妊娠期B族溶血性链球菌对孕妇凝血功能阴道微生态及妊娠结局的影响

Effect of Group B Haemolytic Streptococci on Maternal Coagulation Vaginal Microecology and Pregnancy Outcome

目的:探究妊娠期B族溶血性链球菌(GBS)对孕妇凝血功能、阴道微生态及妊娠结局的影响。方法:选取2020年1月至2022年2月本院收治的妊娠期GBS感染患者210例为研究对象,另选取同期产检正常孕妇210例为对照组,比较两组孕妇凝血功能、阴道微生态及妊娠结局的差异,并分析GBS与凝血功能、阴道微生态及妊娠结局的相关性。结果:研究组患者AP、APTT、INR水平明显低于对照组,Fbg水平明显高于对照组(P<0.05)。两组产妇在阴道滴虫阳性比较差异无统计学意义(P>0.05),但研究组患者阴道微生态失调率、真菌阳性、细菌阳性、p H值异常率、清洁度异常率高于对照组,差异有统计学意义(P<0.05)。研究组患者剖宫产、胎膜早破、产褥感染、宫内感染、早产儿、病理性黄疸、新生儿感染、新生儿窒息发生率明显高于对照组(P<0.05)。结论:妊娠期感染B族溶血性链球菌(GBS)孕妇存在血液高凝、阴道微生态紊乱与不良妊娠结局风险。维持阴道微生态稳定,注重凝血功能检测,及早进行处理,有利于降低不良妊娠结局风险。

Objective:To investigate the effect of group B hemolytic streptococcus(GBS)on maternal blood coagulation,vaginal microecology and pregnancy outcome.Methods:A total of 210 pregnant women with GBS infection who were admitted to our hospital from January 2020 to February 2022 were selected as the research subjects,and 210 pregnant women with normal obstetric examination during the same period were selected as the control group.The coagulation function,vaginal microecology and pregnancy outcomes of the two groups of pregnant women were compared.and the association of GBS with coagulation function,vaginal microecology and pregnancy outcome was analyzed.Results:Patients in the study group had significantly lower AP,APTT and INR levels than the control group and significantly higher Fbg levels than the control group(P<0.05).The difference between the two groups was not statistically significant(P>0.05)when comparing positive Trichomonas vaginalis,but the rate of vaginal micro-ecological disorders,positive fungi,positive bacterial vaginosis,abnormal pH,and abnormal cleanliness was higher in the study group than in the control group,which was statistically significant(P<0.05).The incidence of caesarean section,premature rupture of membranes,puerperal infection,intrauterine infection,prematurity,pathological jaundice,neonatal infection and neonatal asphyxia was significantly higher in the study group than in the control group(P<0.05).Conclusion:Pregnant women with Group B haemolytic streptococcal(GBS)infection during pregnancy are at risk of blood hypercoagulation,vaginal microecological disorders and adverse pregnancy outcomes.Maintaining stable vaginal microecology,focusing on coagulation testing and early management can help to reduce the risk of adverse pregnancy outcomes.