The Infection Of Group B Streptococcus And Its Effect On Perinatal Outcome

Objective To investigate the colonization rate of the group B streptococcus in the reproductive tract of terminal pregnant women and its high risk factors and explore the effects of GBS infection on the outcome of full-term pregnancy.Methods From June 2015 to August 2016,a total of 884 cases of pregnant women who had 35 ~ 37 weeks gestation in Anhui Maternal And Child Health Hospital(Exclusion criteria:(1)long-term residents outside Hefei;(2)some people have been vaginal lavage,vaginal medication and other operation before sampling;(3)sexual life history within 24 hours;(4)use antibiotics within one month;(5)pregnant women with severe genital tract malformations(6)The pregnant women have serious internal and external diseases or autoimmune diseases).Use sterile cotton swab to collect secretion of the place under pregnant woman vaginal 1/3 and rectum,and adopt fluorescence quantitative Polymerase Chain Reaction(PCR)technology to check Group B streptococcus(GBS),while take leucorrhea to implement routine analysis and observe the pregnancy outcome after implement regular antibiotic therapy for GBS positive pregnant women before the birth.Results(1)The colonization rate of GBS in late pregnant women was 10.41%(92/884).GBS positive rate of Older pregnant women(more than 35 years old)was 11.76%(10/85),GBS positive rate of aged less than 35 years old was 10.26%(82/799);GBS positive rate of women in primiparity was 9.77%(77/788),GBS positive rate of multipara was 15.63%(15/96);GBS positive rate with Number of abortions(greater than or equal to 3 times)was 13.89%(5/36),GBS positive rate with abortion times less than 3 times were 10.26%(87/848);GBS positive rate of pregnant women who live in the villages and towns was 15.79%(15/95),GBS positive rate of pregnant women who live in the city was 9.76%(77/789).(2)The leucorrhea analysis test results is bacterial vaginosis 8.14%(72/884),chomonad1.24%(11/884),mould 6.67%(59/884);positive rates of mould,trichomoniasis,acterial vaginal disease in GBS positive group are 3.26%(3/92)?8.70%(8/92)?17.39%(16/92),negative group consists of 7.07%(56/792)?0.38%(3/792)?7.07%(56/792).The difference in the detection rate of colpitis mycotica among pregnant women from GBS positive group and GBS negative group had no statistical significance.The positive rate of trichomonas vaginitis and bacterial vaginosis among pregnant women from GBS positive group were both evidently higher than that from GBS negative group,the difference had statistical significance.(3)The cesarean section rate,preterm birth rate,meconium-stained amniotic fluid rate,and premature rupture of fetal membranes rate were 55.43%,(51/92),6.52%(6/92),14.13%(13/92)and 15.22%(14/92)in the GBS positive group after regular antibiotic treatment,and 48.11%(381/792),5.68%(45/792),10.61%(84/792),12.37%(98/792)in the negative group.The comparison between the two group shows no statistical significance(P>0.05).(4)The postpartum hemorrhage rate and the puerperal infection rate of pregnant women with positive GBS after transvaginal termination of pregnancy was 2.44%(1/41)?0(0/41),The GBS negative group was 2.43%(10/411)?3.89%(16/411),and the difference had no statistical significance(P>0.05);The postpartum hemorrhage rate and the puerperal infection rate of pregnant women with positive GBS after cesarean delivery was 3.92%(2/51)?1.92%(1/51),The GBS negative group was 2.89%(11/381)?4.20%(16/381),and the difference had no statistical significance(P>0.05).(5)After the regular antibiotic treatment,the GBS positive in the rate of in fetal distress?neonatal asphyxia ?neonatal infection and pathological jaundice was 5.43%(5/92)? 1.09%(3/92)?4.35%(4/92)?10.86%(10/92),and the GBS negative was 5.93%(47/792)?1.01%(8/792)?2.02%(16/792)?14.90%(118/792),the difference was no statistically significant.Conclusions The colonization rate of GBS among pregnant women in the late trimester of pregnancy in Hefei region was 10.41%;age,pregnancy and birth times,living environment of pregnant women had no evident relevance with GBS infection;trichomonas vaginitis and bacterial vaginosis among pregnant women in the late trimester of pregnancy are closely related to GBS colonization;The postpartum hemorrhage rate and the puerperal infection rate had no evident relevance with GBS colonization GBS positive pregnancy pregnant women with sensitive antibiotics after child adverse pregnancy outcomes have not significantly increased.