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Lamellar Bodies Count (LBC) as a Predictor of Fetal Lung Maturity in Preterm Premature Rupture of Membranes Compared to Neonatal Assessment
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作者 Malames Mahmoud Faisal Noha Hamed Rabei +1 位作者 Hoda Ezz El-Arab Abd El-Wahab Abeer Hosny El-Zakkary 《Open Journal of Obstetrics and Gynecology》 2023年第6期1047-1057,共11页
Background: Respiratory distress syndrome (RDS) is a major cause of neonatal morbidity and mortality, affecting approximately 1% of all live births and 10% of all preterm infants. Lamellar bodies represent a storage f... Background: Respiratory distress syndrome (RDS) is a major cause of neonatal morbidity and mortality, affecting approximately 1% of all live births and 10% of all preterm infants. Lamellar bodies represent a storage form of pulmonary surfactant within Type II pneumocytes, secretion of which increases with advancing gestational age, thus enabling prediction of the degree of FLM. Preterm premature rupture of membranes (PPROM) complicates approximately 1/3 of all preterm births. Birth within 1 week is the most likely outcome for any patient with PPROM in the absence of adjunctive treatments. Respiratory distress has been reported to be the most common complication of preterm birth. Sepsis, intraventricular haemorrhage, and necrotizing enterocolitis also are associated with prematurity, but these are less common near to term. Objective: To assess the efficacy of the amniotic fluid lamellar body counting from a vaginal pool in predicting fetal lung maturity in women with preterm premature rupture of membranes. Methods: This study was conducted at Ain Shams University Maternity Hospital in the emergency ward from January 2019 to September 2019. It included 106 women with singleton pregnancies, gestational age from 28 - 36 weeks with preterm premature rupture of membranes. This study is designed to assess the efficacy of the amniotic fluid lamellar body counting (LBC) from a vaginal pool in predicting fetal lung maturity in women with preterm premature rupture of membranes. Results: The current study revealed a highly significant increase in the lamellar body count in cases giving birth to neonates without RDS compared to that cases giving birth to neonates with RDS. Also, no statistically significant difference between LBC and age, parity and number of previous miscarriages in the mother was found. Gestational age at delivery was significantly lower among cases with respiratory distress. Steroid administration was significantly less frequent among cases with respiratory distress. However, lamellar bodies had high diagnostic performance in the prediction of respiratory distress. Conclusion: Lamellar body count (LBC) is an effective, safe, easy, and cost-effective method to assess fetal lung maturity (FLM). It does not need a highly equipped laboratory or specially trained personnel, it just needs the conventional blood count analyzer. Measurement of LBC is now replacing the conventional Lecithin/Sphyngomyelin L/S ratio. LBC cut-off value of ≤42.5 × 10<sup>3</sup>/μL can be used safely to decide fetal lung maturity with sensitivity of 95.7% and specificity of 97.6%. 展开更多
关键词 fetal Lung Maturity Lamellar Bodies Count Preterm premature rupture of membranes Respiratory Distress Syndrome
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Previable Premature Rupture of Membranes in Dichorionic Diamniotic Twin Gestation, Loss of Leading Twin, Emergency Cervical Cerclage and Ceaserean Delivery at Term
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作者 Darlington-Peter Chibuzor Ugoji Ugochukwu Sunday Julius Ezenyirioha +4 位作者 Ifeanyichukwu Jude Ofor Chukwuemeka Joseph Nwoye God’s Miracle David Banso Sunday Emmanuel Ucha Ugochi Chimerem Ugoji 《Case Reports in Clinical Medicine》 2023年第1期14-21,共8页
Introduction: Multiple pregnancies have a higher risk of premature delivery and a weakened cervix has been associated with it. In most cases, emergency cerclage has proved to be beneficial as the birth of the first tw... Introduction: Multiple pregnancies have a higher risk of premature delivery and a weakened cervix has been associated with it. In most cases, emergency cerclage has proved to be beneficial as the birth of the first twin is usually followed by the unavoidable delivery of the second twin and most fetus dies shortly after delivery. Studies have noted that delayed delivery of the second fetus in a twin pregnancy is an effective management choice and the use of cervical cerclage after the first delivery is associated with a longer inter-delivery interval. We present a case of previable premature rupture of membrane of a dichorionic diamniotic twin gestation leading to the loss of the leading twin and subsequently having emergency cervical cerclage for the second twin and caesarean delivery at term. Case Presentation: She was a case of a 29 years old, G<sub>6</sub>P<sub>1</sub><sup>+4</sup> with 1 living child at a gestational age of 17 weeks plus 5 days who initially was diagnosed with dichorionic diamniotic twin gestation following an early ultrasound but presented with a history of bleeding and passage of liquor per vaginam. Ultrasound done on admission showed cervical funneling and a stable state of the second twin. She subsequently had emergency cervical cerclage after stabilization on account of previable premature rupture of membrane of a dichorionic diamniotic twin gestation with the loss of the leading twin. A repeat ultrasound done prior to discharge showed closed cervical os and a good state of the fetus. She then had elective caesarean delivery at term with a good feto-maternal outcome. Conclusion: Emergency cervical cerclage should be part of the options of management after stabilization in cases of previable premature rupture of membrane in a dichorionic or multichoronic gestation so as to save the viable once. 展开更多
