妊娠期下生殖道感染调查

Analysis of lower genital tract infection during gestational period

目的:调查妊娠期妇女下生殖道感染及不良妊娠结局的发生率。方法:对象为在天坛医院进行产前检查并住院分娩的412例孕妇,孕36周时取阴道及宫颈分泌物进行滴虫(T)、外阴阴道假丝酵母菌病(VVC)、细菌性阴道病(BV)、衣原体(CT)、支原体(UU或Mh)及B族-溶血性链球菌(GBS)检测。根据感染情况分为感染组和非感染组,并追踪两组患者不良妊娠结局的发生情况。结果:412例妊娠期妇女下生殖道感染总检出率为27.62%,单一病原菌感染者70例,检出率为16.99%,其中UU最多,检出率6.55%,BV次之,检出率2.91%。多种病原菌同时感染者44例,检出率10.68%,其中以BV合并其他病原菌感染者最多,检出率7.28%。感染组胎膜早破、未足月胎膜早破、早产、产褥感染、绒毛膜羊膜炎发生率均较非感染组高(与非感染组相比,P<0.05)。BV合并其它病原菌感染导致不良妊娠结局的总致病率为96.64%,远高于其它单一病原菌感染的致病率。结论:UU或BV合并其它病原微生物感染是妊娠期下生殖道感染中较常见的感染类型,相对于其它单一病原体感染,BV合并其它病原菌感染更易导致不良妊娠结局的发生,有必要对妊娠期妇女进行下生殖道感染的筛查和治疗。

Objective：To study the incidence of lower genital tract infection during gestational period and its influence on adverse pregnancy outcomes.Methods：The secretion of vagina and cervix from 412 cases who had been pregnant for 36 weeks were sampled to be tested for trichomoniasis （T）,vulvovaginal candidiasis （VVC）,bacterial vaginosis （BV）,chlamydia trachomatous （CT）,mycoplasma （Ureapplasma urealyticum,UU or Mycoplasma genitallium,Mg）,and group B-hemolytic streptococcus （GBS）.The patients were classified into two groups based on whether they were infected,and the adverse pregnancy outcomes in the two groups were compared.Results：The incidence of lower genital tract infection was 27.67%.UU （6.55%） was the most frequently find pathogen,which was followed by BV （2.91%） and VVC.The incidence of one infectious disease of lower genital tract was 16.99% （70 cases）,the incidence of two or more infectious diseases of lower genital tract was 10.68% （44 cases）.BV incorporate with other infections was the most one of two and more infectious disease of low genital tract,the incidence was 7.28%.The incidence of premature rupture of membranes,preterm premature rupture of membranes,preterm labor,puerperal infection,chorioamnionitis,were higher in pregnant women with infection than those without infection （P 0.05）.The total incidence of adverse pregnancy outcomes induced by BV combined with other pathogenic infections was 96.64%,much higher than that induced by other single pathogen infection.Conclusion：UU or BV incorporate with other infections are the common types of lower genital tract infection.Compared to other single pathogen infection,BV incorporate with other infections is more likely to induce the occurrence of adverse pregnancy outcomes,it is necessary for pregnant women to screen and treat lower genital tract infection.