摘要
目的了解胎儿窘迫、胎膜早破时胎盘病理变化及羊水病原学改变,以进一步探讨其发病机制及对围产儿预后的影响。方法对236例分娩期发生胎儿窘迫和(或)胎膜早破的孕产妇(研究组)及157例正常孕产妇(对照组),用光学显微镜观察两组患者的胎盘及胎儿附属物,对其羊水行病原体培养,并追踪围产儿结局。结果研究组羊水中病原体培养阳性率为13.6%,对照组为3.8%,两组差异有统计学意义(P<0.01);研究组胎盘病理提示绒毛膜羊膜炎占94.5%,与对照组阳性率20.4%相比,差异有统计学意义(P<0.01);新生儿窒息、围产儿死亡等发病率与绒毛膜羊膜炎严重程度呈正相关(P<0.005);而不同程度绒毛膜羊膜炎与羊水病原学阳性率之间差异无统计学意义。结论胎盘绒毛膜羊膜炎是诊断宫内感染的重要依据,与胎膜早破、胎儿窘迫的发生密切相关,其对宫内感染诊断的敏感性高于羊水病原体检测,且胎盘炎症的严重程度与围产儿预后密切相关。
OBJECTIVE To investigate the changes of the placentas pathology and the amniotic fluid etiology of fetal distress and premature rupture of membrane（PROM）,in order to make further investigation of their etiology and influence of perinatal prognosis.METHODS A total of 236 samples were in study group including fetal distress or premature rupture of membrane,and 157 samples including nomal puerperant were in control group.The placentas and its attachments were observered with optical microscope.The pathogens culture of amniotic fluid was performed and the result was tracked.RESULTS The positive rate of the amniotic fluid culture in study group was 13.6%,higher than that in control group（3.8%）.The difference was statistically significant.the detection rate of chorioamnionitis in study group was higher than that in control group（94.5% vs 20.4%）.The difference was statistically significant（P0.001）.The asphyxia of the neonate and the perinatal death presented the positive correlation（P0.005）.However,there were no statistically significant difference between the chorioamnionitis and the positive rate of the amniotic fluid etiology.CONCLUSION Placental chorioamnionitis is a significant evidence for identifying the intrauterine infection,it is more sensitive than the detection of amniotic fluid pathogens,and also is closely related with the premature rupture of membrane and the fetal distress,and the placental inflammation is closely related with the perinatal prognosis.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第17期2604-2605,共2页
Chinese Journal of Nosocomiology
关键词
胎儿窘迫
胎膜早破
胎盘绒毛膜羊膜炎
宫内感染
Fetal distress
Premature rupture of membrane
Placental chorioamnionitis
Intrauterine infection
