灭滴灵阴道用药对细菌性阴道病晚孕妇女不良妊娠结局的预防效果

Improving pregnancy outcome with vaginal metronidazole in women with bacterial vaginosis in the third trimester.

目的 :探讨灭滴灵治疗细菌性阴道病对不良妊娠结局是否有改善作用。方法 :在产科门诊对用阴道分泌物涂片革兰氏染色Nugent诊断标准孕 2 8 32周妇女进行细菌性阴道病筛查 ,对检出的患者随机分为二组 :观察组 5 2例 ,未给予治疗 ;治疗组 5 0例 ,采用灭滴灵阴道用药治疗 (40 0mg ,每天一次 ,7天为一疗程 ) ,必要时再次治疗。并对其妊娠结局进行随访。结果 ;治疗组胎膜早破、未足月胎膜早破及低体重儿的发生率 (分别为 18% ,2 %和 8% )均低于观察组 (分别为 38 5 % ,15 4%和 19 2 % ) ,P均 <0 .0 5。治疗组新生儿平均出生体重 (32 15± 475g)高于观察组 (2 96 5± 6 6 5 g) ,P <0 .0 0 5。治疗组早产、产褥感染和新生儿感染的发生率均低于观察组 ,但无统计学意义 (P >0 .0 5 )。结论 :妊娠晚期灭滴灵阴道用药治疗细菌性阴道病可降低胎膜早破、低出生体重儿的发生率 ,我们认为 ,为了提高产科质量 ,有必要对妊娠妇女进行BV的系统筛查和治疗。

To assess whether whether treatment of bacterial vaginosis improves pregnancy outcome.Methods:Bacterial vaginosis was screened at 28 to 32 weeks' gestation by Gram stained vaginal smears (Nugent criteria).Those with bacterial vaginosis were randomized into two groups:Observation group,no treatment was given; Treatment group, metronidazole(400mg vaginally,once daily for 7 days) was igven,and reteatment was given as necessary.The pregnancy outcomes of these gravidac were followed up .Results:Compared with observation group,women in treatments group had significantly fewer premature rupture of membrane(PROM,18%vs.38.5%,P<0.05),preterm premature rupture of membrane (PPROM,2% vs.15.4%,P<0.05),and low birth weight (LBW,8%vs.19.2%,P<0.05)and higher mean birth weight of neonates (3215±475gvs.2965±665g,P<0.005).The incidence of preterm delivery,puerperal infection,and neonatal infection in BV treatment group were also lower than those in BV observation group, but it wasn's statistically significant (P>0.05).Conclusions:The treatmnet of bacterial vaginosis with vaginal metronidazole .reduces the rate of PROM,PPROM,and LBW,and improves the mean birth weight of neonatal infants.