Clinical Evaluation Of Adequate Intrapartum Antibiotic Prophylaxis For Group B Streptococcus Infection In Latepregnancy

Objective:The changes of laboratory parameters and adverse maternal and fetal pregnancy outcomes in pregnant women with or without group B streptococcus(GBS)infection inlate pregnancy were compared,the status of GBS carrying bacteria and the necessity of clinical GBS examination were analyzedas well;The changes of laboratory parameters and adverse maternal and fetal pregnancy outcomes in women with GBS infection in late pregnancy with or without adequate intrapartum antibiotic prophylaxis(IAP)were compared,the effectiveness of adequate IAP as a treatment before labor were analyzed,all of which are aimed atfurther guiding the rational use of drugs by medical staff in obstetrics and gynecology.Method:Women in late pregnancy who went to the Yan’an Affiliated Hospital for daily obstetrical examination and delivered in our hospital from July 2018 to July 2020 were retrospectively collected to observe the pregnant women with positive GBS infection.At 35-37 weeks of gestation,GBS examination of vaginal and rectal secretions was performed(thechromogenicmediumwasused to detectegroup B streptococci).In the another group,women in late pregnancy who had negative GBS examination during the same period and delivered in our hospital were selected,with a total sample size of340.The general data of pregnant women such as the days of pregnancy,number of pregnancy,body mass index,age,etc.,were collected,and the laboratory parameters,maternal and neonatal pregnancy outcomes were compared between the two groups.For pregnant women with GBS screening positive in the third trimester,antibiotics were used after natural rupture of the membrane or before delivery,and divided into adequate IAP group and insufficient IAP group according to different duration and dose of antibiotic use.The antibiotics of the pregnant women in the adequate IAP group were used at least4 h before delivery and the duration was at least 2h,and the dose was up to the standard;the insufficient IAP antibiotics were used for insufficient time,the type and dose of use did not meet the standard.The laboratory indicators and maternal and child pregnancy outcomes were compared between the two groups.Results:1.GBS detection rate: The results of GBS examination were obtained from3405 pregnant women.The positive rate of GBS was 6.55%(223/3405)and the negative rate was 93.45%(3182/3405).2.There were significant differences in laboratory parameters WBC and PLT between GBS positive and GBS negative groups(P<0.05).There was no significant difference in laboratory parameters NEU,PT,and D-D(P>0.05).Compared with the adequate IAP group and the insufficient IAP group,PLT and WBCd were statistically significant 24 h after delivery(P<0.05).In terms of mothers,GBS positive group had 25 cases(14.71%)ofpuerperal infection,18cases(10.59%)of premature rupture of membranes,13 cases(7.65%)of chorioamnionitis,and 12 cases(7.06%)of amniotic fluid contamination,the incidence of the negative group was lower in the two groups.4 cases of chorioamnionitis(5.13%)and7 cases of puerperal infection(8.97%)occurred in theinadequate IAP group,the incidence was lower than in the inadequate IAP group,and the difference was statistically significantsignificant(P<0.05).3.In terms of neonates,49 cases of pathological jaundice(28.82%),34 cases of hospitalizations(20.00%),22 casesof neonatal seizures or irritability(12.94%),13 cases of newborns failed hearing primary screening(7.65%),12 cases of neonatal underweight(7.06%),10 cases of neonatal pneumonia(5.88%),and 8 cases of neonatal asphyxia(4.71%)occurred in the GBS positive group,with a higher incidence compared with the GBS-negative group,and the difference was statistically significant(P<0.05);One case of neonatal pneumonia,5 cases of neonatal convulsion or irritation(6.41%),and 6 cases of neonatal rash or erythema(7.69%)occurred in the adequate IAP group,Lower incidence rate than inadequate IAP group and the difference was statistically significant(P<0.05).Conclusions:1.Adverse maternal and fetal outcomes caused by GBS infection,so the screening of GBS deserves attention and is necessary as a necessary prenatal examination.2.Adequate intrapartum antibiotic prevention strategies to ensure the effective therapeutic concentration of antibiotics,have better efficacy in clinical application,can effectively reduce inflammation-related laboratory parameters,relieve infection symptoms,reduce adverse maternal and fetal outcomes,and recommend standardized clinical use of antibiotics(antibiotic category and dose,timing of antibiotic use).