Prevalence of asymptomatic genital infection among pregnant women in Benin City,Nigeria

The prevalence of asymptomatic genital infection among pregnant women and their susceptibility to antibacterial agents was investigated to provide baseline data on common asymptomatic genital microorganisms and identify potentials for development of clinical disease among this cohort of patients. High vaginal swabs were obtained from five hundred consecutive and consenting pregnant women attending the antenatal clinic of the University of Benin Teaching Hospital (UBTH) and the Central Hospital, both in Benin City, Nigeria. A total of three hundred specimens showed significant microbial growth, giving a prevalence rate of 60% for asymptomatic genital infections. Candida albicans (65%), Staphylococcus aureus (51.8%) and Enterobacteriacae (E. coli and Klebsiella species) were predominantly isolated, followed by Trichomonas vaginalis and Neisseria gonorrhoea. Most of the bacterial isolates were susceptible to ciprofloxacin, ceftazidime, cotrimoxazole, norfloxacin and augmentin. All the isolates except Streptococcus faecalis were resistant to ampicillin. These results show a high rate of asymptomatic genital tract infections among pregnant women in Benin City, which have implications for adverse maternal and neonatal outcomes.     

妊娠合并乙型肝炎病毒感染围分娩期管理

对乙型肝炎(乙肝)病毒感染孕妇采取合理的围分娩期管理以阻断母婴垂直传播是降低我国慢性乙肝感染率的关键。新生儿出生后及时注射乙肝免疫球蛋白,并按照0、1、6方案接种乙肝疫苗,可有效阻断乙肝的围分娩期传播。孕妇在晚孕期进行抗病毒治疗可能通过降低母体病毒水平而减少围分娩期传播风险,但抗病毒药物对胎儿的安全性仍需进一步验证。     

乙型肝炎表面抗原与乙型肝炎e抗原阴性孕妇乙型肝炎病毒宫内感染的研究

目的 探讨应用套式PCR方法检测乙型肝炎表面抗原(HBsAg)及乙型肝炎e抗原(HBeAg)阴性孕妇乙型肝炎病毒(HBV)宫内感染的状况。方法 选择HBsAg与HBeAg阴性,其他HBV血清标志物阳性孕妇及其新生儿24例作为病例组,同期HBV血清标志物全部阴性孕妇及其新生儿16例作为对照组。采用套式PCR方法检测两组孕妇及其新生儿的血清及外周血单个核细胞(PBMC)中HBV-DNA。结果(1)病例组24例孕妇中,血清HBV-DNA阳性8例,阳性率为33％;PBMC中HBV-DNA阳性10例,阳性率为42％r。其中血清与PBMC均阳性3例,总阳性率为63％r(15／24)。(2)病例组24个新生儿中,血清HBV-DNA阳性3例,阳性率为13％,PBMC中HBV-DNA阳性6例,阳性率为25％。其中血清与PBMC均阳性1例,宫内感染率为33％(8／24)。(3)病例组24例孕妇中,血清阴性而PBMC阳性共7例,其新生儿4例发生宫内感染,感染率为4／7。(4)对照组16例孕妇及其新生儿血清及PBMC中HBV-DNA全部阴性。结论 HBsAg及HBeAg阴性孕妇也可发生HBV宫内感染,采用灵敏度高的套式PCR方法检测孕妇及其新生儿血清及PBMC中HBV-DNA,对诊断HBV宫内感染具有重要临床意义。     

Effect of uniplant on liver function in Egyptian women with asymptomatic hepatitis B virus infection

