孕期TCT结果与胎膜早破及母婴预后的关系

Relationship between papanicolaou test result in pregnancy and prerupture of membrane and perinatal outcome

目的 探讨孕期薄层液基细胞学涂片法 (Thinpreppap ,TCT)检查结果与胎膜早破和母婴预后之间的关系。方法 收集 2 0 0 1年于我院分娩的我院产前资料完整的患者 5 2 0例 ,回顾性分析产前初诊时TCT检查结果 ,统计学分析TCT检查结果和胎膜早破发生和母婴预后的关系。结果 5 2 0例中总共有 95例 (1 8 3% )发生胎膜早破。TCT提示有炎性细胞涂片的有 88例 ,其中有 1 7例 (1 9 3% )发生胎膜早破 ,与对照组 (78/ 4 32 ,1 8 1 % )无明显统计学差别 (χ2 =0 0 78,P >0 0 5 )。TCT提示线索细胞超过 2 0 %、念珠菌感染和滴虫感染的分别有 2 3例、 5 9例和 6例。这些患者发生胎膜早破的比例分别为 1 7 4 % (4 / 2 3)、 2 2 0 % (1 3/ 5 9)和 1 / 6 ,和对照组没有明显的统计学差别。对比TCT有炎性细胞涂片和正常涂片两组早产的发生率 (3/ 84vs 1 0 / 4 32 )、新生儿窒息 (1 / 88vs 2 / 4 32 )、 1minApgar评分小于 1 0分 (4 / 88vs 1 5 / 4 32 )、出生体重 [(3346± 373)gvs (331 0± 4 92g) ]、剖宫产率 (5 6 8%vs 5 9 3% )均未发现有明显的统计学差别。结论 TCT的结果提示有炎症细胞涂片、线索细胞超过 2 0 %、念珠菌性阴道炎、滴虫感染与胎膜早破的发生之间没有统计学相关性。

Objective To analysis the relationship between papanicolaou test during pregnancy and the incidence of prerupture of membrane (PROM) and perinatal outcome.Methods 520 cases with papanicolaou test (thinpap smear) in the first prenatal care were collected,women were followed till delivery.The relationship between thinpap smear results and the incidence of PROM and perinatal results were analyzed statistically.Results There were 95 PROM in 520 women (18 3%).88 cases were reported with inflammatory by pap smears,in which 17 (19 3%) cases had PROM.It was not significantly different from the control group(χ 2=0 078, P> 0 05).There were 23,59 and 6 cases with clue cell more than 20%,moniliasis infection and trichomoniasis infection in thinpap smear respectively.The incidence of PROM in these patients was 17 4%(4/23)?22 0%(13/59)and 1/6 respectively,which was not significantly different form the control group.Perinatal results were analyzed between women with inflammatory thinpap smear and normal ones.The incidence of preterm labor(3/84 vs.10/432), newborn asphyxia(1/88 vs.2/432),one-minute Apgar score less than 10(4/88 vs.15/432),birth weight[(3346±373)g vs.(3310±492g)]and Cesarean rate(56 8% vs.59 3%)were not significantly different between the two groups.Conclusions The incidence of PROM of women with inflammatory thinpap smear,clue cell more than 20%,moniliasis infection and trichomoniasis infection during pregnancy is not different from the control group.The perinatal outcome with inflammatory thinpap smear is not different from the control group.