解脲支原体宫内感染与胎膜早破关系的研究

目的 探讨解脲支原体(UU)宫内感染与胎膜早破的相关性。方法 运用培养法对妊娠晚期32例胎膜早破孕妇(试验组)和20例正常孕妇(对照组)的剖宫产术中羊水进行支原体培养检测,评价6种抗菌药物对抑制支原体的敏感性;同时运用PCR-微板核酸分子杂交法对上述羊水进行解脲支原体DNA检测。结果 试验组分离培养检测的UU感染阳性率为28.1％,对照组UU感染阳性率为5.0％(P>0.05);6种抗生素药敏试验提示氧氟沙星药物敏感性最弱;在同时进行的PCR-微板核酸分子杂交法试验中,试验组的UU检出率为46.9％,对照组的UU检出率为10.0％,两组比较差异有显著性(P<0.01)。结论 解脲支原体所致的宫内感染是部分妊娠晚期胎膜早破的原因之一。PCR-微板核酸分子杂交法联合培养法,是诊断解脲支原体宫内感染的特异、快速和准确的方法。     

孕妇沙眼衣原体、解脲支原体感染对围产结局的影响

目的研究孕妇沙眼衣原体(CT)和解脲支原体(UU)的感染对围产结局的影响。方法选取门诊行产前检查及住院待产的正常孕妇149例,采用ELISA方法检测母体血清中的抗UUIgG和抗CTIgG抗体,二者均未检出者作为对照组,对所有对象随访至妊娠结束,并详细记录分娩过程及新生儿情况。结果与对照组相比,UUIgG阳性组及复合阳性组[UUIgG( )且CTIgG( )]其早产、胎膜早破及死胎、畸胎的发生率具有显著性差异(P<0.05,P<0.05,P<0.05;P<0.01,P<0.05,P<0.01)。结论UU、CT感染可以引起不良妊娠结局,如早产、胎膜早破、畸胎、死胎,应积极预防和治疗。     

荧光定量PCR检测解脲支原体感染与胎膜早破的关系

目的:探讨解脲支原体(UU)感染与胎膜早破的关系。方法:采用荧光定量PCR检测法分别对50例胎膜早破和50例正常妊娠非胎膜早破妇女的宫颈分泌物、胎盘母面、新生儿咽拭子进行解脲支原体检测。结果:胎膜早破组宫颈分泌物、胎盘母面、新生儿咽拭子中,UU检测率明显高于对照组,两组比较,差异均有显著性(P<0.05)。结论:解脲支原体感染与胎膜早破的发生关系密切。     

解脲支原体和巨细胞病毒感染与胎膜早破的关系

目的研究解脲支原体(UU)和巨细胞病毒(HCMV)感染对胎膜早破的影响。方法应用聚合酶链反应(PCR)技术对82例胎膜早破孕妇(观察组)和104例正常孕妇(对照组)的宫颈分泌物进行UU和HCMV检测。结果胎膜早破组宫颈分泌物UU和HCMV阳性检出率分别为43.9％和39.0％,均明显高于对照组(P＜0.05,P＜0.01)。胎膜早破组UU和HCMV复合感染率为17.1％,也较对照组明显升高(P＜0.05)。结论孕妇UU和HCMV感染与胎膜早破密切相关。     

宫颈支原体感染与胎膜早破的关系探讨

目的探讨宫颈支原体感染与胎膜早破的关系及其对妊娠结局的影响。方法对北京市海淀区妇幼保健院2004年6月至2005年6月收治的93例胎膜早破孕妇(观察组)和96例孕足月、无胎膜早破住院待产孕妇(对照组)的宫颈分泌物,进行人型支原体(Mh)、解脲支原体(Uu)培养,并对其妊娠结局进行分析。结果观察组Mh感染率(6.45%)高于对照组(4.17%),但差异无统计学意义(P>0.05);观察组Uu感染率66.67%与对照组感染率55.21%比较,差异无统计学意义(P>0.05),观察组按是否早产再分两组,早产胎膜早破组产妇解脲支原体感染率为100%,明显高于足月胎膜早破组产妇61.73%,差异有统计学意义(P<0.05),早产胎膜早破组人型支原体感染率16.67%与足月胎膜早破产妇感染率2.47%比较,差异无统计学意义(P>0.05),但解脲支原体阳性孕妇分娩新生儿高胆红素血症明显增多,差异有统计学意义(P<0.05)。结论孕妇Mh、Uu感染与胎膜早破相关性不明显;Uu感染对早产的胎膜早破有明显影响,可能是导致早产胎膜早破的重要原因,并可能与新生儿高胆红素血症有关。     

