Correlation Of Infection And Premature Rupture Of Membrane

ObjectiveThe clinical information of premature rupture of membrane (PROM) patients and the normal pregnant women were statistical analyzed and compared. To observe the C-reactive protein level, white blood cell count value, reproductive tract pathogenic examination, including ureaplasma urealyticum in the cervical secretions, chlamydia trachomatis, vaginal bacterial culture, bacterial vaginosis (BV) detection, leucorrhea conventional examination and vaginal cleanliness in the pregnant women, and to explore the relation of these clinical examination methods with the occurrence of PROM.MethodsFrom Feb2011to Ju12011, the clinical information of70patients who suffered from PROM and70general gestation women were collected and analyzed. There is no history of hypertension, diabetes mellitus, heart, liver or kidney diseases in all the patients, and no statistically significant difference in the age or week of pregnancy between PROM patients and general gestation women (P>0.05). The clinical examinations were as follows:routine blood test (including white blood cell count), detection of C reactive protein (CRP), leucorrhea conventional examination (including vaginal cleanliness), vaginal bacterial culture, bacterial vaginosis (BV) detection, chlamydia trachomatis, ureaplasma urealyticum detection of cervical secretions. The relation between infection in genitourinary tract and the PROM was explored.Specimen collection method:(1) Patients need not fasting, randomly taken from3ml venous blood and sent to the laboratory to detect routine blood test and C-reactive protein.(2) Patients were at the bladder lithotomy position; vulva was disinfected by iodophor; sterile speculum was used to expose the vagina and cervix. The first three vaginal swabs were taken to the vaginal side of the posterior wall and the secretions were collected for the leucorrhea conventional examination, bacterial culture and bacterial vaginosis (BV) detection. Then two vaginal swabs were inserted into the cervical canal1-2cm, rotated for a few circles and stay for a moment; these cervical secretions were sent for detections of chlamydia and mycoplasma.Methods of detection: CRP was measured by immune transmission turbidimetric method, using high sensitivity commercial kits. The Ureaplasma urealyticum was tested by in vitro mycoplasma diagnostic kits. The Chlamydia was tested by rapid detection reagents for Chlamydia. Blood agar, MacConkey agar and sand Paul’s agar were used for vaginal bacterial culture. The bacterial vaginosis (BV) were detected by sialidase method. Physiological saline method of direct smear was used for leucorrhea conventional examination.ResultsThe CRP level of PROM patients was5.98±2.08mg/L, and white cell count was14.84±2.03×109/L. In the normal pregnant women group, the CRP level and white cell count were1.95±1.46mg/L and12.10±1.63×109/L, respectively. The CRP level in the PROM group was significantly higher than that of non PROM, and was consist with the rise of white cell count(P<0.01).39bacterial growth were positive in genital secretions of the PROM group, including10BV (+),3tichomonad (+),17ureaplasma urealyticum(+),13clamydia trachomatis(+) in cervical secretions. The vaginal cleanliness of most PROM patients was above II grade, and there were23mixed infection patients among them. In the non PROM group, there were only18patient who were found bacterial growth in the vaginal secretions, most was Staphylococcus epidermidis, including3BV(+),8ureaplasma urealyticum(+),5clamydia trachomatis(+) in cervical secretions. The vaginal cleanliness of most non PROM patients was I grad, and there were11mixed infection patients. The infection rate of PROM patients was significantly higher than that of control group, and vaginal cleanliness of PROM patients was significantly lower than that of the normal pregnant women (P<0.05).ConclusionThe incidence rate of prenatal infection in the PROM patients was significantly higher than the non PROM pregnant women. The infection was the mainly cause for the PROM. Since premature birth, umbilical cord prolapse, fetal distress and mother of child infection could be induced by PROM, the relevant factors of PROM should be correctly handled to avoid it. C-reactive protein detection, pathologic examination of the reproductive tract may indicate the existence of prenatal infection, and guide the clinical application of antibiotics to prevent puerperal infection and neonatal infections. These clinical examinations could be the routine tests to prevent the PROM.