胎膜早破孕妇GBS、VVC、BV感染及对妊娠结局的影响

Premature Rupture of Membranes Pregnant Women GBS, VVC, BV Infection and Its Influence on Pregnancy Outcome

摘要: 目的：探讨胎膜早破孕妇GBS、VVC、BV感染及其对妊娠结局的影响，预防和治疗胎膜早破，改善妊娠结局，促进母儿健康。方法：收集最近三年湘雅二医院和湖南省财贸医院产科妊娠晚期胎膜早破孕妇283例作为研究组，另收集302例同期未胎膜早破正常孕妇作为对照组，所有收集孕妇均进行GBS、VVC、BV感染率检测，比较两组妊娠结局。结果：1) 研究组GBS、VVC及BV感染率高于对照组，两组比较差异有统计学意义(P < 0.05)；2) 研究组两种及两种以上混合感染发生率高于对照组，差异有统计学意义(P < 0.05)；3) 不良妊娠结局比较：研究组GBS、VVC及BV感染患者中绒毛膜羊膜炎、产后出血、低出生体重儿及新生儿肺炎发生率均显著高于对照组(P < 0.05)，而胎儿窘迫、早产发生率差异无统计学意义(P > 0.05)；4) 研究组GBS不良妊娠结局之早产的发生率明显高于VVC、BV感染的不良妊娠结局发生率(P < 0.05)，VVC、BV的不良妊娠结局发生率差异无统计学意义(P > 0.05)；5) 对照组GBS，VVC及BV感染患者不良妊娠结局发生率组内两两比较结果显示差异无统计学意义(P > 0.05)；6) 两组病例中，胎膜早破组的各项炎症指标显著高于未胎膜早破组(如：N%、CRP及PCT均升高)，两组比较有统计学意义(P < 0.05)。结论：1) GBS、VVC、BV感染是导致胎膜早破的重要原因，尤其是未足月胎膜早破的重要致病因素；2) 胎膜早破孕妇GBS、VVC、BV感染将导致不良妊娠结局发生率增高。

Abstract: Purpose: To investigate the effects of GBS, VVC and BV infection on premature rupture of mem-branes, to prevent and treat premature rupture of membranes, to improve the outcome of preg-nancy and to promote the health of mother and child. Method: A total of 283 pregnant women with maternal premature rupture of membranes were enrolled in the last three years, and 302 normal pregnant women with no premature rupture of membranes were collected as control group. All pregnant women were collected with GBS, VVC, BV infection rate test, compared the two groups of pregnancy outcome. Results: 1) The study group GBS, VVC and BV infection rate were higher than the control group, and the difference between the two groups was statistically significant (P < 0.05). 2) The incidence rate of two or more mixed infections was higher than that in the control group, and the difference was statistically significant (P < 0.05). 3) Adverse pregnancy outcomes: the team in patients with GBS, VVC and BV infection chorioamnionitis, postpartum hemorrhage and incidence of low birth weight and neonatal pneumonia were significantly higher than that of control group (P < 0.05), while the incidence of fetal distress, premature birth there was no statistically significant difference (P > 0.05). 4) Team of GBS and incidence of adverse pregnancy outcomes of preterm birth was obviously higher than that of VVC, BV infection incidence of adverse pregnancy outcomes (P < 0.05), VVC, BV, the incidence of adverse pregnancy outcome there was no statistically significant difference (P > 0.05). 5) In the control group, GBS, VVC and BV patients with adverse pregnancy outcomes showed no statistically significant difference (P > 0.05). 6) In the two groups, the inflammatory markers of the premature rupture group were significantly higher than those in the premature rupture group (e.g., N %, CRP and PCT), and the two groups were statistically significant (P < 0.05). Conclusion: 1) GBS, VVC and BV infections are important causes of premature rupture of membranes, especially the important pathogenic factors of premature rupture of the membrane. 2) Premature rupture of pregnant women’s GBS, VVC and BV infection will lead to increased incidence of adverse pregnancy outcomes.