稽留流产与生殖道感染的关系分析

目的:探讨生殖道解脲支原体(UU)和沙眼衣原体(CT)感染与稽留流产的关系及其临床意义。方法:应用培养法分别对150例稽留流产患者(实验组)、120例正常妊娠人工流产孕妇(对照组)进行UU及CT的检测,并行统计分析。结果:实验组中UU、CT、UU+CT的感染率分别为38.00%、24.67%、17.33%,时照组中UU、CT、UU+CT的感染率分别为17.50%、13.33%、7.50%,两组间分别比较差异有统计学意义(P<0.05)。结论:生殖道解腺支原体和沙眼衣原体感染对稽留流产有一定的影响,是其病因之一。     

围产期解脲脲原体感染与不良妊娠结局

目的　探讨围产期解脲脲原体（ＵＵ）感染及其对妊娠结局的影响。方法　应用解脲脲原体培养法和ＥＬＩＳＡ 方法,分两部分研究了ＵＵ 在孕妇下生殖道中的定植和ＵＵ 的宫内感染。结果　ＵＵ 在孕妇下生殖道中的定植率为６５％ ,ＵＵ 在孕妇下生殖道中的定植与胎膜早破有关;ＵＵ 可引起宫内感染,并与胎膜早破、绒毛膜羊膜炎以及新生儿出生体重和孕周的降低有关。　结论　围产期ＵＵ 感染尤其是ＵＵ 的宫内感染与多种不良妊娠结局的发生有关。     

解脲支原体感染与妊娠结局及新生儿肺炎的关系

目的 探讨解脲支原体（ＵＵ）感染与妊娠结局及新生儿肺炎的关系。方法 采用分离培养法对６０５例孕产妇的宫颈分泌物进行ＵＵ检测,并对其中９０例ＵＵ阳性的孕产妇分娩新生儿喉咽部分泌物进行ＵＵ检验。结果 孕产妇宫颈分泌物ＵＵ阳性组与阴性组比较,其胎膜早破、早产、产褥病率、低了生体重、新生儿肺炎的发病率高,差异有显著性（Ｐ〈０．０５）,新生儿喉咽部分泌物ＵＵ阳性组与阴性组比较,新生儿肺炎的发病率有显著差异（     

溶脲脲原体感染与精子密度关系的研究

目的:探讨溶脲脲原体(UU)感染与精子密度之间的关系。方法:在上海同济医院和仁济医院男科两研究中心就医,年龄在20-45岁的对象共346例,分为UU阳性和阴性两组,比较两组对象精子密度,应用混合线性模型-协方差分析,调整中心和禁欲时间计算修正均数;并构建多元线性回归模型控制混杂因素影响。结果:UU阳性对象精子密度均值为47.97×106/ml,而阴性对象为61.49×106/ml,差异有统计学意义(P<0.01)。在控制禁欲时间、研究中心、居沪年限、年龄、独用卫生间、饮酒史等因素的多元线性回归模型显示,UU感染对象的精子密度仍然较低(P<0.05)。结论:UU感染与精子密度下降有关。     

稽留流产与宫颈解脲支原体感染之间的关系探讨

稽留流产是指胚胎或胎儿已死亡滞留在宫腔内尚未自然排出者。是妊娠期常见的并发症之一。稽留流产原因十分复杂，除遗传因素、生殖器官异常、内分泌失调、免疫因素外，感染所致的流产越来越受到国内外学者的重视。支原体感染是最为关注的与不良妊娠结局有关的病原体。许多作者认为支原体感染可导致不良的妊娠结局。为了解稽留流产与支原体感染的关系，我们对妊娠期发生稽留流产妇女的宫颈分泌物进行解脲支原体培养及药物敏感试验，并与正常、但要求终止妊娠的妇女进行对比研究，探讨稽留流产与宫颈解脲支原体感染之间的关系。     

Prevalence of group B streptococcal colonization in pregnant women and their newborns based on the results of examination of patients in the Obstetric and Gynecology Department of the National Research Institute of Mother and Child--a pilot study