关键词 Previable premature rupture of Membrane Cervical Cerclage Twin Gestation Multiple Gestation Multiple Pregnancy TWIN Preterm Delivery Cervical Incompetence CERCLAGE Interval Delivery
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The Study of Vaginal Fluid Urea, Creatinine, B-HCG and Placental Alpha-1 Microglobulin in Diagnosis of Premature Rupture of Membranes 被引量:2
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作者 Hesham M. Borg Mona Omar Ghada A. Suliman 《Open Journal of Obstetrics and Gynecology》 2019年第6期811-826,共16页
Purpose: To evaluate and compare the reliability, accuracy and the cost benefit ratio of vaginal washing fluid urea, creatinine, Beta Human Chorionic Gonadotropin (β-HCG) and placental alpha Microglobulin-1 (PAMG-1) ... Purpose: To evaluate and compare the reliability, accuracy and the cost benefit ratio of vaginal washing fluid urea, creatinine, Beta Human Chorionic Gonadotropin (β-HCG) and placental alpha Microglobulin-1 (PAMG-1) for diagnosis of premature rupture of membranes (PROM). Material and Methods: A diagnostic study conducted on 70 patients. The patients were divided into three groups: Group A (n = 25): (Confirmed PROM group) patients who were either in labor or not in labor, Gestational age was from 24 weeks onwards and fulfilled the following criteria and/or two of these criteria with low AFI positive pooling, positive nitrazine paper test, positive fern test. Group B (n = 25): (Suspected PROM group) patients who fulfilled the following criteria: Patients with fluid leakage complaint with negative pooling and/or negative nitrazine paper test and/or negative fern test. Group C (n = 25): (Control group with no PROM) patients that were admitted to prenatal clinic for their regular prenatal control visit with 24 - 42 weeks of gestational age without any complaint or complication and with negative pooling, negative nitrazine paper test and/or negative fern test. The vaginal washing fluid urea, creatinine, Beta-Human Chorionic Gonadotropin (β-HCG) and placental alpha Microglobulin-1 (PAMG-1) were determined for diagnosis of premature rupture of membranes (PROM). Results: PAMG-1 detection in cervico vaginal discharge was a very good test for diagnosis of PROM with high sensitivity, specificity, positive predictive value, negative predictive value, accuracy and P-value (96%, 100%, 100%, 95.84%, 97.78% and <0.0001 respectively). Urea and Creatinine is the second option in diagnosis of PROM with high sensitivity, and specificity after PAMG-1 with a privilege of low cost than PAMG-1. Furthermore they were more accurate than β-HCG. Conclusion: Detection of PAMG-1 in cervico vaginal discharge is promising in diagnosis of PROM & especially in those cases of suspected PROM and it should be done as a worse trial in every case of suspected PROM. Urea and Creatinine is the second option in diagnosis of PROM with high sensitivity, and specificity after PAMG-1 with a privilege of low cost than PAMG-1. Also they were more accurate than β-HCG and they can be used if PAMG-1 is not available for detection of doubtful PROM cases. 展开更多
关键词 β-HCG PAMG-1 premature rupture of membranes (PROM)
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Maternal and fetal outcomes in term premature rupture of membrane 被引量:6
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作者 Tigist Endale Netsanet Fentahun +1 位作者 Desta Gemada Mamusha Aman Hussen 《World Journal of Emergency Medicine》 CAS 2016年第2期147-152,共6页
BACKGROUND: Premature rupture of membrane(PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is ver... BACKGROUND: Premature rupture of membrane(PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is very important to decrease maternal and child mortality and for better management and prevention of complications. Thus, this study aimed to detect the maternal and fetal outcomes and associated factors in term PROM at Mizan-Aman General Hospital, south-west Ethiopia.METHODS: A retrospective cross sectional study was conducted using data available at MizanAman General Hospital during a period of 3 years(January 2011 to December 2013). We examined records of 4 525 women who gave birth in the hospital; out of these women, 185 were diagnosed with term PROM and all of them were included in the study. The data of these women were collected using a checklist based on registration books. The data were analyzed using SPSS version 20.0 statistical package. The association between independent and dependent variables was assessed by bivariate and multiple logistic regression analyses. 95%CI and P value less than 0.05 were considered statistically signifi cant.RESULTS: Of the 4 525 women who gave birth in the hospital, 202 were complicated by term PROM. About 22.2% of the women showed unfavorable maternal outcomes. The most common cause of maternal morbidity and mortality was puerperal sepsis. About 33.5% of neonates experienced unfavorable outcomes. The duration of PROM >12 hours(AOR=5.6, 95%CI 1.3–24.1) latency >24 hours(AOR=2.8, 95%CI 1.7–11.8), residing in rural areas(AOR=4.2, 95%CI 3.96–29.4) and birth weight less than 2 500 g were associated with unfavorable outcomes.CONCLUSION: Women residing in rural areas, long latency, and neonates with birth weight less 2 500 g may have unfavorable outcomes. Therefore, optimum obstetric and medical care is essential for the reduction of the devastating complications related to disorders. 展开更多
关键词 premature rupture of membrane Maternal outcomes fetal outcomes
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Support Epidemiology and Prognosis of Premature Rupture of Membranes in Pikine National Hospital Center
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作者 Moussa Diallo Abdoul Aziz Diouf +6 位作者 Hadja Maimouna Barro Daff Natty Seck Aminata Niass Youssou Toure Khalifa Fall Codou Sene Seck Alassane Diouf 《Open Journal of Obstetrics and Gynecology》 2019年第11期1519-1526,共8页
