解脲支原体和衣原体感染与胎膜早破及妊娠结局之间的临床分析

Clinical Analysis between Ureaplasma Urealyticum and Chlamydia Infection and Premature Rupture of Membranes and Pregnancy Outcome

目的了解妊娠期妇女阴道环境中解脲支原体和衣原体的感染情况,分析妊娠期妇女阴道环境中解脲支原体和衣原体感染与胎膜早破之间的关系以及发生胎膜早破所造成的妊娠结局。方法收集2016年10月—2017年10月在郑州大学第五附属医院产科进行产检并住院分娩的胎膜早破孕妇200例作为实验组,按照纳入标准随机选择同期住院分娩的正常孕妇200名作为对照组。分别对实验组和对照组孕妇阴道分泌物进行解脲支原体、衣原体检测,并对实验组围产儿与对照组围产儿结局进行比较。观察统计两组结果并进行数据分析,进而得出解脲支原体和衣原体感染与胎膜早破之间的关系以及发生胎膜早破对围产儿的影响。结果发生胎膜早破者的解脲支原体与衣原体感染率分别为41.0%、39.0%,对照组的阳性率为14.5%,解脲支原体及衣原体感染的发生率在实验组和对照组间差异有统计学意义(χ~2=35.03,41.81,P<0.05);早破组围产儿感染性肺炎和病理性黄疸的发生率分别为18.0%,14.5%,对照组的发生率分别为6.5%,5.5%,围产儿预后结局与对照组也差异有统计学意义(χ~2=12.3、9,P<0.005)。结论胎膜早破与阴道内微生物感染有一定相关性,其中解脲支原体和衣原体感染在引起胎膜早破结局中发挥着重要作用,胎膜早破发生也对围产儿结局造成了一定影响,因此应对孕妇在孕产前进行阴道内相关微生物筛查,针对病因采取措施,以降低胎膜早破发生,减少不良妊娠结局的发生,从而提高围产儿生存质量。

Objective To investigate the infection status of Ureaplasma urealyticum and Chlamydia in vaginal environment of pregnant women, and to analyze the relationship between Ureaplasma urealyticum and Chlamydia infection and premature rupture of mem-branes in pregnant women’s vaginal environment and the premature rupture of membranes pregnancy outcome. Methods From October2016 to October 2017, 200 pregnant women with premature rupture of membranes in the obstetrics department of the Fifth Affiliated Hospital of Zhengzhou University were enrolled as experimental group. 200 normal pregnant women who were hospitalized during the same period were randomly selected according to the inclusion criteria in the control group. Ureaplasma urealyticum and chlamydia were detected in the vaginal secretions of the experimental group and the control group, and the perinatal outcomes of the perinatal children in the experimental group and the control group were compared. The results of the two groups were observed and analyzed,and the relationship between Ureaplasma urealyticum and Chlamydia infection and premature rupture of membranes and the effect of premature rupture of membranes on perinatal infants were obtained. Results The infection rates of Ureaplasma urealyticum and Chlamydia were 41.0% and 39.0%, respectively. The positive rate of the control group was 14.5% and 11.0%. The chi-square test was performed on Ureaplasma urealyticum and Chlamydia infection. The incidence of Ureaplasma urealyticum and Chlamydia infection was statistically different between the experimental group and the control group(χ~2=35.03,49.81,P<0.05). The premature infants with infectious pneumonia and pathological jaundice in the early-break group incidence rates were 18.0% and 14.5%, respectively.The incidence of the control group was 6.5% and 5.5%. The prognosis of perinatal infants was also statistically different from the control group(χ~2=12.3,9,P=0.005). Conclusion Premature rupture of membranes is associated with microbial infection in the vagina. Ureaplasma urealyticum and chlamydia infection play an important role in causing premature rupture of membranes. Premature rupture of membranes also has a certain impact on perinatal outcomes. Therefore, pregnant women should be screened for related microbial examination before pregnancy, and measures should be taken to reduce the occurrence of premature rupture of membranes and reduce the occurrence of adverse pregnancy outcomes, so as to improve the quality of life of perinatal children.