Correlation Between Vaginal Microecological Changes In Late Pregnancy And Adverse Pregnancy Outcomes

Objective: Through a comparative analysis of vaginal microecological changes in pregnant women with and without asymptomatic vaginitis in late pregnancy,and to explore the correlation between vaginal microecological changes in late pregnancy and adverse pregnancy outcomes,to provide basic research data to prevent and reduce adverse pregnancy outcomes.Methods: A total of 160 pregnant women ? 35 weeks of gestation who were diagnosed at the obstetrics and gynecology department of the Affiliated Hospital of Inner Mongolia Medical University from December 2018 to December 2019 were selected.Collect 1/3 secretions on the vaginal wall for vaginal microecological testing.According to the screening results,136 cases of vaginal microecological imbalance were taken as the study group,including 50 cases with vaginal inflammation symptoms and 86 without vaginal inflammation symptoms.Twenty-four patients with normal vaginal microecology were used as the control group.And track the pregnancy outcomes of the three groups.Results: 1.Vaginal microecological imbalance in the third trimester: The incidence of vaginal microecological imbalance was 85.00%(136/160).Among them,Vulvovaginal candidiasis(VVC)accounted for 17.65%(24/136),Bacterial vaginosis(BV)accounted for 13.24%(18/136),and BV and VVC mixed infection accounted for 2.94%(4/136),declining lactobacillus function accounted for 58.82%(80/136),and bacterial colony inhibition accounted for 7.35%(10/136).(1)Among the symptomatic patients in the study group,the incidence of VVC was higher than that of asymptomatic patients(P < 0.05),and the incidence of mixed infection of BV,BV and VVC was higher than that of asymptomatic patients,but thedifference was not statistically significant(P > 0.05).(2)Among the asymptomatic patients in the study group,the incidence of decreased lactobacillus function was higher than those with symptoms(P < 0.05),and the incidence of bacterial colony suppression was higher than those with symptoms,but the difference was not statistically significant(P > 0.05).2.Correlation between vaginal microecological imbalances and adverse outcomes:(1)The incidence of adverse pregnancy outcomes was 51.25%(82/160).Among them,the adverse pregnancy outcome in the study group was 46.88%(75/160),27.50%(44/160)were symptomatic,and 19.38%(31/160)were asymptomatic.The control group had an adverse pregnancy outcome of 4.37%(7/160).(2)Compared with asymptomatic patients in the study group,the incidence of premature rupture of membranes,intrauterine infection and neonatal hyperbilirubinemia were higher than those of asymptomatic patients(P < 0.05).There was no significant difference between the two groups in terms of mattress infection and neonatal infection(P > 0.05).(3)Compared with those in the control group,the incidence of premature rupture of membranes and uterine cavity infection was higher in the study group than in the control group(P > 0.05);there was no significant difference between the two groups in terms of premature delivery,puerperal infection,neonatal infection,and neonatal hyperbilirubinemia(P > 0.05).(4)There was no significant difference in adverse pregnancy outcomes between the asymptomatic group in the study group and the control group(P >0.05).3.Correlation between vaginal microecological imbalance without pathogenic infection and adverse pregnancy outcomes:(1)In the case of declining lactobacillus function in the study group,compared with asymptomatic patients,premature rupture of membranes and high bile in newborns The incidence of hemoglobinemia was higher than that of asymptomatic patients(P < 0.05);there was no significant difference between the two groups in terms of premature delivery,uterine infection,puerperal infection,and neonatal infection(P > 0.05).Compared with the control group,the incidence of neonatal hyperbilirubinemia in the study group was higher than that in the control group(P < 0.05);in terms of premature rupture of membranes,premature delivery,uterine infection,puerperal infection,and neonatal infection There was no significant difference between the two groups(P > 0.05).There was nosignificant difference in the incidence of adverse outcomes between the asymptomatic group of the study group and the control group(P > 0.05).(2)Due to the small sample size of the bacterial flora,case dispersion cannot be compared.Conclusions: 1.The vaginal microecological imbalance in late pregnancy is associated with adverse pregnancy outcomes,and those with symptoms are prone to adverse pregnancy outcomes.Lactobacillus function declines and symptomatic patients are prone to adverse pregnancy outcomes.It is necessary to strengthen the management of such groups and provide reasonable guidance and intervention during pregnancy to prevent and reduce the occurrence of adverse outcomes.2.Pregnant women with symptoms should be tested for vaginal microecology during pregnancy,which can reduce the misdiagnosis of vaginal microecological disorders without pathogens and further prevent the occurrence of adverse pregnancy outcomes.Excessive intervention and testing are not recommended for asymptomatic pregnant women.3.For pregnant women with vaginitis in late pregnancy,in addition to the detection and treatment of pathogenic bacteria,attention should also be paid to improving their vaginal microecology.