GBS阳性合并足月胎膜早破孕妇的临床治疗及妊娠结局分析  

Clinical treatment and pregnancy outcome analysis of group B streptococcus positive patients with full-term premature rupture of membranes

作　　者：刘颖娜 黄小霞 LIU Ying-na;HUANG Xiao-xia(Department of Obstetrics,Shenzhen Hospital of Southern Medical University,Shenzhen 518100,Guangdong,CHINA)

机构地区：[1]南方医科大学深圳医院产科,广东深圳518100

出　　处：《海南医学》2023年第14期2033-2036,共4页Hainan Medical Journal

摘　　要：目的探讨B族链球菌(GBS)阳性合并足月胎膜早破围分娩期抗生素预防性治疗对妊娠及新生儿结局的影响。方法选取2019年4月至2020年3月期间于南方医科大学深圳医院产科住院分娩的229例孕妇作为研究对象,所有孕妇均在孕35~37周行阴道与直肠分泌物GBS检测提示阳性。将GBS阳性且足月胎膜早破经阴道试产的60例孕妇作为研究组,将同期GBS阳性未合并胎膜早破经阴道试产的169例孕妇作为对照组。两组孕妇入院后均予围分娩期抗生素预防性治疗(IAP)。比较两组孕妇的妊娠结局(羊水污染、宫内感染、产后出血、中转剖宫产)与新生儿结局(新生儿感染、胎儿窘迫、新生儿高胆红素血症、新生儿窒息)。结果两组孕妇的年龄、孕周、孕次、产次比较,差异均无统计学意义(P>0.05);两组孕妇的羊水污染、宫内感染、产后出血、中转剖宫产的发生率比较,差异均无统计学意义(P>0.05);两组孕妇的胎儿窘迫、新生儿窒息、新生儿高胆红素血症、新生儿感染的发生率比较,差异均无统计学意义(P>0.05)。结论足月合并胎膜早破的GBS阳性孕妇存在感染高危,但GBS筛查联合及时有效的IAP治疗能有效地改善不良围产结局。Objective To analyze the clinical treatment and pregnancy outcome of group B streptococcus(GBS)positive patients with full-term premature rupture of membranes.Methods A total of 229 pregnant women who gave birth in the Department of Obstetrics,Shenzhen Hospital of Southern Medical University from April 2019 to March 2020 were selected as the research subjects.All pregnant women underwent GBS tests for vaginal and rectal secretions at 35-37 weeks of pregnancy,indicating positive results.Sixty pregnant women who were GBS positive and underwent vaginal delivery for premature rupture of membranes at term were included in the study group,while 169 pregnant women who were GBS positive during the same period but did not undergo vaginal delivery for premature rupture of membranes were included in the control group.Both groups of pregnant women were treated with antibiotic prophylactic therapy(IAP)during the perinatal period after admission.The pregnancy outcomes(amniotic fluid contamination,intrauterine infection,postpartum hemorrhage,conversion to cesarean section)and neonatal outcomes(neonatal infection,fetal distress,neonatal hyperbilirubinemia,neonatal asphyxia)were compared between the two groups of pregnant women.Results There was no statistically significant difference in age,gestational week,gestational frequency,and parity between the two groups of pregnant women(P>0.05).There was no statistically significant difference in the incidence of amniotic fluid contamination,intrauterine infection,postpartum hemorrhage,and conversion to cesarean section between the two groups of pregnant women(P>0.05).There was no statistically significant difference in the incidence of fetal distress,neonatal asphyxia,neonatal hyperbilirubinemia,and neonatal infection between the two groups of pregnant women(P>0.05).Conclusion GBS positive pregnant women with full-term premature rupture of membranes are at high risk of infection,but GBS screening combined with timely and effective IAP treatment can effectively improve adverse perinata

关 键 词：B族链球菌 胎膜早破 围分娩期 抗生素预防性治疗 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]