无痛分娩下人工破膜用于孕足月生殖道B族链球菌感染产妇对分娩风险及新生儿感染的临床价值  

Clinical value of artificial rupture of membranes during painless delivery for pregnant women infected with group B Streptococcus of reproductive tract in childbirth risk and neonatal infection

作　　者：张赟[1] 苏家林[1] 谢淑琴[1] 李婷 郑九生[1] 辛思明[1] ZHANG Yun;SU Jialin;XIE Shuqin;LI Ting;ZHENG Jiusheng;XIN Siming(Department of Obstetrics and Gynecology,Jiangxi Maternal and Child Health Hospital,Jiangxi Province,Nanchang 330000,China)

机构地区：[1]江西省妇幼保健院妇产科,江西南昌330000

出　　处：《中国当代医药》2025年第11期73-77,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202111258)。

摘　　要：目的探讨无痛分娩下人工破膜对孕足月生殖道B族链球菌(GBS)定植产妇母婴预后的影响。方法选取2021年12月至2023年12月于江西省妇幼保健院孕足月拟经阴道分娩,且经生殖道检查存在GBS定植的400例孕产妇作为研究对象。采用红蓝球法将孕产妇分为观察组、对照组,每组各200例。两组均进行自然分娩,观察组采用人工破膜,对照组采用自然临产胎膜自破,比较两组产妇的分娩结局、产程、新生儿Apgar评分、新生儿不良结局与感染情况。结果观察组的产妇会阴撕裂占比、第一产程均低于对照组,差异有统计学意义(P<0.05)。两组产妇的产后出血、绒毛膜羊膜炎、产后感染发生率比较,差异无统计学意义(P>0.05);两组新生儿的1、5 min Apgar评分,与新生儿败血症、病理性黄疸、中转新生儿重症监护中心(NICU)、新生儿肺炎等不良结局和新生儿感染发生率比较,差异无统计学意义(P>0.05)。结论对孕足月生殖道GBS感染的产妇进行无痛分娩下人工破膜,能够降低会阴撕裂发生风险,缩短第一产程,且不会增加产后出血、感染等多种母婴不利结局,但并未降低新生儿感染风险。Objective To investigate the effect of artificial rupture of membranes during painless delivery on maternal and infant prognosis of pregnant women colonized by group B Streptococcus(GBS).Methods A total of 400 pregnant women in Jiangxi Maternal and Child Health Hospital from December 2021 to December 2023 were selected as the study subjects.The pregnant women were divided into observation group and control group by red and blue ball method,with 200 cases in each group.Natural delivery was performed in both groups.The observation group was treated with artificial rupture,while the control group was treated with spontaneous rupture of membranes during labor.The outcomes of labor,duration of labor,neonatal Apgar score,neonatal adverse outcomes and infection of the two groups were compared.Results The proportion of perineal tear and the first stage of labor in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the incidences of postpartum hemorrhage,chorioamniotic infection and postpartum infection between the two groups(P>0.05).There were no statistically significant differences of the 1,5 min Apgar score,and the incidences of adverse outcomes such as neonatal sepsis,pathological jaundice,transfer neonatal intensive care center(NICU)and neonatal pneumonia,and the incidence of neonatal infection between the two groups(P>0.05).Conclusion Artificial rupture of membranes under painless delivery for pregnant women with genital tract GBS infection during full-term pregnancy can reduce the risk of perineal tear,shorten the first stage of labor,and will not increase postpartum hemorrhage,infection and other adverse outcomes for mothers and infants,but it does not reduce the risk of neonatal infection.

关 键 词：B族链球菌 人工破膜 母婴结局 产妇 

分 类 号：R714[医药卫生—妇产科学]