荧光定量PCR在妊娠35～37周B族链球菌感染检测中的应用及妊娠结果分析

目的 运用荧光定量PCR法快速检测B族链球菌(GBS)感染并探讨其对妊娠结局及新生儿的影响.方法 收集1235例妊娠晚期孕妇阴道拭子,采用细菌培养法和荧光定量PCR法检测是否感染GBS,并比较GBS阳性和阴性两组患者的妊娠结局.结果 荧光定量PCR检测法阳性率显著高于细菌培养法(19.51％ vs.9.72％),且差异有统计学意义.两组孕妇妊娠结局和两组新生儿出生后健康状况如宫内感染、新生儿感染等发生率比较差异有统计学意义.结论 荧光定量PCR法检测GBS可早期预防治疗,有效改善孕妇妊娠结局和新生儿出生后健康状况,对孕晚期孕妇进行GBS感染的检测具有重要的临床意义.     

孕妇B族链球菌的检测及其临床价值

目的 探讨免疫层析法在检测孕妇B族链球菌(GBS)感染中的临床价值.方法 选取2014年12月至2015年12月间我院待产孕妇320例,各取2份阴道分泌物标本.1份用免疫层析法快速检测GBS;另1份用于接种THB培养基,第2天转至血平板,并对可疑菌落进行生化鉴定.同时对320例孕妇的妊娠结局进行随访.结果 免疫层析法检测出GBS感染41(12.81％)例,培养法检测出GBS感染36(11.25％)例,以细菌培养法为参考标准,免疫层析法的符合率为98.4％.通过临床跟踪随访,320例孕妇中有16例发生早产、胎膜早破等异常情况,其中有13例GBS阳性.结论 GBS与早产、胎膜早破等异常妊娠关系密切;免疫层析法较传统细菌培养法检出率无统计差异,且有步骤简单、省时等优点,适合应用于临床筛查GBS感染.     

阴道分泌物白细胞介素8与孕妇宫内感染关系探讨

目的探索一种早期诊断宫内感染简便、易行的方法,对绒膜羊膜炎患者早期诊断、早期治疗,以减少围产期并发症及不良妊娠结局的发生。方法对375例不同孕周的孕妇检测其阴道分泌物沙眼衣原体(CT),解脲支原体(Uu),人型支原体(Mh),细菌性阴道病(BV)等病原微生物进行白细胞介素8(IL-8)定量检测及妊娠结局的随访观察,观察IL-8浓度与孕妇阴道感染及发生流产、早产、胎膜早破、胎儿宫内生长受限(FGR)等宫内感染的关系。结果发现有阴道微生物感染的孕妇(255例),阴道分泌物IL-8浓度明显高于无阴道感染的对照组(120例),发生宫内感染、流产、早产、胎膜早破、胎儿宫内生长受限(FGR)等的几率明显高于对照组。结论阴道分泌物IL-8浓度的监测可以作为早期诊断宫内感染的有效预测指标。     

孕晚期孕妇生殖道GBS感染及预防性治疗与妊娠结局和新生儿预后的关系

目的 探讨孕晚期孕妇生殖道B族链球菌(GBS)感染情况及预防性治疗对妊娠结局和新生儿预后的影响。方法 选取2020年1月至2023年4月于江西省妇幼保健院就诊的500例待产孕妇，利用荧光聚合酶链反应(PCR)法检测500例孕晚期孕妇生殖道感染GBS情况，分为GBS阳性组(n=102)和GBS阴性组(n=398)，收集其临床资料，分析孕晚期孕妇感染GBS的影响因素，并进行药物敏感(药敏)试验。根据是否接受预防性治疗将GBS阳性组孕妇分为研究组(接受预防性治疗，55例)和对照组(未接受预防性治疗，47例)，比较两组孕妇妊娠结局和新生儿出生后情况。结果 500例孕晚期孕妇GBS阳性率为20.4%(102/500)。孕早期体质量指数(BMI)≥25kg/m²、经产、糖耐量异常、流产史和阴道与宫颈炎症为孕晚期孕妇感染GBS的独立危险因素(P<0.05)。GBS药敏试验结果显示，其对青霉素、头孢曲松、万古霉素、头孢噻肟、氨苄西林、苯唑西林、环丙沙星和利奈唑胺的敏感率较高(91.18%～100.00%)，对红霉素的敏感度较低(38.24%)。研究组孕妇胎膜早破、产后出血、...     