Premature rupture of membranes (PROM) complicates 3% of preterm pregnancies and occurs in 60% to 80% of term pregnancies. However, its management remains largely controversial. The objective of this study was to estab... Premature rupture of membranes (PROM) complicates 3% of preterm pregnancies and occurs in 60% to 80% of term pregnancies. However, its management remains largely controversial. The objective of this study was to establish the epidemiological profile, to study the management and the prognosis of Premature rupture of membranes (PROM) in our practice. Patients and methods: It was a prospective, descriptive and analytical study from May 1st 2016 to January 31st 2017 at the Pikine National Hospital Center. The target population consisted of all patients received at the hospital with premature rupture of membranes and who had given birth in the structure. The variables studied were: marital status, mode and reason for admission;risk factors;antecedents;prenatal care;the clinical and paraclinical examinations;support and immediate maternal and fetal neonatal complications. Results and comments: The mean maternal age was 27.34 years and the majority of women were aged between 18 and 39 years (94.4%). Fifty-one point three percent of patients were primiparous, large multiparous represented only 2.5%. The majority of patients (385 patients or 66.9%) had consulted in the first 12 hours following the onset of fluid flow. For 20.1% of them this flow was associated with uterine contractions. Hidden risk factors were dominated by the twin pregnancy. The blood count showed that 38.8% of patients had leukocytosis and CRP was positive in 18.3% of patients. An ampicillin-based antibiotics was established in 42.6% of cases, corticosteroid therapy in 5.2% and 1% in tocolysis. An expectation was adopted in 65.7% of cases, induction of labor in 7.3% and a cesarean section immediately in 27% of cases. In total, 65.7% of patients had vaginal delivery and 34.3% cesarean. The perinatal mortality rate was 3.6% or 22 newborns on 610. Two cases of endometritis were observed and one case of immediate postpartum hemorrhage. No maternal deaths were recorded. Conclusion: These results show that the prognosis of premature rupture of membranes remains favorable in our practice. To improve this prognosis, we recommend sensitization of patients during prenatal care regarding signs of danger, a systematic bacteriological sample from all pregnant at the end of their pregnancy and the health personnel to direct patients’ references to structures in case of PROM. 展开更多
关键词 premature rupture of membranes CHILDBIRTH STILLBIRTH CHORIOAMNIONITIS
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Expectant Management of Preterm Ruptured Membranes before 34 Gestational Weeks at the University Hospital of Kinshasa, a Tertiary Referral Hospital in the Democratic Republic of Congo
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作者 Roger Mbungu Mwimba Anselme Mbungu Mulaila +6 位作者 Joëlle Lumaya Ambis Andy Mbangama Muela Adrien Tandu Umba Berry Kinkenda Nsiangangu Malka Salamo Azama Thérèse Biselele Bakambuvua Kahindo P. Muyayalo 《Open Journal of Obstetrics and Gynecology》 CAS 2022年第7期633-648,共16页
Premature Rupture of Membranes (PROM) with the resulting prematurity remains a major public health issue in the Democratic Republic of Congo (DRC). This study aimed to assess expectant management of PPROM before 34 we... Premature Rupture of Membranes (PROM) with the resulting prematurity remains a major public health issue in the Democratic Republic of Congo (DRC). This study aimed to assess expectant management of PPROM before 34 weeks at the university hospital of Kinshasa. We conducted a retrospective analysis of expectantly managed PROM before 34 weeks between January 2008 and December 2018. Maternal and fetal outcomes were collected, and all data were analyzed using the SPSS 23.0 software. Of the 113 patients included in the study, 2.6% were diagnosed with PROM before 34 weeks. We observed prolongation of the pregnancy duration;the median latency period was eight days, and the average gestational age at delivery of 32.85 ± 2.5 weeks. Chorioamnionitis (23%), severe oligoamnios (7%), and acute fetal distress (4%) were complications observed during the latency period. In the postpartum period, endometritis (6.2%), neonatal jaundice (39.8%), anemia (25.7%), ulcerative necrotizing enterocolitis (6.2%), cerebromeningeal hemorrhage (5.3%), and acute respiratory distress syndrome (4.4%) were complications observed. The risk of infection during the latency period was significantly associated with irregular (P = 0.045) or lack (P = 0.006) antenatal care (ANC) attendances and C-Reactive Protein (CRP) results 6 (P = 0.013). The risk of neonatal death was significantly associated to infection during the latency period (P = 0.011), irregular (P = 0.009) or lack of ANC (P = 0.000) attendances, Birth weight g (P = 0.039) as well as Gestational age at birth between 28 to 30 Weeks (S) (P = 0.021). These findings report first-time pregnancy outcomes related to the management of PPROM before 34 weeks in our setting. We found that the conservative attitude adopted allowed the prolongation of pregnancies, reducing the risks associated with prematurity. Nevertheless, attendance in good quality ANC could reduce the frequency of PROM and related adverse outcomes. 展开更多
关键词 premature rupture of membranes Gestational Age Expectant Management Pregnancy Outcomes D. R. Congo
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Premature Rupture of Membrane and Neonatal Infection 被引量:2
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作者 Laila Yahya A. Alhubaishi 《Open Journal of Obstetrics and Gynecology》 2019年第10期1388-1391,共4页
Premature rupture of membrane (PROM) is obstetric dilemma that carries risk of neonatal and maternal complications. PROM has controversy in management although many factors affect the outcome of PROM.
