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。     

解脲支原体感染与早产及胎膜早破的关系

目的 探讨解脲支原体（ＵＵ）感染与早产及胎膜早破的相关性。方法 采用分离培养法,分别对４６例胎膜早破和７例早产患者（试验组）以及３２例正常妊娠（对照组）妇女的宫颈分泌物,胎膜和脐带进行了ＵＵ检测;对部分试验组和对照组的胎盘组织进行电镜观察,并与阳性培养物负染电镜观察结果引比较,结果 试验组宫颈分泌物,胎膜和脐带中ＵＵ检出率为均为７３．６％（３９／５３）,对照组宫颈,胎膜和脐带中的ＵＵ检出率分别为４     

解脲支原体和消眼衣原体感染与早产胎膜早破的关系

目的 探讨生殖道解脲支原体（ＵＵ）和沙眼衣原体（ＣＴ）感染与早产胎膜早破的关系。方法 采用聚合酶链反应方法,对３０例早产胎早孕妇宫颈分泌物进行ＵＵ和ＣＴ检测,并对分娩后的胎盘和胎膜分别进行了ＵＵ及组织病理学检查,同时分别选择３０例足月胎膜早破（ＰＲＯＭ０和４０列正常孕妇作对照。结果 ＰＰＲＯＭ孕妇宫颈分泌物ＵＵ阳性率明显高于ＰＲＯＭ和正常组;ＣＴ阳性率高于和正常组;ＵＵ和ＣＴ同时感染的阳性率高于Ｐ     

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（     

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。     

孕妇宫颈解脲支原体感染与妊娠结局的关系

解脲支原体 (UU )是寄居于人体泌尿生殖道的常见微生物 ,妊娠期间寄居于孕妇下生殖道的解脲支原体可垂直传播 ,引起胎儿或者新生儿感染[1 ] 。UU感染是部分早产、低出生体重儿和胎膜早破的原因[2 ] 。因此 ,我们对 3 89例孕妇宫颈分泌物进行UU检测及临床观察 ,现将结果报道如下。1　方法1 1　研究对象　以 2 0 0 1年 4～ 11月随机选择我院产前住院待产 3 89例正常孕妇为研究对象 ,排除慢性肝肾疾病、糖尿病、慢性高血压、妊高征 (中、重度 )、心脏病、多胎妊娠、胎死宫内以及孕期使用抗生素的孕妇 ;孕周在 2 8～ 42周 ,年龄 2 1～ 3 8岁 …     

胎膜早破与下生殖道病原体感染的的关系

目的:通过对临床导致早产胎膜早破的生殖道病原微生物的分析,从而探讨生殖道解脲支原体(UU)和沙眼衣原体(CT)感染与早产胎膜早破(PPROM)的关系方法:试验组为60例,采用泌尿生殖道病原性支原体药敏定量培养板和沙眼衣原体检测试剂盒(免疫层析法)对PPROM孕妇宫颈分泌物进行UU和CT检测,同时分别选择60例足月胎膜早破(PROM)孕妇和60例正常孕妇作对照结果:PPROM孕妇宫颈分泌物UU阳性率(78%)明显高于PROM孕妇(41%)和正常孕妇(19%)(P<0.01);PPROM孕妇宫颈分泌物CT阳性率(63%)高于PROM孕妇(21%)和正常孕妇(5%)(P<0.01);PPROM孕妇UU和CT同时感染的阳性率(43%)高于PROM孕妇(13%)和正常孕妇(0)(P<0.05)。结论:UU和CT感染可能是导致PPROM的发生关键。     

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。     

解脲支原体感染与自然流产的关系

对４０例自然流产（自然流产组）及人工流产和正常妊娠中期妇女４０例（对照组）的流产胚胎组织及宫颈粘液，进行解脲支原体分离培养。结果：自然流产组解脲支原体分离阳性率为５５．０％，对照组为１０．０％。两者比较，差异有极显著意义（Ｐ＜０．０１）。随着自然流产次数增加，解脲支原体阳性率有增高的趋势（Ｐ＜０．０５）。提示解脲支原体生殖道感染与部分自然流产关系密切，可作为确定自然流产病因的指标。     