Group B streptococcus is a main cause of perinatal infections and neonatal sepsis. In Poland there is no epidemiological data of the prevalence group B streptococcal colonization in pregnant women and the risk for their newborns. OBJECTIVES: The aim of the study is to define the prevalence of streptococcal B colonization in pregnant women and their newborns. MATERIALS AND METHODS: The pregnant women and their newborns from Obstetric and Gynecology Department of National Research Institute of Mother and Child were included to our study during 2001 and 2002 years. Cervical, vaginal and perianal swab were obtained. Women with positive cultures were treated with antibiotic during labor. The external swabs of their neonate were obtained. RESULTS: 1678 pregnant women took part in our study. The GBS (streptococcus agalactiae) colonization was found in 331 women. The prevalence of pregnant women group B streptococcal colonization in the study is 19.7%. 70 of 203 neonates form mothers with positive results of our screening, had the GBS colonization confirmed. The prevalence of confirmed streptococcal colonization in neonates was 34.5%. One newborn developed early onset neonatal sepsis, during the study period. CONCLUSIONS: The prevalence of pregnant women group B streptococcal colonization about 20%. For the prevention of newborns intrapartum infections a major thing is the prevalence of the transmission risk to newborns from mothers with a GBS colonization and the appropriate intrapartum management.     

妊娠合并甲型H1N1流感14例临床分析

目的:探讨妊娠合并甲型H1N1流感的临床特点、治疗及其结局.方法:对2009年11月2日至2009年12月2日我院救治的14例妊娠期感染H1N1流感孕妇的临床情况进行总结性分析.结果:14例孕妇住院3～21天,平均8.6天.4例继续妊娠,7例手术结束妊娠,1例引产,2例自娩.13例新生儿存活,1例死亡,存活新生儿中5例早产,无新生儿H1N1感染病例,无孕妇死亡病例.结论:妊娠期感染H1N1流感孕妇更容易出现呼吸困难症状,病理妊娠及妊娠合并内科疾病者更易成为危重症病例.而早期应用奥司他韦能有效促进病情恢复,并未发现有母儿不良结局.     

妊娠不同时期感染新型冠状病毒肺炎的随访研究

目的通过研究不同妊娠时期感染新型冠状病毒患者的妊娠结局,分析新型冠状病毒对孕妇及新生儿出生后近期体格生长发育的影响,了解武汉地区COVID-19孕产妇及新生儿在后期的随访情况及需要解决的问题。方法收集2020年1月30日至2020年4月30日在武汉大学人民医院住院治疗的妊娠合并新型冠状病毒肺炎确诊病例共25例,总结早期(5例)、中期(5例)、晚期妊娠(15例)患者感染SRAS-CoV-2的临床特征、治疗、妊娠结局以及母婴随访等。结果5例早期妊娠合并COVID-19患者中,4例治愈出院后选择放弃妊娠,1例住院期间生化妊娠。5例中期妊娠合并COVID-19的患者中,活产儿4例,引产1例(胎儿心脏多发异常,双肾多发囊性病变,鼻骨偏短,羊水少)。新生儿出生后首次SRAS-CoV-2核酸鼻咽拭纸检测阴性。2020年10月随访结果显示,新生儿身长、体重及神经系统发育未见明显异常,1例患儿溶血性黄疸,1例患儿心脏室间隔缺损,卵圆孔未闭,二尖瓣反流,拟近期手术。15例晚期妊娠合并COVID-19患者中,早产3例,足月产12例。新生儿出生后首次SRAS-CoV-2核酸鼻咽拭纸检测阴性,2020年10月随访结果显示,新生儿身长、体重未见异常,1例小肠坏死伴高胆红素血症,4例细菌性肺炎,2例患儿肌张力过高。选取6例患者的胎盘行SARS-CoV-2检测均为阴性,病理检查中有1例胎盘胎膜未见明显异常,1例胎盘局灶可见散在的中性粒细胞,4例胎盘表现为急性绒毛膜炎(母体反应1级)。结论早期妊娠感染新型冠状病毒患者治愈后均选择终止妊娠。中、晚孕期感染新型冠状病毒肺炎孕妇分娩的新生儿近期随访身长、体重未发现明显异常,但仍有流产、胎儿畸形、绒毛膜炎、新生儿细菌性肺炎、肌张力增高等。因此,孕期新型冠状病毒感染可能导致不良围产期结局,这有待更大样本的流行病学研究调查证实。     

