Background： Preterm premature rapture of membrane （PPROM） can lead to serious consequences such as intrauterine infection, prolapse of the umbilical cord, and neonatal respiratory distress syndrome. Genital infecti...Background： Preterm premature rapture of membrane （PPROM） can lead to serious consequences such as intrauterine infection, prolapse of the umbilical cord, and neonatal respiratory distress syndrome. Genital infection is a very important risk which closely related with PPROM. The preliminary study only made qualitative research on genital infection, but there was no deep and clear judgment about the effects of pathogenic bacteria. This study was to analyze the association of in fections with PPROM in pregnant women in Shaanxi, China, and to establish Bayesian stepwise discriminant analysis to predict the incidence of PPROM. Methods： In training group, the 112 pregnant women with PPROM were enrolled in the case subgroup, and 108 normal pregnant women in the control subgroup using an unmatched case-control method. The sociodemographic characteristics of these participants were collected by face-to-face interviews. Vaginal excretions fiom each participant were sampled at 28 36-6 weeks of pregnancy using a sterile swab. DNA corresponding to Chlamrdia trachomalix （CT）, Ureaplasma urealyticwn （UU）, Candida albicans, group B streptococci （GBS）, herpes simplex virus- 1 （HSV-1）, and HSV-2 were detected in each participant by real-time polymerase chain reaction. A model of Bayesian discriminant analysis was established and then verified by a mull）center validation group that included 500 participants in the case subgroup and 5（10 participants in the control subgroup from five different hospitals in the Shaanxi province, respectively. Results： The sociological characteristics were not significantly different between the case and control subgroups in both training and validation groups （all P 〉 0.05）. In training group, the infection rates of UU （11.6% vs. 3.7%）, CT （17.0% vs. 5.6%）, and GBS （22.3% vs. 6.5%） showed statistically different between the case and control subgroups （all P 〈 0.05）, Iog-transfomacd quantification of UU, CE GBS, and HSV-2 showed statistically diff展开更多
未足月胎膜早破(Preterm premature rupture of membranes,PPROM)在产科中是一种很常见的并发症。到目前为止学者们对其明确的病因和发病机制并不是很清楚,尽管如此,许多研究表明该病与感染、胎位异常、流产引产史、医源性创伤、微量元...未足月胎膜早破(Preterm premature rupture of membranes,PPROM)在产科中是一种很常见的并发症。到目前为止学者们对其明确的病因和发病机制并不是很清楚,尽管如此,许多研究表明该病与感染、胎位异常、流产引产史、医源性创伤、微量元素、酶类作用、细胞凋亡等多种因素有关。近年来未足月胎膜早破的发生率逐步上升。其病因研究也层出不穷,成为一个热点课题。本文综述了近年来关于未足月胎膜早破的相关病因及发病机制。展开更多
目的探讨研究诱发因素对未足月胎膜早破(PPROM)患者母婴结局的影响。方法收集2009年至2013年在该院进行分娩的112例早产合并PPROM患者的临床资料进行回顾性分析,根据文献记载及临床分析,将不良妊娠史、瘢痕子宫与感染确定为PPROM的诱导...目的探讨研究诱发因素对未足月胎膜早破(PPROM)患者母婴结局的影响。方法收集2009年至2013年在该院进行分娩的112例早产合并PPROM患者的临床资料进行回顾性分析,根据文献记载及临床分析,将不良妊娠史、瘢痕子宫与感染确定为PPROM的诱导因素,将54例有明显诱发因素的患者作为甲组,原因不明早产合并PPROM 58例为乙组,比较两组患者一般情况、分娩方式及妊娠结局。结果 (1)甲组孕妇平均年龄及既往不良孕产史发生率均高于乙组,而分娩孕周显著低于乙组;(2)甲组阴道顺产率明显低于乙组,而剖宫产率则显著升高;(3)甲组新生儿体重、1 min Apgar评分均显著低于乙组;新生儿窒息率则高于乙组(P<0.05)。两组其他方面比较差异无统计学意义(P>0.05)。结论有明显诱因致早产合并PPROM者,母儿患病率相对较高。孕妇年龄、既往不良孕产史同妊娠结局有关。针对不同病因,应采取不同处理措施,以减少母儿的发病率和死亡率,改善妊娠结局。展开更多
