临产孕妇念珠菌感染及不良妊娠结局调查

目的 对临产孕妇念珠菌感染及不良妊娠结局进行调查。方法 知情同意下,选择2013年1月～2014年6月,到茂名市妇幼保健院产科住院的542例临产孕妇,采集其阴道分泌物进行念珠菌检查。所选对象年龄段为20～30岁,均自诉无阴道致病原感染不适症状,但包括很小部分表述有阴道念珠菌感染临床表现者。采用10 g/dl氢氧化钾溶液湿片和革兰氏染色油片两种方法,两法显微镜下同时找到假丝酵母菌的芽生孢子或假菌丝确诊为阳性结果,否则为阴性。分别选择阳性为观察组,阴性为对照组,记录两组孕妇发生胎膜早破、会阴伤口感染、新生儿鹅口疮、新生儿尿布疹四种不良妊娠结局情况。统计学方法:计数资料用卡方检验,计量资料用方差分析。结果 获得念珠菌阳性125例,阴性417例,感染率为23.1%,水平较国内报道的19.3%高。观察组孕妇胎膜早破、新生儿尿布疹、会阴伤口感染、新生儿鹅口疮发生率分别是19.2%,8.0%,16.8%和12.8%; 明显高于对照组的8.4%,1.2%,3.8%和1.7%(χ²=12.578～29.273,P值均<0.01)。结论 孕妇念珠菌感染可增加不良妊娠结局,保健或临床医生应建议孕妇,对该菌行常规检查并及早诊治,以便更好预防不良妊娠结局。

Investigation Analysis of Monilia Infection and Adverse Pregnancy Outcomes of Pregnant Women in Labor

Objective To investigate Monilia infectionand adverse pregnancy outcomes of pregnant women in labor.MethodsBefore informed consent,542 cases of pregnant women in labor were collected in Obstetrics Department of Maternity and Child Healthcare of Maoming City from January 2013 to April 2014,and all of these cases were examined by Monilia inspection of vaginal secretions.All of these cases were 20 to 30 yearsold,without vaginal pathogenic infection symptoms,but included in a few of formulation of clinical features of vaginal Candida infection.With the two methods of 10% potassium hydroxide solution wet sheet and Gram staining,if blastospore or pseudohypha of Candida mycoderma were found out in the two methodsunder microscope,this case was diagnosed as positive result,otherwise as negative result.Respectively choosing positive cases as observation group,and negative cases as control group,the indexes of premature rupture of membranes,perineum wound infection,neonatal thrush and neonatal diaper rash of the two groupswere recorded.The statistical method:enumeration data by chi-square test,measurement data using analysis of varianc.Results The positive rate of Monilia was 23.1%(125/542),higher than 19.3% reported in domestic.The incidence rates of neonatal diaper rash,premature rupture of membranes,neonatal thrush and perineum wound infection of the observation group wererespectively 19.2%,8.0%,16.8% and 12.8%,all much higher than the controlgroup respectively was 8.4%,1.2%,3.8% and 1.7%,(χ²=12.578～29.273,all P<0.01).Conclusion Monilia infection ofpregnant women in labor could increase the chance of adverse pregnancy outcomes.Healthy or clinical doctors should suggest that pregnant women early carry outroutine examination and early treatment,in order to prevent adverse pregnancyoutcomes.