围生期B族链球菌感染对足月孕妇妊娠结局的影响

目的:了解妊娠晚期妇女生殖道B族链球菌(GBS)的定植率及高危因素,探讨GBS感染对足月妊娠孕妇母儿妊娠结局的影响.方法:选择妊娠35~37周孕妇884例应用PCR方法进行GBS检测,同时对阴道分泌物进行病原体检测,并观察其妊娠结局.结果:孕妇产前GBS的阳性率为10.4%.其他病原体检出率分别为细菌性阴道病8.1%、滴虫1.2%、霉菌6.7%;GBS阳性和阴性组孕妇霉菌检测阳性率差异无统计学意义(P>0.05);GBS阳性组孕妇滴虫和细菌性阴道病检测阳性率均明显高于GBS阴性组孕妇(P<0.01).GBS阳性组剖宫产、产后出血、羊水粪染、胎膜早破和产褥感染的发生率与阴性组差异无统计学意义(P>0.05).GBS阳性组和GBS阴性组胎儿窘迫、新生儿窒息、新生儿感染和病理性黄疸的发生率差异均无统计学意义(P>0.05).结论:妊娠晚期阴道炎症与GBS定植率密切相关;对GBS阳性妊娠足月孕妇应用敏感抗生素治疗后母儿不良妊娠结局无明显升高.

Effect of the perinatal group B streptococcus infection on the outcome of full-term pregnancy

Objective:To investigate the colonization rate of the group B streptococcus(GBS) in the reproductive tract of terminal pregnant women and its high risk factors,and explore the effects of GBS infection on the outcome of full-term pregnancy. Methods:The GBS in 884 pregnant women with gestation age for 35 to 37 weeks were detected using fluorescence quantitation polymerase chain reaction,the microorganism from vaginal secretion in all cases were also detected, the pregnant outcome were observed. Results:The antenatal positive rate of GBS in 884 pregnant women was 10. 4%,and the positive rates of the bacterial vaginitis,trichomonal vaginitis and mould vaginitis were 8. 1%,1. 2% and 6. 7%,respectively. The difference of the positive rate of mould between the GBS positive and negative pregnant women was not statistically significant(P >0. 05). The positive rates of trichomonad and bacterial vaginal diseases in GBS positive pregnant women were significantly higher than those in GBS negative pregnant women(P <0. 01). The differences of the incidences of cesarean section,postpartum hemorrhage,meconium pollution of amniotic fluid,premature rupture for membranes and puerperal infection between the GBS positive and negative pregnant women were not statistically significant(P>0. 05). The differences of the incidence of fetus distress,neonate asphyxia and neonatal infection and pathological jaundice between the GBS positive and negative pregnant women were not statistically significant(P>0. 05). Conclusions:The colonization rate of GBS is closely related to the vaginal inflammation of terminal pregnant women. The GBS positive pregnant women should be treated with sensitive antibiotics,but the bad outcome of full-term pregnancy can not be significantly improved after treatment.