解脲支原体感染与妊娠结局的关系探讨

目的探讨解脲支原体（UU）感染与妊娠结局的关系,了解妊娠期UU感染对围产儿及孕产妇的影响。方法采用培养法对369例孕产妇的宫颈分泌物进行检测。结果369例孕妇中UU阳性者210例,占56.9%,UU阳性组与阴性组比较,其胎膜早破、早产、低出生体重儿、新生儿肺炎、胎儿宫内窘迫、剖宫产的发生率高,差异有显著性（P〈0.05）。结论解脲支原体感染可引起不良的妊娠结局。     

孕期沙眼衣原体感染与妊娠结局的关系

目的研究孕期沙眼衣原体(Chlamydia trachomatis,CT)与妊娠结局的关系.方法120例CT感染给予治疗的孕妇为A组;选择在年龄、孕周与之匹配因故未治疗的57例CT感染孕妇为B组;同期行围产监测的120例正常孕妇为C组.比较不良妊娠结局及宫内感染率.结果B组的自然流产、胎膜早破、早产、低体重儿、产褥感染、新生儿结膜炎、新生儿肺炎的发生率高于C组,P＜0.05,差异有显著性意义.A组与B组相比,其妊娠结局好转、宫内感染率下降,P＜0.05,差异有显著性意义.结论孕期CT感染可造成不良妊娠结局,治疗降低了宫内垂直传播率,应在孕前、孕早期常规筛查以便早诊早治从而改善妊娠结局.     

妊娠晚期B族链球菌感染及干预措施对妊娠结局的影响

目的:探讨妊娠晚期孕妇B族溶血性链球菌(Group B streptococcus,GBS)感染情况,及产时预防性抗生素治疗对妊娠结局的影响.方法:对2018年3月至2020年3月本院行GBS筛查并最终分娩的1826例孕妇进行回顾性分析,其中GBS筛查阳性的66例为GBS阳性组,同期GBS筛查阴性的66例作为对照组;根...     

妊娠晚期孕妇下生殖道支原体感染及分娩结局分析

目的回顾性分析230例妊娠晚期孕妇下生殖道支原体感染及分娩结局分析。方法用支原体培养、鉴别试剂对230例妊娠晚期29～42周孕妇的宫颈阴道分泌物进行支原体检测,同时临床观察其妊娠结局。结果宫颈阴道分泌支原体阳性率为66.5%,阴性率33.5%。两组比较：胎儿宫内窘迫、胎膜早破、早产、出生低体重儿、低Apgar评分（1分钟）、阴道杂菌等的发生率无显著性差异（P〈0.05）,新生儿感染发生率有显著性差异（P〈0.05）。结论妊娠晚期孕妇下生殖道支原体感染及其分娩结局分析,阳性组发病率与阴性组比较有显著差异（P〈0.05）,因此,认为妊娠中、晚期进行支原体检查,以减少感染,有利于提高围生期保健质量,     