未足月胎膜早破(preterm premature rupture of membranes,PPROM)是指在妊娠37周前,胎膜在临产前发生自发性破裂[1]。PPROM是多病因导致的临床病理事件,一般认为与遗传因素、生殖道炎症、亚临床宫内感染、羊膜腔内受力不均、营养因素等...未足月胎膜早破(preterm premature rupture of membranes,PPROM)是指在妊娠37周前,胎膜在临产前发生自发性破裂[1]。PPROM是多病因导致的临床病理事件,一般认为与遗传因素、生殖道炎症、亚临床宫内感染、羊膜腔内受力不均、营养因素等有关,涉及母体、胎儿与环境之间的相互作用以及母胎界面的调节紊乱[2]。单胎妊娠PPROM发生率为2%~4%,双胎妊娠PPROM发生率为7%~20%,PPROM是造成早产和母儿感染的主要原因之一,严重威胁母儿健康[1],其处理策略一直是产科临床工作中的难点。PPROM孕妇破膜时,胎儿未足月,尤其是34孕周前的PPROM,胎儿器官发育不成熟,通常需延长孕周,但在期待过程中,易合并宫内感染,即发生绒毛膜羊膜炎(chorioamnionitis)[1]。保胎过程中,随着孕周延长,早产相关风险有所下降;但破膜时间亦随之延长,继发宫内感染的风险明显升高,可导致严重的母儿感染[3]。两大风险如何权衡,使母儿风险降至最低,是PPROM临床处理的关键。然而,对于PPROM期待治疗的期限、感染的防治策略以及终止妊娠的时机等问题,国内外尚存在一定争议[2]。而PPROM期待治疗过程中宫内感染的监测和早期识别,是决定期待治疗的期限、选择终止妊娠时机、改善母儿结局的关键技术难点。本文将对PPROM孕妇宫内感染的多种新型生物标志物及其用于监测组织学绒毛膜羊膜炎(histologic chorioamnionitis)的研究进展进行综述。展开更多
文摘Background： Preterm premature rapture of membrane （PPROM） can lead to serious consequences such as intrauterine infection, prolapse of the umbilical cord, and neonatal respiratory distress syndrome. Genital infection is a very important risk which closely related with PPROM. The preliminary study only made qualitative research on genital infection, but there was no deep and clear judgment about the effects of pathogenic bacteria. This study was to analyze the association of in fections with PPROM in pregnant women in Shaanxi, China, and to establish Bayesian stepwise discriminant analysis to predict the incidence of PPROM. Methods： In training group, the 112 pregnant women with PPROM were enrolled in the case subgroup, and 108 normal pregnant women in the control subgroup using an unmatched case-control method. The sociodemographic characteristics of these participants were collected by face-to-face interviews. Vaginal excretions fiom each participant were sampled at 28 36-6 weeks of pregnancy using a sterile swab. DNA corresponding to Chlamrdia trachomalix （CT）, Ureaplasma urealyticwn （UU）, Candida albicans, group B streptococci （GBS）, herpes simplex virus- 1 （HSV-1）, and HSV-2 were detected in each participant by real-time polymerase chain reaction. A model of Bayesian discriminant analysis was established and then verified by a mull）center validation group that included 500 participants in the case subgroup and 5（10 participants in the control subgroup from five different hospitals in the Shaanxi province, respectively. Results： The sociological characteristics were not significantly different between the case and control subgroups in both training and validation groups （all P 〉 0.05）. In training group, the infection rates of UU （11.6% vs. 3.7%）, CT （17.0% vs. 5.6%）, and GBS （22.3% vs. 6.5%） showed statistically different between the case and control subgroups （all P 〈 0.05）, Iog-transfomacd quantification of UU, CE GBS, and HSV-2 showed statistically diff
文摘未足月胎膜早破(Preterm premature rupture of membranes,PPROM)在产科中是一种很常见的并发症。到目前为止学者们对其明确的病因和发病机制并不是很清楚,尽管如此,许多研究表明该病与感染、胎位异常、流产引产史、医源性创伤、微量元素、酶类作用、细胞凋亡等多种因素有关。近年来未足月胎膜早破的发生率逐步上升。其病因研究也层出不穷,成为一个热点课题。本文综述了近年来关于未足月胎膜早破的相关病因及发病机制。
文摘目的探讨研究诱发因素对未足月胎膜早破(PPROM)患者母婴结局的影响。方法收集2009年至2013年在该院进行分娩的112例早产合并PPROM患者的临床资料进行回顾性分析,根据文献记载及临床分析,将不良妊娠史、瘢痕子宫与感染确定为PPROM的诱导因素,将54例有明显诱发因素的患者作为甲组,原因不明早产合并PPROM 58例为乙组,比较两组患者一般情况、分娩方式及妊娠结局。结果 (1)甲组孕妇平均年龄及既往不良孕产史发生率均高于乙组,而分娩孕周显著低于乙组;(2)甲组阴道顺产率明显低于乙组,而剖宫产率则显著升高;(3)甲组新生儿体重、1 min Apgar评分均显著低于乙组;新生儿窒息率则高于乙组(P<0.05)。两组其他方面比较差异无统计学意义(P>0.05)。结论有明显诱因致早产合并PPROM者,母儿患病率相对较高。孕妇年龄、既往不良孕产史同妊娠结局有关。针对不同病因,应采取不同处理措施,以减少母儿的发病率和死亡率,改善妊娠结局。