关键词 premature rupture of MEMBRANE PERINATAL Care NEONATAL MORBIDITY
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Heterotopic pregnancy after assisted reproductive techniques with favorable outcome of the intrauterine pregnancy:A case report
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作者 Ya-Nan Wang Lian-Wen Zheng +2 位作者 Lu-Lu Fu Ying Xu Xue-Ying Zhang 《World Journal of Clinical Cases》 SCIE 2023年第3期669-676,共8页
BACKGROUND Heterotopic pregnancy(HP)is a rare condition in which both ectopic and intrauterine pregnancies occur.HP is uncommon after natural conception but has recently received more attention due to the widespread u... BACKGROUND Heterotopic pregnancy(HP)is a rare condition in which both ectopic and intrauterine pregnancies occur.HP is uncommon after natural conception but has recently received more attention due to the widespread use of assisted reproductive techniques(ART)such as ovulation promotion therapy.CASE SUMMARY Here,we describe a case of HP that occurred after ART with concurrent tubal and intrauterine singleton pregnancies.This was treated successfully with surgery to preserve the intrauterine pregnancy,resulting in the birth of a low-weight premature infant.This case report aims to increase awareness of the possibility of HP during routine first-trimester ultrasound examinations,especially in pregnancies resulting from ART and even if multiple intrauterine pregnancies are present.CONCLUSION This case alerts us to the importance of comprehensive data collection during regular consultations.It is important for us to remind ourselves of the possibility of HP in all patients presenting after ART,especially in women with an established and stable intrauterine pregnancy that complain of constant abdominal discomfort and also in women with an unusually raised human chorionic gonadotropin level compared with simplex intrauterine pregnancy.This will allow symptomatic and timeous treatment of patients with better results. 展开更多
关键词 Heterotopic pregnancy Assisted reproductive techniques Preterm labor premature rupture of membranes Case report
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FPR1 Antagonist (BOC-MLF) Inhibits Amniotic Epithelial-mesenchymal Transition
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作者 Xiao-mei HUANG E LIAO +2 位作者 Jun-qun LIAO Ya-ling LIU Yong SHAO 《Current Medical Science》 SCIE CAS 2024年第1期187-194,共8页
Objective:Premature rupture of membranes(PROM)is a common pregnancy disorder that is closely associated with structural weakening of fetal membranes.Studies have found that formyl peptide receptor 1(FPR1)activates inf... Objective:Premature rupture of membranes(PROM)is a common pregnancy disorder that is closely associated with structural weakening of fetal membranes.Studies have found that formyl peptide receptor 1(FPR1)activates inflammatory pathways and amniotic epithelial-mesenchymal transition(EMT),stimulates collagen degradation,and leads to membrane weakening and membrane rupture.The purpose of this study was to investigate the anti-inflammatory and EMT inhibitory effects of FPR1 antagonist(BOC-MLF)to provide a basis for clinical prevention of PROM.Methods:The relationship between PROM,FPR1,and EMT was analyzed in human fetal membrane tissue and plasma samples using Western blotting,PCR,Masson staining,and ELISA assays.Lipopolysaccharide(LPS)was used to establish a fetal membrane inflammation