宫颈支原体感染与前置胎盘剖宫产术中出血关系研究

The Relationship between Cervical Mycoplasma Infection and Hemorrhage in Cesarean Sectionthe Among Patients with Placenta Previa

目的:探讨宫颈支原体感染与前置胎盘剖宫产术中出血的关系。方法:选择25例孕周>28周、前置胎盘出血患者,B超描述胎盘边缘距宫颈内口情况、血池、海绵状回声,入院患者取宫颈分泌物支原体培养+药敏检查,随访25例患者至剖宫产结束分娩。结果:B超海绵状回声与剖宫产术中出血正相关[P=0.11,OR=1.53,95%CI(1.11,2.12)];分泌物支原体阳性与胎盘海绵状回声两者呈正相关(r=0.408);剖宫产术中出血与支原体阳性呈正相关(r=0.145,P=0.48;OR=1.20;95%CI(0.74,1.92)];完全性前置胎盘与分泌物支原体阳性呈正相关[r=0.442,P=0.02;OR=5.06;95%CI(0.75,33.77)]。结论:宫颈支原体作为前置胎盘孕妇子宫内膜炎的标志,可作为剖宫产术时大出血的预测指标。

Objective： To study the relationship between cervical myeoplasma infection and hemorrhage in cesarean section among patients with placentaprevia.Method： 25 cases of pregnant week〉28weeks, placenta bleeding patients were selected, B ultrasound description ofthe placental edge from the cervix, blood pool, sponge like echo, hospitalized patients with mycoplasma culture＋drug sensitivity test, 25 patients were followed up to the end of cesarean section.Result： All of 5 cases with increased number of placental lacunas and 13 cases（65%） of the 20 cases without increased number of placental lacunas have experienced uterine lower segment bleeding during cesarean section[（P=0.11, OR=1.53, 95%CI（1.11, 2.12）].A positive correlation was determined between cervical mycoplasma colonization and the existence of placental lacunas on ultrasonography（r=0.408）.A positive correlation was determined between cervical mycoplasma colonization and uterine lower segment bleeding during cesarean section[r=0.145, P=0.48 ; OR=1.20 ; 95%CI（0.74, 1.92）]. 9 cases（56%） of 16 cases who were diagnosed as placenta previa retails and 1 case（11%） of 9 cases who were diagnosed as placenta previa partialis and/or marginalis had positive cervical culture results for mycoplasma Colonisation that revealed a positive correlation between placenta previa totalis and cervical mycoplasma colonization[r=0.442, P=0.02 ; OR=5.06 ; 95%CI（0.75, 33.77）].Conclusion： Cervical colonization of mycoplasma as a marker of endometritis in pregnancies complicated with placenta previa that can predict the lower uterine segment bleeding risk during cesarean section.