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| Effect of vaginal microecology changes on premature rupture of membranes and maternal and fetal outcomes |
| WANG Bi1 HUA Fu2▲ |
1.Huai’an College of Women and Children Clinical， Xuzhou Medical University， Jiangsu Province, Huai’an 223000, China;
2.Huai’an Clinical College, Xuzhou Medical University， Jiangsu Province, Huai’an 223000, China |
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Abstract Objective To investigate the effect of vaginal microecology changes on premature rupture of membranes (PROM) and maternal and fetal outcomes. Methods Pregnant women with PROM who delivered in Huai’an College of Women and Children Clinical, Xuzhou Medical University (hereinafter referred to as “our hospital”) from September 2019 to February 2020 were selected as research objects. According to the different periods of PROM, they were divided into term PROM (tPROM) 32 cases and preterm PROM (PPROM) 48 cases, 32 healthy pregnant women in our hospital during the same period were selected as control group. The detection of vaginal secretions and vaginal microflora among three groups were compared; the incidence of pathological jaundice, puerperal infection rate, neonatal blood gas pH value and Apgar 1 min score were compared among three groups. Results The positive rates of acetylglucosaminidase, catalase, β-glucuronidase, leucocyte lipase and the ratio of pH > 4.5 in PPROM group were higher than those in control group, and the differences were statistically significant (P < 0.017). The positive rates of acetylglucosaminidase, catalase, sialidase, leucocyte lipase and the ratio of pH > 4.5 in tPROM group were higher than those in control group, and the differences were statistically significant (P < 0.017). The infection rates of bacterial vaginitis and chlamydia trachomatis in PPROM group were higher than those in tPROM group and control group; the abnormal rate of vaginal secretions and the infection rate of vulvovaginal candidiasis were higher than those in control group, and the differences were statistically significant (P < 0.017). The abnormal rate of vaginal secretions and ureaplasma urealyticum infection in tPROM group were higher than those in control group, and the differences were statistically significant (P < 0.017). The rate of cesarean section, incidence of pathological jaundice and neonatal blood gas pH in PPROM group were higher than those in tPROM group and control group, and Apgar 1 min was lower than that in tPROM group and control group, and the differences were statistically significant (P < 0.017 or P < 0.05). Conclusion Changes in vaginal microenvironment during pregnancy and reproductive tract infection are the pathogenic factors of PROM, and changes in vaginal microenvironment affect maternal and fetal outcomes.
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