孕34周前不同类型自发性早产与宫内感染的关系

Relationship between different types of spontaneous preterm delivery before 34 weeks of pregnancy and intrauterine infection

目的探讨孕34周前不同类型自发性早产(早中期早产)与宫内感染的关系。方法选择选择2017年1月至2019年12月来我院就诊并在28~33+6周分娩的92例单胎自发性早产患者,根据临床类型分为自发宫缩组(32例)和胎膜早破组(60例)。比较两组患者临床绒毛膜羊膜炎、亚临床绒毛膜羊膜炎的发生率及母婴结局。结果自发宫缩组的亚临床绒毛膜羊膜炎发生率明显高于胎膜早破组(P<0.05);两组的临床绒毛膜羊膜炎发生率比较,差异无统计学意义(P>0.05)。自发宫缩组48 h内分娩率、自然分娩率、新生儿窒息率均明显高于胎膜早破组(P<0.05);两组的胎儿窘迫、胎盘早剥及产褥感染发生率比较,差异无统计学意义(P>0.05)。结论自发性宫缩早产患者的亚临床绒毛膜羊膜炎发生率明显高于胎膜早破早产患者,表明自发宫缩性早产与宫内感染的关系更为密切,临床需引起关注。

Objective To explore the relationship between different types of spontaneous preterm delivery before 34 weeks of pregnancy(early and mid term preterm delivery)and intrauterine infection.Methods A total of 92 patients with spontaneous preterm birth of single fetus who visited our hospital from January 2017 to December 2019 and delivered at 28-33+6 weeks were selected and divided into spontaneous contractions group(32 cases)and premature rupture of membranes group(60 cases)according to the clinical types.The incidences of clinical chorioamnionitis and subclinical chorioamnionitis and maternal and infant outcomes were compared between the two groups.Results The incidence of subclinical chorioamnionitis in the spontaneous contractions group was significantly higher than that in the premature rupture of membranes group(P<0.05);there was no significant difference in the incidence of clinical chorioamnionitis between the two groups(P>0.05).The delivery rate within 48 h,natural delivery rate and neonatal asphyxia rate in the spontaneous contractions group were significantly higher than those in the premature rupture of membranes group(P<0.05);there were no significant differences in the incidence of fetal distress,placental abruption and puerperal infection between the two groups(P>0.05).Conclusion The incidence of subclinical chorioamnionitis in patients with spontaneous uterine contraction premature delivery is significantly higher than that in patients with premature rupture of membranes premature delivery,indicating that spontaneous uterine contraction premature delivery is more closely related to intrauterine infection,which should be paid attention to clinically.