Uniplant is a single 35mm contraceptive implant releasing nomegestrol acetate with an effective life span of one year. This study was undertaken to evaluate the possible effects of three-year use of uniplant on some liver enzymes (SGPT, SGOT and GGT) in Egyptian women and to evaluate whether the past asymptomatic hepatitis B virus infection would predispose to any changes in these enzymes. This is an uncontrolled prospective study including 187 women of reproductive age who desired contraception for three years (three segments each year). They were apparently healthy on clinical assessment with no history of jaundice or liver diseases. They also had normal levels of liver function enzymes (SGPT, SGOT & GGT). Fasting blood samples were drawn at admission for assessing the levels of these liver enzymes and to detect anti-HBS antibodies as a marker of past asymptomatic hepatitis B virus infection (HBV) and HBS antigen to diagnose the chronic carrier state. The liver enzymes were measured at 6th. 12th, 18th, 24th, 30th and 36th month of use, and 3-6 months after implant removal. Out of 187 subjects enrolled 159, 83 and 33 women completed one, two and three years of Uniplant use respectively. The mean levels of SGPT, SGOT and GGT showed slight but significant elevations at the end of the first and second years of use compared to the pre-insertion levels. By the end of the third year, the elevated mean values of all enzymes gradually decreased to approach the pre-insertion levels without any significant differences. The percentage of anti-HBS antibodies positive titre due to past asymptomatic infection was 23.3% (n = 41) while HBsAg positive antigenaemia (i.e., carrier state) was 3.4%, (n = 5). In both groups of women--anti-HBS antibodies positive (n = 41) without antigenaemia and anti-HBS antibodies negative (n = 129)--the changes in the mean levels of all enzymes during uniplant use were closely similar without any statistical significance. These results demonstrated that: (1) uniplant induced slight but significant elevations in the mean levels of SGPT, SGOT and GGT these elevations were within the normal ranges, completely reversible and of doubtful clinical significance. (2) The non-carrier women who had been exposed to past asymptomatic HBV infection showed no significant effects on the studied liver enzymes compared to the normal women during long-term use of Uniplant.     

Prevalence and risk factors for hepatitis C virus (HCV) infection among pregnant Brazilian women

Objectives: To determine the prevalence and the risk factors associated with HCV infection among women at childbirth, and to assess potential for infectivity of anti-HCV-positive women. Methods: A total of 6995 women were interviewed and screened for HCV antibodies. Association and logistic regression analyses were conducted. Results: The anti-HCV prevalence was 1.5% by EIA-3 and 0.8% by RIBA-3; HCV-RNA (RT-PCR) was detected in 74% of the RIBA-positive samples. Blood transfusion, race (blacks), alcohol abuse, a history of STD and anti-HBc positivity were independent risk factors for HCV positivity. Except for parenteral exposure, independent predictors of anti-HCV were a history of STD, anti-HBc positivity, a sex partner with multiple sex partners and a sex partner with a history of hepatitis. Conclusions: The prevalence of anti-HCV is higher in pregnant women than in blood donors. Sexual exposure may facilitate the spread of HCV and there is a high potential for mother-to-infant transmission.     

孕妇感染人类微小病毒B19的研究

目的 通过检测孕妇血中微小病毒Ｂ１９的感染,了解对新生儿的影响。方法 应用聚合酶链反应技术（ＰＣＲ）检测２９例临床有感染症状的孕妇血清中微小病毒Ｂ１９ＤＮＡ。结果 ２９例孕妇血清中微小病毒Ｂ１９ＤＮＡ阳性反应的有４例,其新生儿有１例因胎儿水肿死亡,２例出现溶血性黄疸,１例低体重儿。结论 应用ＰＣＲ技术检测孕妇血清微小病毒Ｂ１９ＤＮＡ有临床实用价值。     

Prevalence of endometriosis in asymptomatic women.

Numerous studies have identified the presence of endometriosis by its "classic" morphologic characteristics in high-risk patient populations. Recent histologic documentation of "subtle" laparoscopic appearances of this condition suggests that many of the earlier studies may have underestimated its prevalence in the general population. We evaluated the frequency of endometriosis in 86 women who denied having the symptoms typical of the condition and who underwent laparoscopy for other indications (acute pain, sterilization, etc.). Of those patients, 45.3% were found to have definitive evidence of pelvic endometriosis (stage I, 32.5%; II, 9.3%, III, 1.1%; IV, 2.3%). The exclusion of nine patients whose only laparoscopic indication was infertility or tubal occlusion resulted in a 44% finding of endometriosis, while 39% of the patients with documented fertility exhibited endometriosis. Forty-four percent of a subset of asymptomatic women undergoing laparoscopic evaluation prior to vaginal hysterectomy were found to have evidence of endometriosis; all but one had stage I, judged amendable to laser excision. The data suggest that endometriosis may be a more common peritoneal finding in asymptomatic, fertile women than previously believed.     

