正常孕妇复合感染后妊娠结局的研究

目的 :探讨正常孕妇复合感染后对妊娠结局的影响并拟定初筛感染原方案。方法 :收集在本院分娩的 2 16例、2 16例正常头位初产妇初诊时的宫颈分泌物。每份标本都采用 3种聚合酶链反应 (PCR)同步检测 9种较常见的感染原 :人型支原体 (MH)、疱疹病毒 1、2型 (HSV- 1、2 )和人乳头瘤病毒 (HPV)应用 1次 PCR;解脲支原体 (U U)、沙眼衣原体(CT)及巨细胞病毒 (CMV)使用套式 PCR;淋球菌 (NG)与弓形体 (TOXO)采用两个基因区 PCR。结果 :1除外 7例因其他因素引起的不良妊娠结局者 ,复合感染率为 9.1% (19/ 2 0 9) ;占总感染数 2 0 .9% (19/ 91)。 2 19例复合感染中除 1例外 ,均感染支原体 ;3例死胎、畸胎均由复合感染疱疹科病毒孕妇所娩 ,其中 1例死胎脑组织检出 CMV- DNA。 3复合感染者之胎儿窘迫、剖宫产和死胎、畸胎率均明显高于未受染者 (P<0 .0 5～ 0 .0 1) ;而单一受染者则未发生死胎、畸胎。结论 :产前 ,最好在孕前 ,正常孕妇也应常规筛查至少两类疱疹科病毒 :CMV和 HSV- 2

The Effect of Mixed Infection in Normal Pregnancies on Pregnant Outcome

Objectives:To research the effect of mixed infection in normal pregnancies on pregnant outcome and to determine the primary screening protolol for pathogens.Methods:Specimens of cervical swab were collected in 216 normal nulliparous,and detected for mycoplasma hominis(MH)?herps simplex virus types1 and 2(HSV 1 and HSV 2)and Human papillomavirus(HPV)by polymerase chain reaction(PCR);for ureaplasma urealyticum(UU)?chlamydia trachomatis(CT)and cytomegalovirus(CMV)by nest PCR;for toxoplasmosis(TOXO) and neisseria gonorrhoeae(NG)by two gene region PCR,in every specimen.Pregnant outcome were also followed up.Results:The mixed infectious rates in normal pregnancies were9.1%(19/209),and the rates in total infectious pregnancies were20.9%(19/91);of 19 mixed infectious cases,MH and/or UU were infected in 18 cases,3 stillborn and congenital defective fetuses were delivered in mixed infectious cases(HSV 2 or CMV),Of the 3 cases,CMV DNA was detected in one stillborn brain,The incidence of fetal distress,cesarean section?stillborn and congenital detective fetuses was significantly higher in mixed infectious cases than that in non infectious cases;howerer,normal fetuses were deliverd in single infectious cases.Conclusion:HSV 2 and MCV must were sereened routinely in antenatal,particularly,before pregnant.