【作者】 任延巍；

【导师】 贺晶；

【作者基本信息】 浙江大学 ， 妇产科学， 2012， 硕士

【摘要】 目的通过对妊娠晚期孕妇阴道菌群的研究,探讨阴道菌群的分布情况,及其与不良妊娠结局的关系,指导今后合理的进行检查及治疗思路,减少不良妊娠结局的发生。方法对我院1280例妊娠晚期孕妇产前常规进行阴道假丝酵母菌、滴虫、细菌性阴道病(BV)、衣原体、淋菌检查,部分病例同时行白带需氧菌培养。共筛检出阳性患者204例,根据自觉症状有无分为有症状组91例和无症状组113例,同时随机选取200例上述检查阴性者做为正常对照组,比较三组不良妊娠结局发生情况。结果1、有症状组与无症状组在胎膜早破、产褥感染、新生儿感染及病理性黄疸方面有显著差异(P<0.05),而在早产、低出生体重儿发生率方面差异无统计学意义(P>0.05)。2、有症状组与正常对照组相比较,胎膜早破、产褥感染及新生儿感染发生率显著升高(P<0.05),而在早产、低出生体重儿及新生儿病理性黄疸发生率方面无显著差异(P>0.05)。3、无症状组与正常对照组在上述不良母儿结局方面均无显著差异(P>0.05)。结论1.妊娠晚期阴道菌群失调与不良妊娠结局密切相关。2.有症状者更易引发不良妊娠结局,必须重视孕妇阴道局部症状。3.为减少不良妊娠的发生,建议对有症状的孕妇进行针对性的检查和治疗；而对无症状孕妇不建议进行常规筛查和治疗。更多还原

【Abstract】 Objective:To investigate the correlation ship of vaginal microflora in the third-trimester and adverse outcomes of pregnancy.Methods:There were1280cases of pregnant women in our hospital who were in the third-trimester taken prenatal routine vaginal candida, trichomonas, bacterial vaginosis (BV), chlamydia and gonococcal check, some of them gotten aerobic training of vaginal discharge.204cases showed abnormal pathogenes, then further divided them into two groups:symptomatic group(91cases) and asymptomatic group(113cases), while200negtive patients were randomly selected as control group, and compared these three groups on adverse outcomes. Results:1、Symptomatic group and asymptomatic group had significant differences in premature rupture of membranes, puerperal infection, neonatal infection and neonatal jaundice (P<0.05), while there were no significant differences in premature delivery, caesarean section rates, fetal distress and the incidence of low birth weight infants (P>0.05).2、On the items of premature rupture of membranes, puerperal infection and neonatal infection rate, symptonmatic group was significantly higher than control group (P<0.05). While in the premature labor, cesarean section rate, fetal distress, low birth weight infants and the incidence of neonatal jaundice were no significant differences (P>0.05).3. There were no significant differences in the above adverse pregnancy outcomes between asymptomatic group and control group (P>0.05).Conclusion:Vaginal microbial disturbances in the third-trimester were closely associated with adverse outcomes, particularly those who were with symptoms should conduct a comprehensive examination and aggressive treatment to reduce the incidence of adverse pregnancy outcomes.更多还原