临床咨询服务对梅毒孕妇终止妊娠的影响分析

Effect of clinical counseling on termination of pregnancy in pregnant women with syphilis

目的探讨临床咨询服务对梅毒孕妇终止妊娠的影响,为有效的辅导梅毒孕妇做出合理的生育抉择提供参考。方法对宝安区2011~2016年梅毒孕妇终止妊娠的情况进行分析,其中,2014~2016年接受梅毒规范化临床咨询服务的806例梅毒孕妇为观察组,终止妊娠者102例;2011~2013年终止妊娠的703例梅毒孕妇为对照组,终止妊娠者159例;对两组终止妊娠(人工流产、自然流产、死胎死产、异位妊娠)的发生率进行比较。结果观察组梅毒孕妇终止妊娠的发生率为12.66%;对照组终止妊娠的发生率为22.62%,两者比较差异有统计学意义(P<0.05)。观察组和对照组人工流产发生率分别为3.10%和7.82%,差异有统计学意义(P<0.05);自然流产发生率分别为2.11%和3.41%;死胎死产发生率分别为2.73%和4.98%,差异有统计学意义(P<0.05);异位妊娠的发生率分别为4.71%和6.40%。将人工流产和死胎死产者按照初筛TRUST滴度分为≤1︰4和≥1︰8两组,观察组和对照组TRUST滴度≤1︰4者,人工流产比例分别为0.99%和5.41%;TRUST滴度≥1︰8者,死胎死产比例分别为1.86%和3.70%;差异均有统计学意义(P<0.05)。结论规范的临床咨询服务应用可以降低梅毒孕妇终止妊娠的发生率,尤其是人工流产和死胎死产的发生率。

Objective To explore the effect of clinical counseling on termination of pregnancy in pregnant women with syphilis,so as to provide guidance for effective counseling for pregnant women with syphilis.Methods The pregnancy termination of pregnant women with syphilis in Baoan District from 2011 to 2016 was analyzed.Among them,806 cases of syphilis pregnant women who received standardized clinical consultation service for syphilis from 2014 to 2016 were selected as observation group,with 102 cases of termination of pregnancy;703 cases of syphilis pregnant women from 2011 to 2013 were selected as control group,with 159 cases of termination of pregnancy;The incidence of termination of pregnancy(induced abortion,spontaneous abortion,stillbirth,ectopic pregnancy)in the two groups was compared.Results The incidence of termination of pregnancy for pregnant women in the observation group was 12.66%,and the incidence of termination of pregnancy in the control group was 22.62%,and there was significant difference between the two groups(P<0.05).The incidence of induced abortion in the observation group and the control group was 3.10%and 7.82%,respectively(P<0.05).The incidence of spontaneous abortion was 2.11%and 3.41%,and the rate of stillbirth death was 2.73%and 4.98%respectively(P<0.05),and the incidence of ectopic pregnancy was 4.71%and 6.40%,respectively.The induced abortion and stillbirth were divided into two groups according to the initial TRUST titer:≤1︰ 4and≥1︰ 8.When the TRUST titers of the observation group and the control group were≤1:4,the ratio of artificial abortion was 0.99%and 5.41%,and when the initial TRUST titer≥1:8,the stillbirth rate was 1.86%and 3.70%respectively,the difference was statistically significant(P<0.05).Conclusion Standardized clinical counseling service can reduce the incidence of termination of pregnancy,especially the incidence in induced abortion and stillbirth.