妊娠期外阴阴道假丝酵母菌病与围生期结局分析

The relationship between vulvovaginal candidiasis during pregnancy and perinatal stage outcome

目的研究不同孕期妊娠期外阴阴道假丝酵母菌病(VVC)发病及其与围生期结局的关系。方法选取在我院常规进行产前检查的孕妇376例,常规阴道分泌物检查,假丝酵母菌培养鉴定,完整收集患者的一般资料和围生期资料。结果376例患者假丝酵母菌涂片或培养阳性率为30.32%,发病率19.15%,共检出假丝酵母菌菌株114株,白色假丝酵母菌占总数的62.28%,早、中、晚孕的VVC发病率分别为32.77%、22.76%、35.07%,差异无统计学意义(P>0.05)。妊娠VVC患者组和携带组剖宫产率、产褥感染率,胎胎膜早破、早产、新生儿假丝酵母菌携带发生率明显高于对照组(P<0.05或<0.01)。结论妊娠期VVC发病率与孕期无相关性,妊娠VVC可致不良围生期结局,早期诊断、治疗十分必要。

Objective To investigate the relationship between vulvovaginal candidiasis （VVC） and the perinatal stage outcome during pregnancy. Methods 376 pregnant women were enrolled in the study. All the cases underwent routine vaginal secretion examination and detection of Candida cultivation. The data of common clinical manifestation and the outcome of perinatal stage were collected. Results In all the 376 cases, the culture positive rate was 30.32%, and morbidity was 19.15%. 114 strains candida were detected, and 62.28% of them were candida albicans. In early, middle, and late stage of pregnancy, the incidence of VVC was 32. 77%, 22.76% and 35.07% respectively, there were no significant differences among different stages （P 〉 0.05 ）. However the incidences of uterine-incision delivery, puerperal infection, premature rupture of membrane, premature birth, neonate fungi-phore, were significantly higher in VVC infection group than those in control group （ P 〈 0.05 or 〈 0. 01 ）. Conclusion The VVC infection during pregnancy is not related to the pregnant stage, however, which can result in adverse outcome during perinatal stage. It suggested that VVC infection should be diagnosed and treated as early as possible.