Office diagnosis of asymptomatic bacteriuria in pregnant women

Diagnosis and treatment of asymptomatic bacteriuria in pregnant patients can virtually eliminate pyelonephritis, the most common medical cause for antepartum hospitalization. However, the ever-increasing cost of the urine culture has led most clinicians away from routine urine screening. Uricult dip-slide paddles provide an inexpensive, efficient way to screen urine. Clean-catch urine specimens were obtained from 544 consecutive asymptomatic pregnant patients seen in the outpatient obstetric clinic at the Medical University of South Carolina. Specimens were analyzed by both traditional culture techniques and the Uricult dip-slide paddles. By comparison, the Uricult test detected 55 of the 56 significant gram-negative urinary pathogens found by culture. Detection of potential gram-positive pathogens is more difficult. A scheme is proposed that allows reliable, inexpensive surveillance in all pregnant patients. Hopefully, this algorithm will rekindle the obstetrician's interest in urine screening.     

妊娠中晚期乙型肝炎表面抗原阳性妇女胎盘感染的研究

目的 探讨乙型肝炎表面抗原（ＨＢｓＡｇ）阳性妇女妊娠中晚期胎盘各层细胞的乙型肝炎病毒感染状况。方法 收集太原市传染病医院妇产科ＨＢｓＡｇ阳性产妇胎盘１６７例（其中足月分娩胎盘１５８例,中期引产胎盘９例）,用免疫组织化学ＡＢＣ染色法检测胎盘蜕膜细胞、滋养层细胞、绒毛间质细胞和绒毛毛细血管内皮细胞ＨＢｓＡｇ和乙型肝炎核心抗原（ＨＢｃＡｇ）。结果 （１）足月分娩胎盘蜕膜细胞、滋养层细胞、绒毛间质细胞和绒毛毛细血管内皮细胞均感染乙型肝炎病毒,以胞浆分布为主,局灶性分布多见。从蜕膜细胞、滋养层细胞、盈盘间质细胞至绒毛毛细血管内皮细胞,乙型肝炎病毒感染率呈下降趋势,总感染率分别为６６．４６％（１０５／１５８）、５８．２３％（９２／１５８）、２７．２２％（４３／１５８）和１２．６６％（２０／１５８）。（２）中期引产胎盘有１例     

Prevalence of Candida albicans and bacterial vaginosis in asymptomatic pregnant women in South Yorkshire, United Kingdom

Objective  The aim of the study was to determine the prevalence and age distribution of Candida albicans and bacterial vaginosis in asymptomatic pregnant women. Method  One thousand and seventy-three (1,073) consecutive women who attended the antenatal clinic at Barnsley District General Hospital, Barnsley, UK, over a 15-month period were studied. Endo-cervical and high vaginal swabs for Candida albicans were obtained. Results  Sixty-five percent (65%) were in the age group of 21–30 years, and the smallest group was of age 40 years and above. Maternal age of all the women was 25.8 years (SD 5.5) with a range of 33. Prevalence of Candida albicans was 12.5%, and the highest percentage of 65.7% (88 patients) was in the age group of 21–30 years. Prevalence of bacterial vaginosis was 3.54%, with almost 90% among the age group of 21–30 years. Conclusion  Prevalence of Candida albicans and bacteria vaginosis among asymptomatic pregnant women was 12.5 and 3.54%, respectively. There is no financial support from an individual or pharmaceutical company.     

