,孕妇在孕早期有维生素C缺乏、铜缺乏和吸烟等情况的话,也都与胎膜的发育不良有关。

      3、子宫颈功能不全:在非妊娠的状态下,子宫颈内口若可以无阻力地扩大到8.0号,就可以诊断子宫颈功能是否不全,子宫颈功能不全的话,主要表现在内口松弛和峡部缺欠。

      4、宫腔内压力异常:宫腔内压力不均的情况,常见于头盆不称和胎位异常;宫腔内压力过大的情况,常见于双胎妊娠、羊水过多、剧烈咳嗽和排便困难等。

      5、创伤和机械性刺激:这种刺激主要分为医源性和非医源性2类。医源性的包括多次羊膜腔穿刺,多次阴道检查和剥膜引产等;而非医源性常见的为妊娠晚期的性交活动。

      胎膜早破对母体和胎儿都会产生较为严重的影响,具体来说,可包括以下几个方面:

      1、大多数的早产与胎膜早破有关。早产儿易发生新生儿呼吸窘迫综合征、胎儿及新生儿颅内出血、坏死性小肠炎等并发症,围生儿死亡率增加。

      2、可能导致宫内感染。这种情况会致胎心率快、子宫有压痛,若羊水有臭味,则表明感染已较严重。宫内感染对围产儿尤其是早产儿的危险很大,其败血症、肺炎等的发生率很高,是围产儿死亡的重要原因。

      3、胎膜早破是难产的信号。胎位异??傻贾绿ツぴ缙?,因此,发生了胎膜早破的准妈妈应注意检查自己有无骨盆狭窄、头盆不称及头位异常的情况。发生难产的话,产程必然延长,这样容易导致宫内感染。

      4、产后出血。宫内感染可以累及蜕膜和子宫肌层,影响子宫收缩而使出血增加,严重者需切除子宫。

      5、羊水栓塞。胎膜早破后静点催产素时,如催产素使用不当,可迫使羊水特别是含有胎粪的羊水从子宫颈静脉进入母体循环。羊水栓塞严重威胁产妇的生命。

      6、脐带脱垂或受压。胎先露未衔接者,破膜后脐带脱垂的危险性增加;因破膜继发性羊水减少,使脐带受压,亦可致胎儿窘迫。如果羊水流完,可导致“干产”。

      总之,胎膜早破的影响不容小觑,妈妈们要多留个心眼!

      胎膜在临产前自然破膜,称为胎膜早破。胎膜发育不良或感染,腹压急剧增加,孕晚期性交等均可成为胎膜早破的原因,胎膜早破的影响颇大,因此,一旦发现,还需及早进行护理。

      可以采取的胎膜早破的护理措施如下:

      1、减轻焦虑、配合治疗

      医生应向孕妇及家属说明其目前的情况,并说明医护人员采取处理措施的目的意义,指导配合治疗与监护,协助孕妇做好各种生活护理,减轻孕妇的焦虑。

      2、防止脐带脱垂,促进围生儿健康

      胎膜已破的,脐带随羊水从胎先露部与骨盆入口的空隙处脱出于子宫颈外口,降至阴道甚至外阴者,称脐带脱垂。

      胎膜早破后,应立即进行肛查或阴道检查,了解先露高低,宫口情况,及有无脐带脱垂。若宫口未开全,先露未入盆,应立即卧床并抬高臀部侧卧位,禁灌肠,并及时听取胎心音,进行严密监护。若发现脐带脱垂者,宫口未开全,则应立即氧气吸入,在胸膝卧位下,带无菌手套将脐带送回宫腔,并做好即行剖宫产准备。若宫口开全,应协助立即助产。

      3、防感染

      ①保持外阴清洁,每日2次外阴擦洗,并勤换消毒卫生垫。

      ②观察羊水量、性质、颜色、气味,注意是否混有胎粪,尤其是头先露者。

      ③观察体温变化,每日测体温4次,若体温上升,白细胞计数升高,血清C-反应蛋白升高,均提示宫内感染,应及早处理。

      ④绝对卧床休息,尽量少做肛查或阴道检查,必要时必须在无菌下进行。

      ⑤破膜超过12小时,可考虑应用抗生素预防感染,超过24小时尚未临产,应按医嘱给予引产。

      4、防早产

      若破膜发生于妊娠37周以前,在预防感染和预防脐带脱垂的护理下,建议保守治疗。在保守治疗中,应尽量避免干扰,少作肛查和阴道检查。并定期监测胎儿,以了解胎儿在宫内的情况,一旦发生异常现象,应及时报告医生,终止妊娠。

      以上就是可以采取的胎膜早破的护理措施。

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