model in pregnant rats,and BOC-MLF was used to treat the LPS rat model.We detected interleukin(IL)-6 in blood from the rat hearts to determine whether the inflammatory model was successful and whether the anti-inflammatory treatment was effective.We used electron microscopy to analyze the structure and collagen expression of rat fetal membrane.Results:Western blotting,PCR and Masson staining indicated that the expression of FPR1 was significantly increased,the expression of collagen was decreased,and EMT appeared in PROM.The rat model indicated that LPS caused the collapse of fetal membrane epithelial cells,increased intercellular gaps,and decreased collagen.BOC-MLF promoted an increase in fetal membrane collagen,inhibited EMT,and reduced the weakening of fetal membranes.Conclusion:The expression of FPR1 in the fetal membrane of PROM was significantly increased,and EMT of the amniotic membrane was obvious.BOC-MLF can treat inflammation and inhibit amniotic EMT. 展开更多
关键词 formyl peptide receptor 1 BOC-MLF epithelial-mesenchymal transition premature rupture of membranes
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Changes of cytokines and matrix metalloproteinases in patients with premature rupture of chorioamnion and its clinical significance
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作者 Hao Li Ai-Ping Ma 《Journal of Hainan Medical University》 2017年第20期73-76,共4页
Objective: To investigate changes of cytokines and matrix metalloproteinases in patients with premature rupture of membranes (PROM) with chorioamnionitis (HCA) and its clinical significance. Methods: A total of 80 pre... Objective: To investigate changes of cytokines and matrix metalloproteinases in patients with premature rupture of membranes (PROM) with chorioamnionitis (HCA) and its clinical significance. Methods: A total of 80 pregnant women with premature rupture of membranes were selected as PROM group and 80 normal pregnant women as control group. The PROM group was subgrouped into HCA group (n=45) and non HCA group (n=35) according to the presence or absence of HCA. Matrix metalloproteinases (MMP-8, MMP-9) and cytokines (IL-8, IL-10, TNF-α) in pregnant women were compared. Results: The level of IL-8, TNF-αwere (420.45±110.26) ng/L, (413.53±125.19) ng/L in the PROM group, which were significantly higher than those in the control group;the levels of IL-10 were(332.07±48.12) ng/L in the PROM groups, which were significantly lower than the control group. The levels of IL-8 and TNF-α in PROM combined with HCA group were significantly higher than those in non-HCA group, the levels of IL-10 were significantly lower than those in non-HCA group. The level of MMP-8, MMP-9 were (11.02±2.48) ng/mL, (648.42±73.35) ng/L in the PROM group, which were significantly higher than the control group. The levels of MMP-8, MMP-9 in PROM combined with HCA were significantly higher than those in non-HCA group with the difference was statistically significant. Conclusion: When premature rupture of membranes and chorioamniositis occurring, pregnant women were accompanied by the level changes of cytokines and matrix metalloproteinases, so timely monitoring of these indicators can offer basis for the early diagnosis the premature rupture of membranes and chorioamnionitis, which will help to reduce morbidity and mortality of the perinatal pregnant women and newborns with important clinical value. 展开更多
