胎膜早破孕妇生殖道微生态检测及炎症指标对妊娠结局和并发症的影响

Effects of reproductive tract microecological detection and inflammatory markers on pregnancy outcomes and complications in pregnant women with premature rupture of membranes

目的研究胎膜早破孕妇生殖道微生态检测及炎症指标对不良妊娠结局和并发症的影响。方法选取120例胎膜早破孕妇为研究组,另选取同期120例正常孕妇为对照组。均检测生殖道病原菌,并收集阴道灌洗液和血清样本,检测相关炎症指标,追踪不良妊娠结局和并发症。结果两组B族链球菌和总检出的检出量和检出率比较,差异有统计学意义(P<0.05),两组支原体、衣原体、酵母菌及滴虫的检出量和检出率比较,差异无统计学意义(P>0.05)。研究组阴道灌洗液来源的样品中分泌型免疫球蛋白A(SIgA)和基质金属蛋白酶-9(MMP-9)指标均显著高于对照组,差异有统计学意义(P<0.05);研究组血清样品中的超敏O反应蛋白(hs-CRP)和降钙素原(PCT)指标均高于对照组,差异具有统计学意义(P<0.05).研究组孕妇早产率34.17%、产褥感染率12.50%及胎盘绒毛膜炎发生率31.67%均显著高于对照组的9.17%、4.17%及7.50%,差异有统计学意义(P<0.05),两组胎儿窘迫率、新生儿窒息率、产后出血率比较,差异无统计学意义(P>0.05)。结论生殖道感染及引发的炎性反应是胎膜早破的高危因素,易于导致多种不良结局,需及时监测和临床干预。

Objective To investigate the effects of reproductive tract microecological detection and inflammatory indicators on adverse pregnancy outcomes and complications in pregnant women with premature rupture of membranes.Methods 120 pregnant women with premature rupture of membranes were selected as the study group,and 120 normal pregnant women were selected as the control group.Genital tract pathogens were detected,and vaginal lavage fluid and serum samples were collected to detect inflammatory indicators and track adverse pregnancy outcomes and complications.Results There were significant differences in the detected amount and detection rate of group B streptococcus and total bacteria between the two groups(P<0.05),but there were no significant differences in the detected amount and detection rate of Mycoplasma,chlamydia,yeast and trichomonas between the two groups(P>0.05).The secreted immunoglobulin A(SIgA)and matrix metalloproteinase-9(MMP-9)in the samples from vaginal lavage fluid in the study group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The high sensitivity C-reactive protein(hs-CRP)and procalcitonin(PCT)in serum samples of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).The preterm birth rate(34.17%),puerperal infection rate(12.50%)and placental chorionitis rate(31.67%)in the study group were significantly higher than those in the control group(9.17%,4.17%and 7.50%),and the differences were statistically significant(P<0.05).The rates of fetal distress,neonatal asphyxia and postpartum hemorrhage were compared between the two groups.There was no significant difference(P>0.05).Conclusion Reproductive tract infection and the inflammatory reaction caused are high risk factors for PROM,easy to lead to a variety of adverse outcomes,requiring timely monitoring and clinical intervention.