两种分娩方式对正常生殖道菌群的影响

目的 :观察剖宫产和自然分娩两种分娩方式对正常产妇生殖道菌群的影响。方法 :选择 4 8例无易感因素的正常产妇 ,2 0例择期剖宫产 ,2 8例自然分娩 ,分别在术前、术时、术后行阴道液、宫腔液细菌培养 ,分娩前后不使用任何抗生素 ,观察分娩期和产褥期生殖道菌群的自然变化和产后感染情况。结果 :剖宫产术前阴道细菌培养阳性率为 6 0 % ,术后为 85 % (P>0 .0 5 ) ,术前宫腔细菌培养为阴性 ,术后为 35 .0 % (P<0 .0 1) ,自然分娩时阴道细菌培养阳性率为 39.3% ,分娩后为 78.6 % (P<0 .0 1) ,分娩时宫腔细菌培养阳性率为 7.1% ,分娩后为 32 .4 % (P<0 .0 1) ;剖宫产术后伤口感染率为5 .0 % ,自然分娩伤口感染率为 3.6 % (P>0 .0 5 )。结论 :两种分娩方式均可影响正常生殖道的菌群生态环境 ,造成菌群失调。在无易感因素的条件下 ,不使用抗生素 ,剖宫产与自然分娩的感染率无差异 ,不增加产褥期感染

The Effect of Two Delivery Ways on the Bacterial Flora in Normal Genital Tract

Objectives:To study the effects of two delivery ways on the bacterial flora in the normal genital tract.Methods:48 cases of late pregnancy women without any high risk factors were divided into two groups:selective caesarean section(CS)group(20cases)and vaginal labor group(28 cases).Bacterial culture of vaginal swab and specimen aspirated from uterine cavity were performed pre and post surgery or labor.No antibiotics were given to investigate the changes of bacterial flora in the genital tract and the prevalence of puerperal infection.Results:In CS group,the positive rates of vaginal bacterial cultures in pre and post surgery was 60.0% and 78.6%( P >0.05).The positive rates of bacterial culture in uterine cavity was 35.0% post operation but all negative before surgery( P <0.01).In vaginal group,the positive rate of vaginal bacterial culture in pre and post labor was 39.3% and 78.6( P <0.01).It's 7.1% and 32.4% in uterine cavity in this group(P<0.01).The infection of incisional wound in two groups was 5.0% and 3.6%,respectively( P >0.05).Conclusions:both of CS and vaginal labor may disturb the bacterial flora in the normal genital tract.And therefore increase unbalance of local flora.There was no difference in the infective rates between two groups.And no increments appeared in puerperal infection without high risk factors.