关键词 premature rupture of membranes CHORIOAMNIONITIS CYTOKINES Matrix METALLOPROTEINASES
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The AL-SENSE Test is Reliable for Detection of Second Trimester Amniotic Fluid
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作者 Marwan Odeh Ella Ophir +2 位作者 Hadar Kesari-Shoham Olga Maximovsky Jacob Bornstein 《International Journal of Clinical Medicine》 2011年第3期307-309,共3页
Objective: To validate the reliability and stability of the AL-SENSE panty-liner for detection of amniotic fluid in the second trimester. Study design: Amniotic fluid drawn during amniocentesis between 16 to 23 weeks ... Objective: To validate the reliability and stability of the AL-SENSE panty-liner for detection of amniotic fluid in the second trimester. Study design: Amniotic fluid drawn during amniocentesis between 16 to 23 weeks of gestation was used for the study.100 μl and 400 μl of amniotic fluid, were dripped onto two panty liners, respectively. After 5 minutes the indicator strip was removed from the AL-SENSE, dried and examined. The color was recorded at time 0 and 5 minutes, and then every 10 minutes for the first 30 minutes, then at 1, 2, 6 and 12 hours. Results: 50 women were enrolled and 49 completed the study. 100% of both volume samples changed color from yellow to blue during the first 5 minutes and remained stable after twelve hours of follow-up. In the 100 μl subgroup, seven of the 49 samples (14.3%) had a delayed color change and in the 400 μl subgroup one of 49 (2.04%) had a delay in change of color. Conclusion: Amniotic fluid drawn during amniocentesis at weeks 16 - 23 of gestation have a positive, stable staining effect on the AL-SENSE panty liner. Hence, AL-SENSE may be reliable for detection of amniotic fluid leakage during the second trimester. 展开更多
关键词 Panty LINER AMNIOCENTESIS SECOND Trimester premature rupture of membranes
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1例未足月胎膜早破青霉素过敏患者抗菌药物应用的药学监护
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作者 刘佳明 褚燕琦 +1 位作者 张青霞 张兰 《中国药物应用与监测》 CAS 2024年第1期76-78,共3页
1例29岁有青霉素过敏史的妊娠女性,因“停经31+周,阴道流液5 h”入院。患者诊断为胎膜早破,有预防性应用抗菌药物指征。临床药师了解患者过敏史后,考虑发生青霉素速发型过敏反应风险较低,建议试行青霉素皮试或使用头孢呋辛。患者拒绝青... 1例29岁有青霉素过敏史的妊娠女性,因“停经31+周,阴道流液5 h”入院。患者诊断为胎膜早破,有预防性应用抗菌药物指征。临床药师了解患者过敏史后,考虑发生青霉素速发型过敏反应风险较低,建议试行青霉素皮试或使用头孢呋辛。患者拒绝青霉素皮试,头孢呋辛皮试阳性。调整为万古霉素(1 g,每8 h 1次,静脉滴注)联合阿奇霉素(首次500 mg口服,第2天250 mg 1次·d^(-1),口服,疗程4 d),行B族链球菌(GBS)筛查及宫腔细菌培养。GBS筛查阴性,建议停用万古霉素。宫腔细菌培养报大肠埃希菌,结合患者症状体征、检验指标考虑污染可能性大,继续使用阿奇霉素。患者羊水较少,予引产后分娩,母儿情况可。阿奇霉素使用5d后停用,患者出院。产后2周随访母儿情况良好。 展开更多
关键词 未足月胎膜早破 青霉素过敏 抗菌药物 临床药师 药学监护
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细胞焦亡相关蛋白在胎膜早破孕妇胎膜组织中的表达及其与妊娠结局的关系
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作者 钱云英 钱桂英 +5 位作者 蔡奚梅 顾伟群 倪海燕 朱丹婴 徐英芳 计文霞 《江苏大学学报(医学版)》 CAS 2024年第4期283-289,306,共8页
目的:探究细胞焦亡相关蛋白半胱氨酸天冬氨酸特异性蛋白酶-1(cysteinyl aspartate specific proteinase,Caspase-1)和核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)在... 目的:探究细胞焦亡相关蛋白半胱氨酸天冬氨酸特异性蛋白酶-1(cysteinyl aspartate specific proteinase,Caspase-1)和核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)在胎膜早破孕妇胎膜组织中的表达及其与妊娠结局的关系。方法:选择2020年1月至2023年1月于常熟市中医院妇产科就诊并分娩的胎膜早破孕妇135例作为观察组,另选择同期产检并分娩的健康孕妇135例作为对照组,比较两组孕妇胎膜组织中NLRP3 mRNA和Caspase-1 mRNA表达。依据妊娠结局将135例胎膜早破孕妇分为妊娠不良组(n=50)和妊娠良好组(n=85),通过单因素和多因素Logistic分析胎膜早破孕妇妊娠不良的独立危险因素;应用Logistic回归模型结合限制性立方样条(restricted cubic splines,RCS)分析胎膜早破孕妇胎膜组织中细胞焦亡相关蛋白表达量与妊娠不良的剂量反应关系;依据独立因素构建列线图预测模型,并对模型进行验证。结果:观察组胎膜组织中NLRP3 mRNA和Caspase-1 mRNA表达显著高于对照组(P<0.001)。就诊时间≥2 h、生殖道感染、NLRP3 mRNA和Caspase-1 mRNA高表达是胎膜早破孕妇妊娠结局不良的独立危险因素(P<0.05);RCS结果显示,胎膜早破孕妇胎膜组织中NLRP3 mRNA、Caspase-1 mRNA表达量与妊娠结局不良呈非线性剂量反应关系,在NLRP3 mRNA表达量为1.20(OR=1.818,95%CI:1.673~1.932)和Caspase-1 mRNA表达量为1.25(OR=2.735,95%CI:1.132~3.821)处发生妊娠结局不良的风险最大;构建的列线图预测模型具有良好的区分度、准确性和临床适用性。结论:NLRP3 mRNA和Caspase-1 mRNA在胎膜早破孕妇胎膜组织中呈高表达,二者是胎膜早破孕妇妊娠结局不良的独立危险因素,随着表达量升高,胎膜早破孕妇妊娠不良的危险性也随之升高。 展开更多
