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目的探讨妊娠中晚期孕妇阴道菌群紊乱的改变对不良妊娠结局的影响。方法选取产科门诊就诊的妊娠28-34周的患者150例。根据检查结果将其分为菌群正常组48例和菌群失常组102例。观察并对比两组患者的不良妊娠结局。结果 102例菌群失常患者中滴虫6例,假丝酵母菌67例,衣原体17例,淋菌2例,细菌性阴道病10例。假丝酵母菌感染率明显高于其他致病菌(P<0.05)。菌群失常组患者早产、胎膜早破、剖宫产、产褥感染发生率分别为15.69%、22.55%、35.29%和18.63%,均明显高于菌群正常组的4.17%、8.33%、18.75%和6.25%(P<0.05)。菌群失常组患者新生儿黄疽、新生儿感染和低出生体重儿发生率分别为24.51%、21.57%、16.67%,均明显高于菌群正常组的10.42%、8.33%、4.17%(P<0.05),在胎儿窘迫的发生率方面两组比较差异无统计学意义(P>0.05)。结论妊娠中晚期阴道菌群紊乱中以假丝酵母菌感染发生率最多,与不良妊娠结局密切相关,增加了早产、胎膜早破、剖宫产、产褥感染、新生儿黄疸、新生儿感染和低出生体重儿等与不良妊娠结局的发生率。
Objective To investigate the influence of changes of vaginal flora in pregnant women during late pregnancy on adverse pregnancy outcome. Methods A total of 150 patients with gestational age from 28 to 34 weeks were enrolled in this study. According to the test results, 48 cases were divided into normal group and 102 cases with abnormal group. Observe and compare the two groups of patients with adverse pregnancy outcomes. Results Among the 102 patients with bacterial flora, there were 6 trichomoniasis, 67 candida, 17 chlamydia, 2 gonococcus and 10 bacterial vaginosis. Candida infection was significantly higher than other pathogens (P <0.05). The incidences of preterm birth, premature rupture of membranes, cesarean section and puerperal infection in patients with bacterial group were 15.69%, 22.55%, 35.29% and 18.63%, respectively, which were significantly higher than those of normal group (4.17%, 8.33% 18.75% and 6.25% respectively (P <0.05). The incidences of neonatal jaundice, neonatal infection and low birth weight infants were 24.51%, 21.57% and 16.67% in the group with normal group, which were significantly higher than those in the normal group (10.42%, 8.33%, 4.17%, P <0.05). There was no significant difference in the incidence of fetal distress between the two groups (P> 0.05). Conclusion The prevalence of Candida infection in the second trimester vaginal flora is the highest, which is closely related to the outcome of adverse pregnancy and increases the risk of premature delivery, premature rupture of membranes, cesarean section, puerperal infection, neonatal jaundice, neonatal infection And low birth weight children with adverse pregnancy outcomes.