解脲支原体与胎儿宫内发育迟缓关系的探讨

目的 探讨孕妇感染解脲支原体对胎儿宫内发育的影响。方法 采用聚合酶链反应（ＰＣＲ）技术,分别对新生儿出生体重小于２５００ｇ的５０例孕妇的宫颈分泌物,新生儿脐血及胎盘（试验组）和正常新生儿出生体垢５０例孕妇的宫颈分泌物,新生儿脐血及胎盘进行解脲支原体检测（对照组）并对两例胎盘进行常规病理检查,结果 试验组新生儿脐血,胎盘解脲支原体的感染例数（３３例）明显高于对照组（７例）两者比较,差异有显著性（Ｐ〉     

Evaluation of the prognostic value of chosen maternal risk factors of complications existing among newborns of GDM mothers

OBJECTIVES: According to WHO definition, gestational diabetes mellitus (GDM) is a disorder of carbohydrates tolerance during pregnancy. The incidence of GDM is about 2-4% in the population at pregnant women. Prematurity, neonatal dystrophy (particularly hypertrophy), hypoglycemia and other clinical abnormalities are more frequent in the group of the neonates of diabetic mothers. DESIGN: The aim of this study was to separate the maternal risk factors of complications existing among neonates of diabetic mothers as well as the statistical analysis of their prognostic values. MATERIAL AND METHODS: 260 newborns of GDM mothers, born at Polish Mothers Health Center were observed. The group of pregnant women was divided into two subgroups according to GDM class--G1 or G2. At 116 (44.6%) pregnant women glycemia was regulated dietetic treatment (G1 class). 144 women (55.4%) were treated with insulin (G2 class). The control group were 153 newborns from pregnant women with excluded GDM after carbohydrates tolerance screening test provide between 24-28 week. Estimation of the newborns status after birth was based on Apgar Score and umbilical blood pH. Basic laboratory tests were done in umbilical blood. Blood glucose concentration were monitored in all cases. Bilirubin concentration, infection screening tests were provided due to clinical status. Statistic evaluation was performed using special computer programs. CONCLUSIONS: G2 class of the Gestational Diabetes Mellitus significantly increases the frequency of newborn macrosomia, LGA, birth trauma, hypoglycemia, hyperbilirubinemia, cardiomyopathy and respiratory disorders. Prematurity is more frequent among newborns from GDM mothers group and it determines a potent risk factor of low Apgar Score, hypoglycemia and respiratory disorders. The following risk factors are unimportant for the frequency of complications existing among newborns of diabetic mothers: mothers age, number of delivers, obstetric complications and delivery of newborn with a congenital malformation in an anamnesis.     

母儿间沙眼衣原体感染的治疗

本文用单克隆抗体免疫荧光法检出足月孕妇宫颈沙眼衣原体（ＣＴ）原体４６例，其中１７例产前经系统治疗，１３例经阴道分娩，新生儿仅１例（７．６９％）发生眼结膜感染；另２９例产前未经治疗的孕妇，２２例经阴道分娩，新生儿７例（３１．８２％）发生眼结膜感染，２例（９．０９％）发生ＣＴ肺炎。经阴道分娩眼结膜ＣＴ感染的新生儿，产前红霉素治疗组明显少手术治疗组。而两组剖宫产儿无１例发生眼结膜ＣＴ感染。建议宫颈ＣＴ阳     

An interesting case presentation: a possible new route for perinatal acquisition of Chlamydia.

Chlamydia trachomatis is currently the most common sexually transmitted disease in the United States. The prevalence in pregnant women ranges between 2% and 47%. It is well known that C trachomatis can be transmitted from the genital tract of an infected mother to her newborn infant, causing conjunctivitis or pneumonia or both, along with their longstanding complications. A review of the literature failed to show, however, conclusive evidence of transmission of infection to the newborn infant when the infant was born by cesarean section with intact amniotic membranes. We present a case of a young black woman with a history of chlamydia cervicitis during pregnancy whose infant was delivered by cesarean section because of failure to progress. She gave birth to a healthy term infant who developed ophthalmia neonatorum on the 3rd day of life. Examinations of conjunctival scrapings with direct fluorescent staining (chlamydia MicroTrak) performed on the 1st and 3rd day of life were positive. The initial test was performed because of the maternal history. The infant was mildly symptomatic at the time the study was repeated for confirmation. Our findings strongly suggest the possibility of either transmembrane or transplacental route of infection in the pathogenesis of neonatal chlamydia infection. Further study is needed to confirm this possibility.     

