文献詳細
今月の臨床 早産─ワンランク上の予防と管理
早産の管理
文献概要
preterm PROMは早産の主な原因の1つで,産科日常臨床において,よく遭遇する疾患である.切迫早産と同様,絨毛膜羊膜炎(chorioamnionitis : CAM)と深い関連(原因の場合もあるし,続発する場合もある)がある.したがって母児の感染や胎児炎症反応症候群(fetal inflammatory response syndrome : FIRS)を念頭においた管理が求められる.切迫早産と異なるところは,羊水の持続的流出の結果,羊水過少に起因する胎児異常,すなわち臍帯圧迫による胎児機能不全が発生しやすいことである.また,羊水過少の期間が長期化する場合,胎児肺低形成や姿勢の異常,骨格の変形が見られることもある.その他,臍帯や四肢の脱出,さらに常位胎盤早期剥離など,突発的な産科異常発生の危険性をともなう場合もある.したがって,分娩に至るまで,常に綿密な母児管理が求められる疾患であるといえる.
参考文献
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