妊娠晚期孕妇GBS感染对生殖道微生态的影响及与未足月胎膜早破的关系

目的 探讨妊娠晚期孕妇GBS感染对生殖道微生态的影响及与未足月胎膜早破（PPROM）的关系。方法 选取2019年1月至2022年2月于海南省妇女儿童医院产科进行住院分娩的PPROM产妇50例，纳入PPROM组；以1∶1比例随机抽取同期住院分娩的足月胎膜早破产妇50例为对照组。分别统计2组孕妇的相关临床病理资料，并对2组产妇实施PPROM单因素与多因素回归分析，构建分类树模型并对模型进行评价。分析生殖道微生态失衡与B族溶血性链球菌（GBS）感染的关系。结果 阴道微生态失衡、GBS感染均是PPROM发生的独立影响因素（P<0.05）。分类树模型对PPROM发生风险的预测效果较好。GBS感染阳性组妊娠晚期孕妇阴道清洁度Ⅲ～Ⅳ级占比、菌性阴道病占比、需氧性阴道炎占比、念珠菌性阴道炎占比、阴道pH>4.5占比均明显高于GBS感染阴性组，差异均有统计学意义（P<0.05）。结论 阴道微生态失衡、GBS感染均为PPROM发生的危险因素。妊娠晚期孕妇生殖道微生态失衡可能与GBS感染有关。分类树预测模型对妊娠晚期孕妇发生PPROM具有较高的预测效果。     

生殖道感染与胎膜早破妊娠结局的相关性研究

目的:分析生殖道感染与胎膜早破及不良妊娠结局,三者之间相关性.方法:选取2020年 2 月至2022年 2月期间我院收治的 240 例产妇作为研究对象,所有患者按照是否胎膜早破分为研究组和对照组,各 120 例.分析两组生殖道感染和妊娠结局情况.结果:胎膜早破组感染支原体、衣原体、B 族链球菌、细菌及总阳性检出率均明显高于对照组(P＜0.05);其中未足月胎膜早破感染支原体、衣原体、B族链球菌、细菌及总阳性检出率均明显高于足月胎膜早破组(P＜0.05);研究组胎盘绒毛膜羊膜炎、产褥感染、新生儿窒息的发生率均明显高于对照组(P＜0.05);破膜时间＞24 h组的阳性率明显高于破膜时间≤24 h组(P＜0.05).结论:生殖道感染易引起胎膜早破,导致不良妊娠结局发生率增高.     

β-族溶血性链球菌感染与胎膜早破及母儿预后

目的探讨β-族溶血性链球茵（GBS）感染与胎膜早破的关系及母儿预后的影响。方法选择胎膜早破（PROM）292例和200例正常妊娠作对照,取宫颈-阴道分泌物进行GBS培养,对GBS阳性的胎膜早破孕妇的羊水作白介素-6测定,并随机选择20例GBS阴性的胎膜早破孕妇作比较,并比较母儿预后。结果胎膜早破孕妇宫颈-阴道分泌物GBS阳性率（14％）明显高于正常组（6．0％）（P〈0．05）,未足月胎膜早破孕妇122例GBS阳性率（17．2％）明显高于足月胎膜早破孕妇170例（11．8％）（P〈0．05）,GBS阳性的胎膜早破孕妇羊水白介素-6（IL-6）176．6±82．4ng／L明显高于GBS阴性的胎膜早破孕妇的122．7±59．3ng／L（P〈0．05）,GBS阳性胎膜早破孕妇的分娩距破膜时间〈24h、胎儿窘迫、低体重儿的发生率较阴性孕妇高（P〈0．05）,产褥感染、新生儿感染发生率较阴性孕妇高,但无统计学意义。结论GBS感染可引起胎膜早破的发生及影响母儿预后。     

围产期孕妇B族链球菌感染的筛查方法对结果的影响

目的 通过比较聚合酶链反应（PCR）、显色平板法两种筛查方法,探讨围产期孕妇B族链球菌（GBS）感染的合适快速检测方法。方法 选取2016年5月~2018年5月我院152例常规产检的围产期孕妇,采集孕妇阴道分泌物后分别做PCR检测与显色平板法,并对结果进行质谱检测确认。比较两种方法对GBS的阳性检出率。结果 PCR检测方法的阳性检出率为 6.58%（10/152）,灵敏度为77.27%（17/22）,显色平板法的阳性检出率11.18%（17/152）,灵敏度为50.00%（10/22）。结论 两种筛查方法均能检测GBS,应用显色平板法对筛查围产期孕妇的GBS感染灵敏度更高。临床中对围产期孕妇的GBS 筛查采用显色平板培养的方法能提高GBS的检出率。     