关键词 细胞焦亡相关蛋白 半胱氨酸天冬氨酸特异性蛋白酶-1 核苷酸结合寡聚化结构域样受体蛋白3 胎膜早破 胎膜组织 妊娠结局
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胎膜早破孕妇阴道微生态和胎盘分离菌及耐药性分析
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作者 章国平 郭明亮 +1 位作者 张翀 贺锐 《分子诊断与治疗杂志》 2024年第3期569-572,577,共5页
目的 比较胎膜早破和正常破裂孕妇孕晚期(孕35~37周)阴道微生态、胎盘拭子细菌分布和耐药性情况,为临床预防和治疗提供病原学依据。方法 收集甘肃省妇幼保健院产科2020年1月1日至2022年6月30日胎盘拭子培养结果,将培养阳性的孕妇分成胎... 目的 比较胎膜早破和正常破裂孕妇孕晚期(孕35~37周)阴道微生态、胎盘拭子细菌分布和耐药性情况,为临床预防和治疗提供病原学依据。方法 收集甘肃省妇幼保健院产科2020年1月1日至2022年6月30日胎盘拭子培养结果,将培养阳性的孕妇分成胎膜早破组和正常破裂组,比较两组基本临床特征及孕晚期阴道微生态、胎盘分离菌和药敏结果。结果 两组孕周、年龄、细菌性阴道病和正常微生态情况差异有统计学意义(P<0.05);多因素Logistic回归分析显示孕周(β=-0.711,OR=0.491)和正常微生态(β=-1.412,OR=4.103)与胎膜早破发生呈负相关,年龄(β=0.076,OR=1.079)呈正相关,细菌性阴道病的差异无统计学意义(P>0.05)。两组胎盘主要分离菌为革兰阴性杆菌,差异无统计学意义(P>0.05),以大肠埃希菌为主,检出率差异有统计学意义(P<0.05),胎膜早破组产超广谱β-内酰胺酶比例较高,对氨苄西林、头孢类耐药性高,差异有统计学意义(P<0.05);其次是革兰阳性球菌(粪肠球菌和无乳链球菌为主),差异无统计学意义(P>0.05)。无乳链球菌对青霉素类、糖肽类等敏感,对喹诺酮类耐药率较高;粪肠球菌对青霉素类、糖肽类、恶唑烷酮类等敏感,对红霉素和克林霉素的耐药性较高。结论 胎膜早破组年龄偏大且孕周小,孕晚期易发生阴道微生态异常,其胎盘拭子大肠埃希菌检出率、对青霉素和头孢类抗生素耐药性较高。 展开更多
关键词 胎膜早破 阴道微生态 胎盘拭子 分离菌 耐药性
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保留胎膜剖宫产在早产孕妇中的应用效果分析
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作者 赵雅玲 罗秋兰 +1 位作者 黎海龙 刘娇兰 《中国社区医师》 2024年第14期61-63,共3页
目的:分析保留胎膜剖宫产在早产孕妇中的应用效果。方法:选取2022年1月—2023年8月于东莞市长安医院行剖宫产的早产孕妇80例作为研究对象,随机分为观察组和对照组,各40例。对照组实施常规剖宫产,观察组实施保留胎膜剖宫产。比较两组治... 目的:分析保留胎膜剖宫产在早产孕妇中的应用效果。方法:选取2022年1月—2023年8月于东莞市长安医院行剖宫产的早产孕妇80例作为研究对象,随机分为观察组和对照组,各40例。对照组实施常规剖宫产,观察组实施保留胎膜剖宫产。比较两组治疗效果。结果:观察组术中出血量、产后24 h出血量少于对照组,差异有统计学意义(P<0.001)。术前,两组红细胞计数、血细胞比容、血红蛋白水平比较,差异无统计学意义(P>0.05);术后3 d,两组红细胞计数、血细胞比容、血红蛋白水平低于术前,但观察组高于对照组,差异有统计学意义(P<0.05)。观察组脐动脉pH、脐静脉血红蛋白水平高于对照组,肿瘤坏死因子-α水平低于对照组,差异有统计学意义(P<0.05)。观察组新生儿出生后1、5 min阿普加评分高于对照组,差异有统计学意义(P<0.05)。结论:保留胎膜剖宫产在早产孕妇中的应用效果显著,可减少孕妇术中及产后24 h出血量,减轻早产儿机体损伤。 展开更多
关键词 保留胎膜剖宫产 早产 孕妇 阿普加评分
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胎膜早破的危险因素及其对新生儿结局影响的临床分析 被引量:1
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作者 董景玉 杨丽君 崔红 《临床和实验医学杂志》 2024年第5期527-531,共5页
目的分析胎膜早破的危险因素及其对新生儿结局的影响,为胎膜早破新生儿是否需要提前干预提供临床依据。方法采用便利抽样法选取2019年1月1日至12月31日北京市通州区妇幼保健院产科住院分娩的2066例单胎产妇及其分娩的新生儿临床资料进... 目的分析胎膜早破的危险因素及其对新生儿结局的影响,为胎膜早破新生儿是否需要提前干预提供临床依据。方法采用便利抽样法选取2019年1月1日至12月31日北京市通州区妇幼保健院产科住院分娩的2066例单胎产妇及其分娩的新生儿临床资料进行横断面研究,统计胎膜早破的发生率,分析胎膜早破的危险因素,分析胎膜早破对新生儿结局的影响,并进一步分析胎膜早破的时间和产前应用抗生素对新生儿结局的影响。结果(1)2019年北京市通州区妇幼保健院产科单胎胎膜早破的发生率为28.94%(598/2066)。(2)多因素Logistic回归分析结果显示:孕周(足月)、剖宫产病史、漏斗骨盆、贫血、孕次、急性绒毛膜羊膜炎及巨大儿是胎膜早破的危险因素(P<0.05)。(3)根据胎膜在临产前是否发生自发性破裂分为胎膜早破组(n=598)和非胎膜早破组(n=1468)。胎膜早破组在早产和新生儿72 h内转新生儿科住院率分别为10.03%、10.20%,均高于非胎膜早破组(2.86%、7.29%),差异均有统计学意义(P<0.05);胎膜早破组与非胎膜早破组的胎儿宫内窘迫、新生儿窒息和新生儿早期感染发生率比较,差异均无统计学意义(P>0.05)。(4)胎膜早破时间对新生儿出生后72 h内新生儿科住院预测的受试者工作特征(ROC)曲线中的切点为胎膜早破时间>21 h,其预测新生儿出生后72 h内转新生儿科住院的曲线下面积为0.601,特异度为77.9%,灵敏度为37.7%。(5)胎膜早破>21 h新生儿早期感染发生率、新生儿科住院发生率和产前抗生素使用率分别为7.04%、16.20%、94.37%,均高于胎膜早破≤21 h新生儿(2.63%、8.33%、35.96%),差异均有统计学意义(P<0.05)。结论2019年北京市通州区妇幼保健院产科单胎胎膜早破的发生率为28.94%;剖宫产病史、漏斗骨盆、贫血、急性绒毛膜羊膜炎、孕次和巨大儿是胎膜早破的危险因素;胎膜早破增加了早产和新生儿科住院率,产前应用抗生素可降低新生儿早期感染发生率。 展开更多
关键词 胎膜早破 危险因素 新生儿 结局
