妊娠期妇女阴道微生态状况和生殖道感染特征分析

Analysis of vaginal micro-ecological status and characteristics of genital tract infection in pregnant women

目的:评价妊娠期妇女阴道微生态,分析其微生态状况和生殖道感染特征。方法:对2017年1月至2019年4月在我院就诊的751例妊娠期妇女取阴道分泌物,观察其清洁度和微生态指标的特点。结果:751例妊娠期妇女中,阴道清洁度以正常(Ⅱ度)为主;阴道乳杆菌数量正常者占76.29%;阴道WBC正常者占68.58%;阴道细菌密集度以Ⅱ~Ⅲ级为主;阴道菌群多样性以Ⅰ~Ⅱ级为主;阴道p H值<4.5者占73.10%。综合各微生态指标,73.50%的妊娠期妇女阴道微生态失调。245例(32.62%)发生生殖道感染,细菌性阴道病、白假丝酵母菌、非白假丝酵母菌和阴道毛滴虫感染率分别为20.91%、14.91%、4.26%、1.73%。结论:妊娠期妇女阴道菌群以乳杆菌为优势菌,但多数孕妇乳杆菌功能不足;妊娠期妇女多数处于微生态失调状态,生殖道感染发生率较高,提示应高度重视其可能引起的不良妊娠结局。

Objective:To evaluate vaginal micro-ecosystem of pregnant women and analyze their micro-ecological status and characteristics of genital tract infection.Methods:From January 2017 to April 2019,751 cases of vaginal discharge of pregnant women in our hospital were obtained to observe the characteristics of vaginal cleanliness and micro-ecological indexes.Results:Of751 pregnant women,the vaginal cleanliness was mainly normal(gradeⅡ);pregnant women with normal vaginal Lactobacilli accounted for 76.29%,and those with normal vaginal WBC accounted for 68.58%;the vaginal bacterial density was mainly gradeⅡ-Ⅲ;the vaginal bacterial diversity was mainly gradeⅠ-Ⅱ;those with vaginal p H value<4.5 accounted for 73.10%.The results showed that 73.50%of pregnant women had vaginal micro-ecology disorder.245 cases(32.62%)had genital tract infection;the infection rates of bacterial vaginosis,Candida albicans,non-Candida albicans and Trichomonas vaginalis were20.91%,14.91%,4.26%and 1.73%,respectively.Conclusion:Lactobacillus is the dominant bacteria in vaginal flora of pregnant women,but the function of Lactobacillus in most pregnant women is insufficient;most pregnant women are in the status of micro-ecology disorder,and the incidence of reproductive tract infection is high,which can induce the adverse pregnancy outcomes to which we should attach great importance.