南京地区妊娠期妇女高危型人乳头瘤病毒感染率及其对妊娠结局的影响

目的 调查南京地区孕妇高危型人乳头瘤病毒及亚型感染率,并探讨其对于妊娠结局的影响.方法 选取2014年2月至2016年5月南京中医药大学附属中西医结合医院(江苏省中医药研究院)产科门诊建卡孕妇1557例,同时分别以2016年1月至6月健康体检人群85例、妇科门诊就诊的各类炎症疾病患者2062例为对照,比较各组人群HR-HPV及亚型感染率,以早产、胎膜早破两种常见不良妊娠为结局,探讨孕期HR-HPV感染对于妊娠结局的影响,并进一步分析HR-HPV不同基因型感染之间孕妇妊娠结局的差异.结果 ①妊娠组、疾病组及健康体检组HR-HPV感染率分别为12.91％、16.39％和11.76％,妊娠组HR-HPV感染率显著低于疾病组(P＜0.05),与健康体检组之间无差异(P＞0.05).妊娠组16、18亚型及其它12种HR-HPV亚型感染率分别为2.63％、0.64％和10.66％,18亚型及其它12种HR-HPV亚型感染率均显著低于疾病组(P＜0.05),而16亚型无显著性差异(P＞0.05).②HR-HPV感染孕妇不良妊娠结局发生率显著高于无HR-HPV感染孕妇(P＜0.05).③二元Logistic回归分析显示,HR-HPV感染是早产、胎膜早破两种常见不良妊娠结局的危险因素(OR:3.323,95％ CI:2.192～5.036,P＜0.001),而年龄、孕产次对妊娠结局没有影响(P＞0.05).④单一HR-HPV 16或18亚型、其它12种高危亚型及两种或两种以上高危亚型感染之间孕妇不良妊娠结局发生率无显著性差异(P＞0.05).结果 孕期HR-HPV感染是早产、胎膜早破两种常见不良妊娠结局的危险因子,因此做好孕前及妊娠期HR-HPV筛查和积极干预,有利于优生优育.     

Vaginal colonization of the Streptococcus agalactiae in pregnant woman in Tunisia: risk factors and susceptibility of isolates to antibiotics

Streptococcus agalactiae or Group B Streptococcus (GBS) is one of the main bacterial causes of serious infections in newborns. We have evaluated prospectively GBS vaginal colonization in pregnant women and we have tried to determine the risk factors of the colonization by GBS and the particularities of the different isolated strains. We have screened 300 pregnant women with vaginal and anal sample in a same swab. Thirty nine (13%) pregnant women are colonized by SGB, 0% in the first trimester, 10.2% in the second trimester and 17% in the third trimester. Different factors are associated significantly with GBS colonization: past history of infection in newborns, genital infection during pregnancy and parity The highest rates of resistance are found in tetracycline (97.4%), erythromycin (51.3%) and lincomycin (46.2%). All the strains were susceptible to amoxicilin and pristinamycin.     

Application of the French guidelines for preventing neonatal group B streptococcal disease in a university hospital

This study evaluated the application of the French guidelines for prevention of neonatal group B streptococcus (GBS) infections. The prevalence of GBS vaginal carriage by pregnant women during the study period was 6%. Less than 50% of pregnant women testing positive for GBS were treated with at least two doses of antibiotics during labour, and most received only one dose or no antibiotics. In addition, several neonates were colonised or infected by GBS although their mothers were GBS-negative. These results are consistent with vaginal screening having a poor sensitivity, as suggested by the low prevalence of GBS carriage.     