妊娠期外阴阴道念珠菌病及其对新生儿的影响

目的　了解妊娠期外阴阴道念珠菌病(Vulvovaginal Candidiasis ,VVC)的发生率,母婴垂直传播及新生儿相关病率。　方法　2002年至2003年在北京妇产医院产前检查和分娩的252 例孕妇行阴道真菌涂片、培养及菌种鉴定,其分娩新生儿行皮肤真菌培养及菌种鉴定,并随诊新生儿。　结果　252例孕妇阴道真菌涂片和/或培养阳性109例,阳性率43.25%。妊娠期VVC的发病率为19.05%(48/252)。109例阳性患者中,剖宫产与阴道分娩儿皮肤真菌携带率分别为20.76%(11/53)和35.71%(20/56), P>0.05;孕期VVC组与真菌携带组新生儿皮肤真菌携带率分别为16.67%(8/48)和37.71%(23/61),P<0.05;孕期治疗组新生儿无真菌携带;未治疗组新生儿真菌携带率为50.82%(31/61)。252例中新生儿真菌培养(+)31例,真菌携带率为12.30%;真菌培养(+)的新生儿尿布皮炎、鹅口疮的发生率为12.90%(4/31)和6.45%(2/31);与新生儿真菌培养(-)组[3.62%(8/221)和0%]相比,P<0.05。阴道真菌涂片和/或培养阳性109 例中,剖宫产组新生儿脐炎、尿布皮炎、鹅口疮的发病率[分别为3.77%(2/53)、15.09%(8/53)和1.87%(1/53)]与阴道分娩组[分别为1.79%(1/56)、7.14%(4/56)和1.79%(1/56)]相比无统计学意义(P>0.05)。孕期真菌阳性未治疗组新生儿脐炎、尿布皮炎、鹅口疮的发病率[分别     

Chlamydia trachomatis infections: implications for pregnant adolescents and their infants

Objective: Chlamydia trachomatis infections are common in pregnant adolescents. Previous studies have shown that treating pregnant women of all ages with erythromycin prevents transmission of this infection to their infants. However, there are no published studies on the efficacy of aggressive screening and treatment of C. trachomatis in pregnant adolescents. This study was undertaken to determine if aggressive screening for C. trachomatis in pregnant adolescents and early treatment with erythromycin can prevent complications in their newborn infants.Methods: A group of pregnant adolescents enrolled at Teen Pregnancy Service of Milwaukee was evaluated prospectively for the presence of C. trachomatis infection. Screening was performed during the 1st and 3rd trimesters by enzyme immunoassay. Adolescents with positive enzyme immunoassays for Chlamydia were treated with erythromycin for 10 days. Those with negative enzyme immunoassays were enrolled as controls. All infants born to adolescents in both groups were followed for episodes of conjunctivitis, pneumonia, and wheezing during their 1st year of life.Results: Ninety mother/infant pairs were followed during the study period. Twenty-eight mothers (31%) had positive enzyme assay tests and all received erythromycin therapy. Nasopharyngeal cultures were obtained from 60 (67%) infants; all were negative. There were no significant differences in general characteristics, development of conjunctivitis (relative risk 1.27), wheezing (relative risk 0.91), or pneumonia (relative risk 1.12) between infants born to adolescents in either group.Conclusions: We conclude that aggressive screening and treatment of C. trachomatis infection in pregnant adolescents may prevent complications in their offspring.     

Transmission rate of Ureaplasma urealyticum,Mycoplasma spp., Gardnerella vaginalis,B-Streptococci,Candida spp. and Chlamydia trachomatis from the mother to the newborn

Summary In a preliminary study of the transmission rate of Ureaplasma urealytcium, Mycoplasma species, Gardnerella vaginalis, B-Streptococci, Candida species and Chlamydia trachomatis from the mother to the newborn, swabs were taken from 45 parturients and their neonates and cultured by suitable methods. Out of 30 parturients with a positive culture, 8 harboured more than one microorganism investigated. U. urealyticum was found in 11 newborn and all of them had a positive mother. Candida spp. were found in 4 newborn, but 3 of these had a negative mother. G. vaginalis was detected in only 1 infant and the mother was negative. C. trachomatis was not isolated from any mother but was present in 2 newborn infants. Thus only U. urealyticum showed clear evidence of transmission from mother to baby.