胎膜早破与孕妇生殖道感染的关系

Relationship between premature rupture of fetal membranes and genital tract infection in pregnant women

目的探讨胎膜早破与孕妇生殖道感染的关系,为临床防治胎膜早破提供更多的理论支持。方法选取60例足月妊娠胎膜早破的孕妇(单胎)为观察组,另选取同期60例足月妊娠无胎膜早破的孕妇作为对照组。对两组孕妇生殖道分泌物进行支原体(UU)、衣原体(CT)、真菌、细菌性阴道病(BV)等检测,观察比较两组的生殖道感染情况及妊娠结局、新生儿并发症情况。结果观察组UU、CT、BV、白色念珠菌感染、混合感染、总感染发生率分别为21.67%(13/60)、18.33%(11/60)、11.67%(7/60)、16.67%(10/60)、16.67%(10/60)、85.00%(51/60),均高于对照组的8.33%(5/60)、5.00%(3/60)、1.67%(1/60)、3.33%(2/60)、6.67%(4/60)、25.00%(15/60),差异有统计学意义(P<0.05)。观察组产褥感染、产后出血发生率均高于对照组,差异有统计学意义(P<0.05);观察组胎儿宫内窘迫、绒毛膜羊膜炎、新生儿肺炎发生率均高于对照组,差异有统计学意义(P<0.05);两组新生儿病理性黄疸发生率比较差异无统计学意义(P>0.05)。结论孕妇生殖道感染与胎膜早破有密切关系,指导女性在妊娠前入院接受生殖道病原学检查,早期发现感染并积极治疗,从而改善妊娠结局。

Objective To investigate the relationship between premature rupture of fetal membranes and genital tract infection in pregnant women, in order to provide more theoretical support for clinical prevention and treatment of premature rupture of fetal membranes. Methods 60 pregnant women with premature rupture of fetal membranes（single birth） were selected as the observation group, another 60 cases of full-term pregnancy without premature rupture of fetal membranes in the same period were selected as the control group. Mycoplasma（UU）, Chlamydia（CT）, fungi and bacterial vaginosis（BV） were detected in the genital tract secretions of pregnant women in the two groups. The genital tract infection, pregnancy outcome and neonatal complications between the two groups were observed and compared. Results The incidence of UU, CT, BV, candida albicans infection, mixed infection and total infection in the observation group were 21.67%（13/60）, 18.33%（11/60）, 11.67%（7/60）, 16.67%（10/60）, 16.67%（10/60）, 85.00%（51/60） respectively, which were significantly higher than 8.33%（5/60）, 5.00%（3/60）, 1.67%（1/60）, 3.33%（2/60）, 6.67%（4/60） and 25.00%（15/60） in the control group,the differences were statistically significant（P0.05）. The incidence of puerperal infection and postpartum hemorrhage in the observation group were significantly higher than those in the control group, the differences were statistically significant（P0.05）, and the incidence of fetal distress, chorioamnionitis and neonatal pneumonia in the observation group were significantly higher than those in the control group, the differences were statistically significant（P0.05）. There was no statistical difference in the incidence of pathological jaundice between the two groups（P0.05）. Conclusion There is a close relationship between the genital tract infection of pregnant women and premature rupture of fetal membranes. It guides the female to receive the genital tract etiological examination before pregnancy, early detection of infection and active treatment, so as to improve the pregnancy outcome.