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孕妇孕晚期生殖道GBS感染对胎膜早破、妊娠结局影响 被引量:1
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作者 刘洋 马晓丹 +1 位作者 吴云 马铟 《中国计划生育学杂志》 2024年第4期866-868,873,共4页
目的:院内妊娠晚期孕妇生殖道B族链球菌(GBS)感染情况调查并探究对胎膜早破、妊娠结局的影响。方法:选取2021年6月-2023年7月于本院定期产前检查的妊娠晚期孕妇3970例GBS感染检测,根据感染情况分为感染组和非感染组,比较两组胎膜早破发... 目的:院内妊娠晚期孕妇生殖道B族链球菌(GBS)感染情况调查并探究对胎膜早破、妊娠结局的影响。方法:选取2021年6月-2023年7月于本院定期产前检查的妊娠晚期孕妇3970例GBS感染检测,根据感染情况分为感染组和非感染组,比较两组胎膜早破发生率及妊娠不良结局。结果:3970例孕妇中103例GBS感染,感染率2.6%,纳入感染组,非感染孕妇中随机选取103例纳入非感染组;感染组年龄≤30岁组感染率(68.0%)高于>30~35岁组及>35岁组,感染组胎膜早破发生率(18.5%)高于非感染组(4.9%),绒毛膜羊膜炎(6.8%)、新生儿肺炎(13.6%)、胎儿生长发育迟缓(8.7%)、新生儿感染(7.8%)、胎儿宫内窘迫(9.7%)发生率均高于非感染组(0、4.9%、1.0%、1.0%、1.9%)(均P<0.05);两组产妇分娩期发热、新生儿黄疸发生率未见差异(P>0.05)。结论:孕晚期孕妇发生GBS感染增加胎膜早破及不良妊娠结局发生风险,临床应及时采取措施治疗干预。 展开更多
关键词 妊娠晚期 生殖道感染 B族链球菌 胎膜早破 不良妊娠结局
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孕妇阴道B族链球菌检测联合胎儿脐带血中性粒细胞CD64指数预测胎膜早破新生儿感染的价值
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作者 谭海燕 蒋玉蓉 《检验医学》 CAS 2024年第1期53-59,共7页
目的 探讨孕妇阴道B族链球菌(GBS)检测联合胎儿脐带血中性粒细胞CD64指数对胎膜早破(PROM)新生儿感染的预测价值,并分析其影响因素。方法 选取2022年3—12月湖南省妇幼保健院170例足月分娩PROM新生儿作为观察组,根据新生儿感染情况分为... 目的 探讨孕妇阴道B族链球菌(GBS)检测联合胎儿脐带血中性粒细胞CD64指数对胎膜早破(PROM)新生儿感染的预测价值,并分析其影响因素。方法 选取2022年3—12月湖南省妇幼保健院170例足月分娩PROM新生儿作为观察组,根据新生儿感染情况分为感染组(48例)和未感染组(122例)。比较新生儿一般资料,分析PROM新生儿感染与临床特征的关系。采用多因素Logistic回归分析评价PROM新生儿感染的影响因素;构建列线图模型,并进行验证。采用受试者工作特征(ROC)曲线评价GBS阳性、CD64指数判断新生儿感染的效能。结果 感染组和未感染组PROM到分娩时间、绒毛膜羊膜炎、GBS阳性、阴道指检次数、产前使用抗菌药物、5 min Apgar评分<7分、羊水污染、CD64指数差异均有统计学意义(P<0.05)。PROM到分娩时间、绒毛膜羊膜炎、GBS阳性、阴道指检次数、CD64指数是PROM新生儿感染的危险因素(P<0.05),这5项指标在列线图预测模型中的总分为294分,对应的感染风险为73.15%。交互作用分析结果显示,CD64指数、GBS阳性对感染组和未感染组具有正相加交互作用(P<0.001)。ROC曲线分析结果显示,CD64指数和GBS阳性单项检测和联合检测判断PROM新生儿感染的曲线下面积分别为0.763、0.807和0.847。结论 孕妇阴道GBS检测联合胎儿脐带血中性粒细胞CD64指数对PROM新生儿感染具有较高的预测价值。PROM到分娩时间、绒毛膜羊膜炎、阴道检查次数是导致PROM新生儿感染的危险因素,临床应重点关注,以降低感染风险。 展开更多
关键词 B族链球菌 中性粒细胞CD64 胎膜早破 新生儿感染
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GBS、衣原体联合解脲支原体检测对胎膜早破患者妊娠结局的预测作用
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作者 罗婷婷 施云 张丽 《分子诊断与治疗杂志》 2024年第3期398-402,共5页
目的 研究B族链球菌(GBS)、衣原体联合解脲支原体(UU)检测对胎膜早破患者妊娠结局的预测作用。方法 选取上海交通大学医学院附属新华医院2021年2月至2023年1月收治的胎膜早破产妇168例为观察组,另选取同期进行孕检且结果正常的165名孕... 目的 研究B族链球菌(GBS)、衣原体联合解脲支原体(UU)检测对胎膜早破患者妊娠结局的预测作用。方法 选取上海交通大学医学院附属新华医院2021年2月至2023年1月收治的胎膜早破产妇168例为观察组,另选取同期进行孕检且结果正常的165名孕妇为对照组。对比两组GBS、衣原体、UU阳性率;分析GBS、衣原体、UU单一检测对观察组不良妊娠结局的预测结果;分析GBS、衣原体、UU三者联合对观察组孕妇不良妊娠结局的预测结果。结果 观察组GBS阳性率、衣原体阳性率、UU阳性率均比对照组高,差异均有统计学意义(P<0.05)。GBS阴性122例,GBS阳性46例,GBS阳性胎膜早破孕妇不良妊娠结局发生率比对照组高,差异有统计学意义(P<0.05)。衣原体阴性128例,衣原体阳性40例,衣原体阳性胎膜早破孕妇不良妊娠结局发生率比对照组高,差异有统计学意义(P<0.05)。UU阴性117例,UU阳性51例,UU阳性胎膜早破孕妇不良妊娠结局发生率比对照组高,差异有统计学意义(P<0.05)。168例胎膜早破孕妇中,GBS、衣原体和UU均为阴性117例,GBS、衣原体和UU为单一一个或两个为阳性11例,GBS、衣原体和UU均为阳性40例;GBS、衣原体和UU均为阳性胎膜早破孕妇不良妊娠结局发生率均比单一或两个感染及阴性胎膜早破孕妇高,差异有统计学意义(P<0.05)。结论 胎膜早破孕妇的GBS、衣原体和UU阳性率均高于正常妊娠孕妇,且GBS、衣原体和UU联合检测可更准确地预测母体和胎儿不良结局。 展开更多
关键词 B族链球菌 衣原体 解脲支原体 胎膜早破 妊娠结局
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未足月胎膜早破发病机制的研究进展 被引量:1
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作者 赖锦文 叶青 +1 位作者 蔡雨静 梁雄 《实用妇科内分泌电子杂志》 2024年第4期33-35,共3页
未足月胎膜早破(PPROM)在产科中是一种出现频率较高且风险较大较难处理的产科并发症,是导致胎儿早产的主要原因之一,若不能及时给予针对性的处理,会严重威胁母儿生命。在现有研究中,PPROM与许多因素有关,如生殖道感染、母胎因素、不良... 未足月胎膜早破(PPROM)在产科中是一种出现频率较高且风险较大较难处理的产科并发症,是导致胎儿早产的主要原因之一,若不能及时给予针对性的处理,会严重威胁母儿生命。在现有研究中,PPROM与许多因素有关,如生殖道感染、母胎因素、不良生活习惯及遗传相关疾病等,之间相互作用和影响,最终导致胎膜降解和破裂。未足月胎膜早破的有着复杂的发病机制,本文通过综述PPROM发病机制的研究进展,讨论导致胎膜弱化的危险因素以及机制,为降低PPROM发生率提供线索和方法。 展开更多
关键词 综述 未足月胎膜早破 研究进展 发病机制
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