Abstract:

The causes of PPROM are multifactorial，but infection is the primary cause.Infection appears to either as a cause or as a consequence of PROM.Application of antibiotics in PPROM can reduce the morbidity rate and prolong the duration of pregnancy.After the diagnosis of PPROM，it is necessary to screen B streptococcus carriage of the vagina and perianal region and perform culture of midstream urine，and use broad spectrum antibiotics at the same time for those who expect to prevent miscarriage.The antibiotic regimen consists of 48 hours of intravenous therapy followed by five days of oral medications with a combination of ampicillin and erythromycin.It may be reasonable to administer erythromycin alone for women who are allergic to ampicillin.For positive group B streptococcus carriage or penicillin allergens appropriate antibiotics should be used.The benefit is greater at earlier gestational ages（＜32 weeks）.Induction is recommended at later gestational ages（＞34 weeks）.The use of antibiotics is according to individual circumstances.Women with PPROM and positive group B streptococcus carriage should receive intrapartum GBS prophylaxis to prevent vertical transmission regardless of earlier treatments.For those seriously infected，the use of broad-spectrum antibiotics should be used.

Key words: preterm birth, preterm premature rupture of membrane, antibiotics

摘要：

未足月胎膜早破（PPROM）病因复杂，但感染是首要病因。PPROM与感染互为因果。PPROM应用抗生素可以降低母儿发病率及延长孕周。PPROM确诊后通过评估适宜期待保胎者应第一时间行阴道和肛周的B族溶血性链球菌（GBS）筛查和中段尿培养，同时应用广谱抗生素。抗生素的选择建议氨苄青霉素联合红霉素，开始为静脉滴注，48 h后口服，共用药7 d。对于青霉素过敏者，应单独使用红霉素类抗生素。但GBS（+），青霉素过敏者应启动其他敏感药物，孕周小于32周者应用抗生素治疗的益处更为明显。孕周≥34周者则建议积极引产。是否应用抗生素根据个体情况决定，GBS（+）者即使之前应用了抗生素治疗，在临产后仍应针对GBS应用青霉素类药物预防母胎感染。严重感染者，注意选用更广谱的抗生素。

关键词: 早产, 未足月胎膜早破, 抗生素