Prevalence and risk factors of human papilloma virus infection in asymptomatic women in southeastern Hungary

A survey was carried out to determine the prevalence of genital human papilloma virus (HPV) infection in asymptomatic women. The overall prevalence of HPV infection was 23%. Age (under 24 years), pathological cytology were significantly associated with exposure to HPV infection. HPV screening is important for young women, especially, where there is a pathological cytological diagnosis.     

HPV infection in pregnant women

AIM: Evaluation of incidence of HPV infection in pregnant women. MATERIALS AND METHODS: Material consisted of 145 pregnant patients with a range age from 18 to 37, in 2nd or 3d trimester of pregnancy. The control-group included non-pregnant women, participants of preventive skinning programme against cervical cancer, as number and age structure as the study group. All patients had cervical specimens collected for cytological evaluation. Specimens for HPV testing were taken by Digene Sampler Cervical Kit--from cervix and posterior fornix. The presence of HPV DNA was detected with the Hybrid Capture II, dividing into 2 groups of high and low risk cancer associated types. RESULTS: DNA HPV was detected in 19 (13.1%) pregnant women treated in Department of Obstetrics, Gynaecology and Oncology. In 14 (9.6%) non-pregnant women from control group the Hybrid Capture II test was positive. The difference in frequency of infection has not statistical significance (Chi 2 = 0.55 alpha = 0.05). Respectively in 11(7.6%) and 8(5.5%) patients from I group HPV of high and low risk cancer associated type were detected. In II group infection of viruses with high risk was detected in 8 (5.5%), and with low cancer risk in 6(4.1%) patients. As I group as II group the presence of DNA HPV was estimated in younger women. CONCLUSIONS: The pregnancy does not seem to be independent factor that increases frequency of HPV infections. Despite of changes in hormonal balance and associated with pregnancy increase of immunity we have not found statistical significant differences between the study-group and control-group. There seem to be in connection with changes of sexual behaviour of pregnant women.     

Determinants of hepatitis B vaccine uptake among pregnant Chinese women in Hong Kong

Objective

To determine the prevalence of a history of hepatitis B vaccination among pregnant Chinese women in Hong Kong, and to identify factors associated with vaccine uptake at their own expense.

Methods

A prospective, cross-sectional survey was conducted in a university obstetric unit in Hong Kong. Pregnant Chinese women who attended the prenatal clinic were invited to complete a self-administered questionnaire, which requested details of their history of hepatitis B vaccination and sociodemographic characteristics.

Results

The prevalence of hepatitis B vaccine uptake was 33%. The following factors were associated with higher hepatitis B vaccine uptake: employment as a healthcare worker; a higher education level; higher monthly family income; routine medical checkups; and premarital checkups.

Conclusion

The findings suggest that the public has insufficient awareness of hepatitis B infection in the community and that providing better information and education to the general public is necessary.     

HBeAg阳性慢性乙型肝炎孕妇胎盘组织Toll样受体3的表达及意义

目的探讨孕妇胎盘组织Toll样受体3(TLR3)的表达与乙型肝炎病毒(HBV)持续感染的关系。方法2008年11月至2009年5月在南方医科大学南方医院产科选取22例HBeAg阳性(HbeAg阳性组)和24例HBeAg阴性(HBeAg阴性组)慢性乙型肝炎(乙肝)孕妇,及正常孕妇25例。建立实时荧光定量RT-PCR检测胎盘组织中TLR3mRNA水平,同时以免疫组化法检测其在胎盘组织中的表达,并采用实时荧光定量PCR和微粒子酶免疫分析法(MEIA)分别定量检测其血清HBV-DNA和HBeAg水平。结果HBeAg阳性孕妇胎盘组织中TLR3mRNA水平(×10-1)(3.204±0.395)明显低于正常对照组(7.834±0.970)和HBeAg阴性组(5.746±0.580),两组相比P0.01;HBeAg阳性孕妇血清HBeAg及HBV-DNA水平[562.2±337.4和(7.15±3.69)×107copy/mL]明显高于正常对照组(0.29±0.06,1.00×103copy/mL)和HBeAg阴性组[0.35±0.07,(2.40±1.71)×103copy/mL](P0.01);胎盘组织中TLR3mRNA表达与HBeAg水平呈负相关(r=-0.495,P0.05),而与血清HBV-DNA水平无显著相关性。结论胎盘组织中TLR3的表达与其持续感染HBV有一定关系,HBeAg对胎盘组织TLR3表达起负调节作用。     

