The Clinical Analysis On The Effect Of Lower Genital Tract Infection For Premature Rupture Of Membranes And Maternal-fetal Outcome

Objective: Explore the relationship of reproductive tract infection between prematurerupture of membranes and maternal-fetal outcomes, and sum up exprerience in clinicalworking by preventing and treat premature rupture of membranes.Methods: Collecting379cases of premature rupture of membranes pregnant women inour hospital from March2011to March2013as a research group, and dividing theobservation group into two subgroups according to the gestational age, which werenamed group A (preterm premature rupture of membrane group):125cases28to36+6weeks of gestation; B group (term premature rupture of membrane group):254cases37to41weeks of pregnancy. The control group was randomly selected from the sameperiod400cases in our hospital childbirth without premature rupture of membranespregnant women. Taking groups of pregnant women in cervical secretions UU, CT, BV,VVC and TV detection, meanwhile taking fetal membranes pathological examination.Statistical analying of mycoplasma, chlamydia, bacterial vaginal disease, candida,trichomonad infection between premature rupture of membranes and the relationshipthe adverse pregnancy outcomes, analyzes premature rupture of membranes, possiblecausative factor.Results:1.125cases of pregnant women with premature rupture of membranes, theinfection rate of mycoplasma, chlamydia, bacterial vaginosis, Candida, Trichomonas were74.4%,21.60%,24.8%,37.6%,15.2%,254cases of pregnant women withpremature rupture of membranes, the infection rates of mycoplasma, chlamydia,bacterial vaginosis, Candida, Trichomonas were48.8%,2.0%,11.0%,12.6%,6.3%,the difference was statistically significant (P <0.01).2. Lower genital tract infection UU,CT, BV, VVC, and TV increasing the incidence of premature birth, neonatal pneumonia,chorioamnionitis, while the incidence of fetal distress, neonatal pathological jaundicedid not significantly increased.3. The comparison between premature rupture ofmembranes and fetal membranes rupture group was: an increased incidence of pretermlabor, puerperal infection, chorioamnionitis, and neonatal pneumonia. The differencewas statistically significant (P <0.05),While the comparison between the two groupsof postpartum hemorrhagefetal distress, neonatal asphyxia, neonatal Jaundice was nosignificant difference (P>0.05).4. The comparison between pregnant and non-infectedpregnant women during pregnancy lower genital tract infection was: a significantincrease(P <0.05) in the incidence of premature labor, puerperal infection,chorioamnionitis, neonatal pneumonia was detected.Increased perinatal mortality inpregnant women of reproductive tractvarious pathogens was found, and only chlamydia,bacterial increased vaginosis perinatal death, the difference was statistically significant.5.379cases of premature rupture of membranes total：237cases (62.53%) of lowergenital tract infection,70cases (18.47%) of the incidence of unexplained,45cases(11.34%) of abnormal fetal position,20(5.28%) cases of cephalopelvic disproportion,13cases (3.43%) of history of adverse pregnancy,9cases (2.37%) of multiplepregnancy,8cases (2.11%) of the multiple induced abortion history≥2times,7cases(1.85%) of sexual intercourse, and trauma,5cases (1.31%) of gestational hypertensioncases,4cases (1.06%) of gestational diabetes, and3cases (0.79%) of uterinemalformations. In the predisposing factors, the reproductive tract infections were withthe highest incidence. Conclusion：1. Reproductive tract infection is an important risk factor for premature rupture ofmembranes, and is more prominent in PPROM. Premature rupture of membranes increased theincidence of premature birth, puerperal infection, chorioamnionitis, neonatal pneumonia.2. Lowergenital tract infection mycoplasma, chlamydia, bacterial vaginosis, Candida andTrichomonas increased premature birth, neonatal pneumonia, chorioamnionitis,puerperal infection.3. Chlamydia and bacterial vaginosis infeetion rates is low，but itinfeet，that perinatal mortality prognosis is poor. Chlamydia, bacterial vaginosissignificantly increased perinatal mortality.4. At present, the majority of pregnantwomen believed medication adversely affect the fetus and refused the treatment ofreproductive tract infections. The lack of treatment of reproductive tract infections causeadverse effects on the fetus during pregnancy, future work should actively carry outresearch in this area, for the lower genital tract infection during pregnancy, pregnantwomen and effective treatment had no significant effect on the fetus programs, in orderto fundamentally reduce premature rupture of membranes, premature birth and perinatalmorbidity.5. Premature rupture of membranes was influenced by factors ofreproductive tract infections, abnormal fetal position, head disproportion of multiplepregnancies, multiple induced abortion history, abnormal gestation and birth,gestational hypertension, Gestational Diabetes Mellitus,placental low,set in latepregnancy sexual intercourse, trauma, while infection is the mainhazard factor. Thehighest infection rate of pregnant women in a variety of pathogens in the reproductivetract was mycoplasma,.