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。     

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。     

外周血单个核细胞在乙型肝炎病毒母婴传播中的作用研究

目的 探讨外周血单个核细胞(PBMC)在乙型肝炎病毒(HBV)母婴传播中的作用及在早期诊断宫内感染的价值。方法 120例经ELISA法确定为乙型肝炎表面抗原(HBsAg)阳性的孕妇为研究组,其中60例为HBsAg和乙型肝炎e抗原(HBeAg)双阳性,定为双阳组;60例仅为HBsAg阳性,定为单阳组。30例非HBV携带的孕妇为对照组。应用PCR法检测母婴血清及PBMC中HBV-DNA。结果 双阳组中,血清HBV-DNA检出率为25.0％(15/60),脐血PBMC中HBV-DNA检出率为50.0％(30/60)。母婴PBMC的HBV-DNA阳性显著相关(P<0.05);脐血血清HBV-DNA检出率与脐血PBMC中HBV-DNA检出率两者比较,具有显著性差异(P<0.001);母婴血清HBV-DNA阳性无相关性(P>0.05)。结论 被HBV感染的PBMC可通过胎盘感染胎儿,可能是HBV宫内传播的一种机制,脐血PBMC HBV-DNA阳性率明显高于脐血清,对早期诊断HBV宫内感染有一定价值;母亲传染性强是宫内感染的重要因素。     

A case-referent study on fetal bacteremia and late fetal death of unknown etiology in Lithuania

BACKGROUND: The objectives were to test the hypothesis that certain strains of microorganisms are present in fetal blood in a significant proportion of parturient women suffering unexplained third trimester fetal death, and to examine the correlation between fetal bacteremia and histologic chorioamnionitis and vasculitis. METHODS: A case-referent study was carried out on 58 pregnant women with fetal death of unknown etiology (cases) and 116 pregnant women at term (referents) with live fetuses. Cultures from maternal endocervix, amniotic fluid, placental homogenate, external ear and blood of newborns were performed in both groups. Histological examination of placentas and fetal membranes was carried out in order to identify chorioamnionitis and chorionic vasculitis. RESULTS: Intrauterine fetal bacteremia was observed in 36% of cases and in 0% of referents (p= 0.001). Escherichia coli was the most common strain, isolated in 21% of fetal blood samples in cases. Extensive histologic chorioamnionitis was observed in 50% of cases with the presence of Escherichia coli in blood of stillborns. Chorionic vasculitis was found in 67% of such cases. Positive significant correlations between isolation of the Escherichia coli from maternal endocervix, amniotic fluid, placenta, fetal ear and blood in stillborns and histological chorioamnionitis and chorionic vasculitis were observed. CONCLUSIONS: Escherichia coli bacteremia was detected in a significant proportion of stillborns suffering a third trimester prelabor death. Fetal bacteremia significantly correlated with histologic signs of inflammation in placenta and membranes. Ascending subclinical intrauterine infection may play an important role in the etiology of otherwise unexplained late prelabor fetal death.     

