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Intrauterine infection and the perinatal outcomes in seven tertiary hospitals in Beijing

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF PERINATAL MEDICINE
Issue:
5
DOI:
10.3760/cma.j.issn.1007-9408.2009.05.006
Key Word:
胎膜早破;绒毛膜羊膜炎;大肠杆菌;链球菌;无乳;预后;Fatal membranes,premature rupture;Chorioamnionitis;Escherichia coli;Streptococcus,agalactiae;Prognosis

Abstract: Objective To investigate the distribution of different flora, and to explore the effect of intrauterine infection (IUI) on perinatal outcomes in some hospitals in Beijing. Methods A retrospective analysis was conducted on 176 IUI cases, which were divided into preterm (n=77) and term group (n=99), from 7 tertiary hospitals in Beijing from January 1, 2007 to December 31, 2007. The basic information, clinical presentations, laboratory tests results and placenta pathology reports of all cases were collected and analyzed. Analysis of the microbial population was perfomed according to the results of bacterial culture and the relationship between IUI and the perinatal outcomes was tested. Results The incidence of IUI in 2007 was 0.67% among all deliveries (176/26 204) and 3.91% of all preterm deliveries(77/1969), and 84. 4% of the preterra women were complicated with preterm premature rupture of fetal membranes (PPROM) (65/77). Significant difference was found between the two groups in the incidence of cesarean section, premature rapture of fetal membrane and artificial rupture of fetal membrane, and duration from membranes rupture to delivery (P<0.05). Neither the rate of puerperiurn infection [3.0% (3/99) vs 2.6% (2/77)] nor the neonatal infection rate [30.3%(30/99) vs 25.9%(20/77)] in the term and preterm group showed significant difference. The rate of neonatal death was higher in the preterm group than in the term group(7.8% vs 0,P<0.05). The primary infected bacteria was E. coli, which accounted for 37.3% (22/59) of those with positive results of culture, followed by group B streptococcus(GBS) [32.2%(19/59)] and Staphylococci [23.7%(14/59)3. Conclusions The incidence of IUI is higher in preterm labor women, especially those with PPROM. The common bacteria of chorioamnionitis are E. coli and GBS. Sensitive antibiotics should be administered according to bacterial culture results.

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