细菌性阴道病与胎膜早破、早产的相关性及意义

The clinical significance and correlation between bacterial vaginosis and premature rupture of membranes as well as premature birth

目的探讨细菌性阴道病与胎膜早破、早产的相关性及临床意义。方法选取2014年5月至2018年5月收治的分娩产妇361例,根据妊娠结局不同分为正常妊娠组(n=225)、早产组(n=23)、胎膜早破组(n=99)及早产胎膜早破组(n=14),比较产妇细菌性阴道病发生情况、阴道乳杆菌阳性情况以及外阴阴道假丝酵母菌病发生情况。结果孕12周时,早产组、胎膜早破组以及早产胎膜早破组乳杆菌阳性率明显低于正常孕妇组(P<0.05),4组间细菌性阴道病、外阴阴道假丝酵母菌病发生率差异无统计学意义(P>0.05);孕32周时,早产组、胎膜早破组以及早产胎膜早破组乳杆菌阳性率明显低于正常孕妇组(P<0.05),早产组、胎膜早破组以及早产胎膜早破组细菌性阴道病发生率明显高于正常孕妇组(P<0.05),4组间外阴阴道假丝酵母菌病发生率差异无统计学意义(P>0.05);早产组、胎膜早破组以及早产胎膜早破组细菌性阴道病检出率明显高于正常孕妇组(P<0.05),4组间外阴阴道假丝酵母菌病检出率以及双重感染检出率差异无统计学意义(P>0.05);相关性分析显示,早产、胎膜早破以及早产胎膜早破与外阴阴道假丝酵母菌病无明显相关性(P>0.05),早产、胎膜早破以及早产胎膜早破与细菌性阴道病呈明显相关性,差异有统计学意义(r=0.342、0.304、0.372,P<0.05)。结论细菌性阴道病与早产、胎膜早破以及早产胎膜早破存在明显相关性,对于孕期存在细菌性阴道病患者应当积极进行有效治疗,建议将细菌性阴道病作为妊娠期常规筛查,从而达到改善妊娠结局的目的。

Objective To investigate the clinical significance and correlation between bacterial vaginosis and premature rupture of membranes as well as premature birth.Methods A total of 361 parturients who gave birth in our hospital from May 2014 to May 2018 were enrolled in the study.According to different pregnancy outcomes,these parturients were divided into normal pregnancy group(n=225),preterm birth group(n=23),preterm premature rupture of membranes group(n=99)and premature rupture of membranes+preterm birth group(n=14).The incidence of bacterial vaginal diseases,and the positive rate of vagina lactobacillus as well as the incidence of vulvovaginal candidiasis were observed and compared among the four groups.Results At 12 weeks of gestation,the positive rate of lactobacillus in preterm birth group,preterm premature rupture of membranes group and premature rupture of membranes+preterm birth group was significantly lower than that in normal pregnant group(P<0.05).There were no significant differences in the incidence rates of bacterial vaginosis and vulvovaginal candidiasis among the four groups(P>0.05).At 32 weeks of pregnancy,the positive rate of lactobacillus in preterm birth group,preterm premature rupture of membranes group and premature rupture of membranes+preterm birth group was significantly lower than that in normal pregnant group(P<0.05),moreover,the incidence rates of bacterial vaginosis and vulvovaginal candidiasis in the three disease group were significantly higher than those in normal pregnant group(P<0.05).In addition there were no significant differences in the incidence rates of vulvovaginal candidiasis among the four groups(P>0.05).Moreover the detection rate of bacterial vaginosis in the three disease groups was significantly higher than that in normal pregnant group(P<0.05),but there was no significant differences in the detection rates of vulvovaginal candidiasis and double infection among groups(P>0.05).The crrelation analysis showed that premature delivery,premature rupture of membranes and preterm premature rupture of fetal membrane was not correlated with the incidence of vulva vagina vulvovaginal candidiasis(P>0.05),however,which was closely correlated with the incidence of bacterial vaginosis(P<0.05).Conclusion The bacterial vaginosis has obvious correlation with premature delivery,premature rupture of membranes and preterm birth+premature rupture of membranes.It is suggested to detect bacterial vaginosis routinely,so as to improve the pregnancy outcome.