三维能量彩色多普勒超声用于检测子痫前期孕妇胎盘组织血流灌注的价值

目的 探讨三维能量彩色多普勒超声检测子痫前期孕妇胎盘组织血流灌注的临床价值.方法 选择2007年7月至2008年5月在首都医科大学附属北京妇产医院超声科行产前超声检查的正常孕妇及子痫前期孕妇共80例,其中36例正常孕妇为正常孕妇组,44例子痫前期孕妇分为轻度子痫前期组(9例),重度子痫前期组(26例),慢性高血压合并子痫前期组(慢高合并子痫前期组,9例).应用三维能量彩色多普勒超声仪检测各组孕妇胎盘三维直方图血管指数(VI)、血流指数(FI)、血管化血流指数(VFI),应用二维多普勒超声检测脐血流收缩期/舒张期血流速度峰值(S/D值).并记录分娩孕周、新生儿出生体重、低出生体重儿百分比和胎盘重量.结果 (1)VI、FI、VFI及脐血流S/D值:正常孕妇组分别为6.3±2.9、38.6±4.4、2.7±1.3及2.5±0.6;轻度子痫前期组分别为5.7±3.8、36.3±7.2、2.4±2.0及2.4±0.3;重度子痫前期组分别为3.0±2.4、31.7±5.0、1.1±1.0及2.9±1.3;慢高合并子痫前期组分别为2.2±1.6、26.1±4.4、0.8±0.6及3.1±1.6.正常孕妇组孕妇胎盘VI、FI、VFI值与轻度子痫前期组比较,差异均无统计学意义(P>0.05),而重度子痫前期组和慢高合并子痫前期组孕妇胎盘VI、FI 、VFI兀值均明显低于正常孕妇组(P<0.01)及轻度子痫前期组(P<0.05).而各组孕妇脐血流S/D值相互比较,差异均无统计学意义(P>0.05).(2)分娩孕周、新生儿出生体重、低出生体重儿百分比和胎盘重量:正常孕妇组分别为(38.7±1.5)周、(3280±520)g、3%及(568±141)g;轻度子痫前期组分别为(37.9 ±1.0)周、(2971±265)g.0及(576±98)g;重度子痫前期组分别为(33.2±2.6)周、(1820±737)g.58%及(458±154)g;慢高合并重度子痫前期组分别为(32.6±2.6)周、(1497±533)g.7/9及(396±141)g.正常孕妇组与轻度子痫前期组分娩孕周、新生儿出生体重、低出生体莺儿百分比和胎盘重量比较,差异均无统计学意义(P>0.05),而重度子痫前期组和慢高合并重度子痫前期组的分娩孕周、新生儿出生体重、低出生体重儿百分比和胎盘重量均明显低于正常孕妇组(P<0.01)与轻度子痫前期组(P<0.05).结论 (1)重度子痫前期及慢高合并子痫前期孕妇胎盘组织的血流灌注明显减少,临床上相应出现胎盘重量及新生儿出生体重下降、分娩孕周偏低、低出生体重儿数量增加等结果;而脐血流S/D值无明显变化.(2)三维能量彩色多普勒超声对胎盘组织血流灌注的检测有重要的临床诊断意义.     

检测人巨细胞病毒晚期mRNA在诊断子宫内活动性感染的价值

目的 探讨人巨细胞病毒（ＨＣＭＶ）晚期ｍＲＮＡ检测在宫内活动性感染中的应用价值。方法 采用逆转录－聚合酶链反应（ＲＴＰＣＲ）法对４２例ＨＣＭＶ－ＩｇＭ阳性孕妇外周血及部分胎儿附属物进行ＨＣＭＶ晚期ｍＲＮＡ检测。结果 ４２例ＨＣＭＶ－ＩｇＭ阳性孕妇中,检出晚期ｍＲＮＡ２３便,两者符合率为５４．７％。对其中１３例晚期ｍＲＮＡ阳性孕妇胎儿附属物进行检测,７例阳性,母婴传播率为５３．８％,而１２例晚期ｍＲ     

输卵管妊娠患者沙眼衣原体及解脲脲原体检测

目的：探讨生殖道沙眼衣原体（ＣＴ）和解脲脲原体（ＵＵ）感染与输卵管妊娠的关系。方法：采用聚合酶链反应方法，检测３４例输卵管妊娠患者（输卵管妊娠组）的宫颈分泌物、输卵管组织、盆腔液中ＣＴＤＮＡ及ＵＵＤＮＡ，同时选择２８例输卵管结扎妇女（输卵管结扎组）和４０例正常早孕妇女（正常早孕组）作为对照。结果：输卵管妊娠组宫颈分泌物ＣＴＤＮＡ和ＵＵＤＮＡ阳性检出率分别为４７．１％和５５．９％，高于输卵管结扎组和正常早孕组（Ｐ＜０．０５）；输卵管妊娠组患者的输卵管组织ＣＴＤＮＡ阳性检出率为２６．５％，高于输卵管结扎组（Ｐ＜０．０５）；输卵管妊娠组与输卵管结扎组输卵管组织ＵＵＤＮＡ及盆腔液ＣＴＤＮＡ和ＵＵＤＮＡ阳性检出率比较，差异无显著性（Ｐ＞０．０５）。结论：输卵管妊娠与生殖道ＣＴ和ＵＵ感染有关。     

