B族链球菌定植产妇的产程管理与围生结局的研究  

Study of labor Process Management and Perinatal Outcome in Pregnant Women Colonized with Group B Streptococcus

作　　者：陈璐璐 王繁 CHEN Lulu;WANG Fan(Department of Obstetrics and Gynecology,The Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院、育英儿童医院产科,325027

出　　处：《医学研究杂志》2024年第1期136-141,共6页Journal of Medical Research

基　　金：浙江省温州市科技局基础性科研项目(Y2020504)。

摘　　要：目的研究足月B族链球菌(group B streptococcus,GBS)定植产妇的产程管理与围生结局。方法收集2020年10月~2021年11月在温州医科大学附属第二医院、育英儿童医院产科住院的GBS筛查阳性的足月产妇355例(GBS阳性组)和同期GBS筛查阴性的足月产妇355例(GBS阴性组)的临床资料,比较产程特征、胎膜破裂持续时间及围生结局。结果与GBS阴性组比较,GBS阳性组产时发热、产后发热、住院时间、组织学绒毛膜羊膜炎、新生儿转科及新生儿败血症发生率均升高(P<0.05)。两者在产程发动方式、分娩方式、胎膜早破、临床绒毛膜羊膜炎、胎膜破裂持续时间、第一产程、活跃期、第二产程、产后出血、会阴损伤、新生儿出生体重、新生儿性别、胎儿宫内窘迫、新生儿黄疸方面比较,差异无统计学意义(P>0.05)。GBS阳性组中,根据不同胎膜破裂持续时间分为<12h组、≥12且<24h组和≥24h组。<12h组作为对照组。与对照组比较,≥12且<24h组第一产程、活跃期、第二产程、住院时间均显著长于对照组;胎膜早破及产钳助娩率高于对照组(P<0.05);≥24h组第一产程、第二产程、住院时间长于对照组,胎膜早破、产时发热、产后发热、组织学绒毛膜羊膜炎、剖宫产率均高于对照组(P<0.05)。GBS阳性组中,新生儿败血症与新生儿无败血症在产程发动方式、分娩方式、胎膜破裂方式、组织学绒毛膜羊膜炎、胎膜破裂时间及产程方面比较,差异无统计学意义(P>0.05)。结论GBS定植不影响产程进展,但增加母婴感染风险。GBS定植的足月产妇在胎膜破裂后24h内分娩,可缩短产程,减少分娩并发症,有利于改善不良围生结局。Objective To study the labor process management and perinatal outcome in full-term pregnant women colonized with group B streptococcus.Methods The clinical data of 355 full-term pregnant women with positive GBS screening(the positive GBS group)and 355 full-term pregnant women with negative GBS screening(the negative GBS group)from October 2020 to November 2021,in the department of obstetrics and gynecology of the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University were collected.The labor characteristics,duration of rupture of membranes and perinatal outcome were compared between the two groups.Results In the positive GBS group,the incidences of intrapartum fever,postpartum fever,hospital stays,histological chorioamnionitis,neonatal admission to neonatal intensive care unit(NICU),and neonatal sepsis were higher than those in the negative GBS group(P<0.05).There was no significant difference between the two groups with mode of initiation of labor,mode of delivery,premature rupture of membrane,clinical chorioamnionitis,duration of rupture of membranes,the first stage of labor,the active stage,the second stage of labor,birth weight of newborn,gender of newborn,fetal distress,and neonatal jaundice(P>0.05).According to the difference of interval between rupture of the fetal membranes,the positive GBS group was divided into three groups:<12 hours group,≥12 and<24 hours group,and≥24 hours group.The<12 hours group was selected as the control group.In the≥12 and<24 hours group,the first stage of labor,active stage,second stage of labor,and hospital stay were longer than those in the control group.The incidence of premature rupture of membranes of term and forceps delivery was higher than that in the control group(P<0.05).In the≥24 hours group,the first stage of labor,second stage of labor,and hospital stay were longer than those in the control group.The incidence of premature rupture of membranes of term,intrapartum fever,postpartum fever,histological chorioamnionitis,and cesa

关 键 词：B族链球菌 产程管理 胎膜破裂 持续时间 母婴感染 

分 类 号：R714[医药卫生—妇产科学]