生殖道感染与未足月胎膜早破孕妇的妊娠结局的相关性回顾调查

目的:探讨生殖道感染与PPROM孕妇的妊娠结局的相关性,以期能为PPROM的防治提供参考。方法:回顾性分析我院2010年6月至2012年12月期间住院分娩的128例PPROM产妇(PPROM组)及128例同期住院分娩的足月胎膜早破产妇(对照组)病历资料,分析两组生殖道解脲支原体(UU)、细菌性阴道病(BV)、衣原体(CT)、假丝酵母菌(CM)感染情况及妊娠结局。结果:PPROM组UU、CT、BV、CM、混合感染感染率分别为27.34%、12.50%、7.81%、10.94%、8.59%,总感染率为67.19%,对照组UU、CT、BV、CM、混合感染感染率分别为9.38%、4.69%、4.69%、7.81%、5.47%,总感染率为32.03%,UU、CT感染率及总感染率PPROM组明显高于对照组,两组比较差异具有统计学意义(P<0.05),BV、CM感染率两组比较差异无统计学意义(P>0.05);PPROM组产妇胎儿宫内窘迫、绒毛膜羊膜炎、新生儿窒息、新生儿肺炎、新生儿病理性黄疸发生率分别为17.19%、73.44%、14.06%、15.63%、20.31%,对照组分别为14.84%、32.03%、11.72%、3.13%、15.63%,绒毛膜羊膜炎、新生儿肺炎发生率两组比较差异具有统计学意义(P<0.05),胎儿宫内窘迫、新生儿窒息及新生儿病理性黄疸发生率两组比较差异无统计学意义(P>0.05);PPORM组产妇生殖道总感染率与绒毛膜羊膜炎、新生儿肺炎发生率直线相关分析显示之间具有正相关(P<0.05)。结论:UU及CT感染为主的生殖道感染可能是导致PPROM发生的主要原因,孕期合并有生殖道感染会引起孕妇及新生儿不良妊娠结局,因此在妊娠早中期进行生殖道感染筛查并且针对性的进行治疗有利于降低PPORM发生率。

Study on the corre1ation between reproductive tract infection and pregnancy outcomes of patients with preterm premature rupture of membranes

Objectives： To study the correlation between reproductive tract infection and pregnancy outcomes of preterm premature ruptures of membranes （PPROM）,and to provide references for prevention and control of PPROM.Method： We retrospectively analyzed case histories of 128 puerperae with PPROM （the PPROM group） who were hospitalized from June 2010 to December 2012.By contrast,the case histories of another 128 puerperae with premature rupture of membranes （the control group） who were hospitalized during the same period were taken as well.Then,the 2 groups are compared in terms of the infections of ureaplasma mycoplasma of reproductive tract （UU）,bacterial vaginal disease （BV）,chlamydia （CT）,candida （CM） and pregnancy outcomes.Results： The infection rates of UU,CT,BV,CM and mixed infection rate in PPROM group were respectively 27.34％,12.50％,7.81％,10.94％ and 8.59％,totaling 67.19％.While in the control group,those figures were respectively 9.38％,4.69％,4.69％,7.81％ and 5.47％,totaling 32.03％.What we learned was that the infection rates of UU and CT and the total infection rates of PPROM group were apparently higher than those of the control group,the differences being statistically significant （P ＜ 0.05）,while the differences of BV,CM infection rates between the 2 groups had no statistical significance （P ＞ 0.05）.The incidences of maternal fetal intrauterine distress,chorioamnionitis and neonatal asphyxia,neonatal pneumonia and neonatal pathologic jaundice in PPROM group were respectively 17.19％,73.44％,14.06％,15.63％ and 14.06％ ; while in the control group,they were 14.84％,32.03％,11.72％,32.03％ and 15.63％.The differences of incidences of chorioamnionitis and neonatal pneumonia between the two groups were statistically significant （P ＜0.05）,whereas the differences of fetal distress,neonatal asphyxia and neonatal pathologic jaundice incidence were not （P ＞ 0.05） ; The linear correlation analysis found no positive correlation between maternal reproductive tract infection,chorioamnionitis and neonatal pneumonia in PPROM group （P ＜ 0.05）.Conclusion： UU and CT infections of reproductive tract may be the main causes for PPROM.Reproductive tract infection during pregnancy could cause adverse pregnancy outcomes.Therefore,a reproductive tract infection screening at the early and middle stage together with a targeted treatment could effectively reduce the incidence of PPORM.