产前B族链球菌感染对母儿的影响

目的　了解孕妇的Ｂ族链球菌（ＧＢＳ）带菌情况及对新生儿的影响。　方法　对１２０ 例产妇产前取阴道后穹窿分泌物,分娩后取胎盘子面分泌物及新生儿胃液分别检测ＧＢＳ,留脐血检测Ｃ反应蛋白、ＩｇＭ、ＩｇＧ 抗体,产后观察母婴情况并随访６ 周。　结果　产前母体ＧＢＳ带菌率１５－８％ ,胎盘带菌率１０ ％ ,新生儿带菌率３－３ ％ ,患病率０－８３ ％ 。ＧＢＳ阳性孕妇既往流产史多,胎膜早破、早产发生率较阴性者高（Ｐ＜ ０．０５） 。产时胎儿窘迫、羊水混浊及新生儿低体重、新生儿肺炎发生率虽比阴性者高,但无统计学意义。脐血Ｃ反应蛋白、ＩｇＭ、ＩｇＧ 无明显升高。　结论　为降低ＧＢＳ感染对围产期母儿的患病率,应对孕妇常规行ＧＢＳ筛检,阳性孕妇应给予预防性治疗并于产前复查,产时应对ＧＢＳ阳性孕妇及新生儿给予适当治疗以避免发生并发症。     

A randomized study of antibiotic therapy in idiopathic preterm labor

A randomized study was undertaken to test the effects of antibiotics as an adjunct to established methods of tocolysis. One hundred fifty patients with cervical dilation of 1 cm or more and no clinically identifiable cause for preterm labor qualified for the study. Fifty-three (35%) received 500 mg ampicillin orally every 6 hours, 50 (33%) received 500 mg erythromycin orally every 6 hours, and 47 served as controls. Antibiotics were prescribed for 10 days, and the treatment was not altered by the results of cervical cultures. Of these 150 patients, 16 (11%) had positive amniotic fluid cultures. The pregnancies with positive amniotic fluid culture were characterized by significantly less time gained after admission (2.6 versus 28.7 days) and lower birth weight (1262 versus 2470 g) than in those with negative cultures. Histologic studies of the placenta revealed chorioamnionitis in 22 (16%) of 134 patients with negative amniotic fluid cultures; these pregnancies were associated with less time gained after admission (12.5 versus 31.9 days) and lower birth weight (1680 versus 2618 g) compared with pregnancies without histologic chorioamnionitis. In patients with similar gestational age and cervical dilation, the adjunctive use of antibiotic therapy resulted in a statistically significant delay from admission to delivery (30 versus 17 days). In cases of negative amniotic fluid cultures, cervical colonization with group B streptococcus and/or Gardnerella vaginalis increased the risk of prematurity, which improved significantly when ampicillin was given.     

Periodontal disease and upper genital tract inflammation in early spontaneous preterm birth

OBJECTIVE: To estimate the relationship between maternal periodontal disease and both early spontaneous preterm birth and selected markers of upper genital tract inflammation. METHODS: In this case-control study, periodontal assessment was performed in 59 women who experienced an early spontaneous preterm birth at less than 32 weeks of gestation, in a control population of 36 women who experienced an early indicated preterm birth at less than 32 weeks of gestation, and in 44 women with an uncomplicated birth at term (>or = 37 weeks). Periodontal disease was defined by the degree of attachment loss. Cultures of the placenta and umbilical cord blood, cord interleukin-6 levels, and histopathologic examination of the placenta were performed for all women. RESULTS: Severe periodontal disease was more common in the spontaneous preterm birth group (49%) than in the indicated preterm (25%, P =.02) and term control groups (30%, P =.045). Multivariable analyses, controlling for possible confounders, supported the association between severe periodontal disease and spontaneous preterm birth (odds ratio 3.4, 95% confidence interval 1.5-7.7). Neither histologic chorioamnionitis, a positive placental culture, nor an elevated cord plasma interleukin-6 level was significantly associated with periodontal disease (80% power to detect a 50% difference in rate of histological chorioamnionitis, alpha = 0.05). CONCLUSION: Women with early spontaneous preterm birth were more likely to have severe periodontal disease than women with indicated preterm birth or term birth. Periodontal disease was not associated with selected markers of upper genital tract inflammation. LEVEL OF EVIDENCE: II-2