Streptococcus salivarius K12 Limits Group B Streptococcus Vaginal Colonization

Streptococcus agalactiae (group B streptococcus [GBS]) colonizes the rectovaginal tract in 20% to 30% of women and during pregnancy can be transmitted to the newborn, causing severe invasive disease. Current routine screening and antibiotic prophylaxis have fallen short of complete prevention of GBS transmission, and GBS remains a leading cause of neonatal infection. We have investigated the ability of Streptococcus salivarius, a predominant member of the native human oral microbiota, to control GBS colonization. Comparison of the antibacterial activities of multiple S. salivarius strains by use of a deferred-antagonism test showed that S. salivarius strain K12 exhibited the broadest spectrum of activity against GBS. K12 effectively inhibited all GBS strains tested, including disease-implicated isolates from newborns and colonizing isolates from the vaginal tract of pregnant women. Inhibition was dependent on the presence of megaplasmid pSsal-K12, which encodes the bacteriocins salivaricin A and salivaricin B; however, in coculture experiments, GBS growth was impeded by K12 independently of the megaplasmid. We also demonstrated that K12 adheres to and invades human vaginal epithelial cells at levels comparable to GBS. Inhibitory activity of K12 was examined in vivo using a mouse model of GBS vaginal colonization. Mice colonized with GBS were treated vaginally with K12. K12 administration significantly reduced GBS vaginal colonization in comparison to nontreated controls, and this effect was partially dependent on the K12 megaplasmid. Our results suggest that K12 may have potential as a preventative therapy to control GBS vaginal colonization and thereby prevent its transmission to the neonate during pregnancy.     

妊娠期糖尿病规范化管理对妊娠结局的影响

目的探讨妊娠期糖尿病（GDM）的规范化管理对妊娠结局的影响。方法选择我院采用旧标准漏诊GDM而采用新标准确诊的GDM孕妇共200例,随机分入研究组1（GDM管理组）和研究组2（GDM不管理组）,每组各100例。对研究组1给予医学营养、运动和药物治疗,进行规范化管理;选取同期120例正常妊娠孕妇作为对照组。观察GDM患者治疗前后血糖水平[空腹血糖（FPG）、餐后2h血糖（2hPG）、餐后最高血糖）]变化情况,同时观察和比较3组孕产妇并发症（妊高症、羊水过多、胎膜早破、产后出血）、分娩方式（阴道分娩、剖宫产）、围生儿结局（早产、巨大儿、新生儿窒息、新生儿呼吸窘迫综合征）。结果与治疗前相比,GDM患者治疗后FPG、2hPG、餐后最高血糖水平均显著降低（P〈0.05）;与对照组相比,研究组1患者在并发症、阴道分娩率、剖宫产率,以及围生儿结局等方面,差异均无统计学意义（P〉0.05）,而研究组2患者与对照组相比各妊娠结局发生率显著不同。结论对于GDM患者进行规范化管理能够达到正常妊娠结局。     

Effect of antenatal corticosteroid and antibiotics in pregnancies complicated by premature rupture of membranes between 24 and 28 weeks of gestation

The aim of this study was to assess the effectiveness of active intervention with antenatal maternal corticosteroid and antibiotics therapy in infants delivered between 24 and 28 weeks of gestation after premature rupture of membrane. This retrospective study included pregnant women complicated by preterm delivery at the Dong-A University Hospital from 1998 to 2002. Patients were divided into labor induction group 1 (n=20), observation group 2 (n=19), and medication group 3 (n=20). We evaluated the effects of prolongation of pregnancy and intervention with maternal corticosteroids and antibiotics therapy on perinatal and neonatal outcomes. Each group did not have a significant difference (p<0.05) in neonatal outcomes, such as respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, retinopathy of prematurity, pneumonia, bronchopulmonary dysplasia, and sepsis. The mean latency period was 4.7 days and 7.6 days in groups 2 and 3, respectively. Therefore, this study was unable to demonstrate any beneficial effects of corticosteroids in improving neonatal outcomes and prolongation of the latency period with antibiotics.