乙型肝炎表面抗原阳性孕妇妊娠早期绒毛细胞乙型肝炎病毒感染状况的研究

目的观察早期妊娠(孕40～90d)HBsAg阳性孕妇绒毛细胞乙型肝炎病毒(HBV)感染状况。方法采用酶联免疫吸附(ELISA)法,复查血清HBsAg阳性的25例早期妊娠妇女血清HBsAg、乙型肝炎e抗原(HBeAg),对其绒毛细胞用免疫组化链霉亲和素-生物素过氧化物酶复合物(SABC)法和原位杂交法检测HBsAg、乙型肝炎核心抗原(HBcAg)和：HBVDNA,并通过透射电镜观察绒毛细胞超微结构变化。结果25例HBsAg阳性孕妇中,HBV感染率为32％(8／25);蜕膜细胞、滋养细胞和绒毛间质细胞均出现HBsAg或HBcAg的阳性染色,出现HBsAg或HBcAg阳性蜕膜细胞、滋养细胞和绒毛问质细胞的标本百分率分别为28％(7／25)、32％(8／25)和16％(4／25);滋养细胞间桥粒连接完整,并在滋养细胞的粗面内质网内可见HBsAg蛋白丝样结构和HBV样结构。结论HBV可感染早期妊娠绒毛细胞;HBV直接穿透滋养细胞问桥粒连接的可能性不大。     

孕妇血清中乙型肝炎病毒DNA含量与胎儿宫内感染的关系

探讨孕妇血清中乙型肝炎病毒ＤＮＡ含量与胎儿宫内感染发生率的关系。方法用斑点杂交法检测１８５例乙型肝炎病毒表面抗原阳性孕妇血清中ＨＢＶＤＮＡ及新生儿ＨＢｓＡｇ。结论孕妇血清ＨＢＶＤＮＡ含量升高是胎儿发生乙型肝炎病毒感染重要因素之一。     

Prevalence of anti-human parvovirus antibody in pregnant women

Human parvovirus B19 (B19) has been shown to be associated with erythema infectiosum. Recently, it was reported that when a pregnant woman is infected with B19, the fetus in her uterus sometimes becomes hydropic and results in a stillbirth. But no epidemiologic study of pregnant women in Japan has been performed yet. We have established an in vitro propagation system of B19 virions and an assay system for detecting anti-B19 antibody by indirect immunofluorescence (IF) staining. We examined the positive rate of anti-B19 antibody among 337 normal blood donors, 329 normal pregnant women, 23 early aborted women and 24 non-immune hydrops fetalis cases by IF staining. The positive rate for anti-B19 IgG among normal blood donors increased with age. It was 22% aged 21 to 30, 44% aged 31 to 40, 65% aged 41 to 50, and 76% aged 51 to 60, respectively. Anti-B19 IgG was detected in 33% of 329 of normal pregnant women. The anti-B19 IgG positive rate was 26% in pregnant women in their twenties and 44% in those in their thirties. There was a significant difference between the two generations. The results show that more than half the women in their twenties and thirties risk B19-infection during pregnancy. Nine of twenty-three early aborted women were positive for anti-B19 antibody. Among six pregnant women who were positive for anti-B19 IgM, four delivered normal babies and the others aborted artificially or spontaneously. Anti-B19 IgG and IgM of twenty four non-immune hydrops fetalis (NIHF) were examined and four cases were found to be anti-B19 IgG positive.(ABSTRACT TRUNCATED AT 250 WORDS)