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急性组织学绒毛膜羊膜炎和/或脐带炎的近足月及足月分娩中胎粪污染羊水与新生儿发病率

Meconium-stained amniotic fluid and neonatal morbidity in near-term and term deliveries with acute histologic chorioamnionitis and/or funisitis.

作者信息

Rao S, Pavlova Z, Incerpi M H, Ramanathan R

机构信息

University of Southern California Keck School of Medicine, Department of Pediatrics, Division of Neonatology, Women's and Children's Hospital, 1240 North Mission Road, Los Angeles, CA 90033, USA.

出版信息

J Perinatol. 2001 Dec;21(8):537-40. doi: 10.1038/sj.jp.7210564.

Abstract

OBJECTIVE

To determine the incidence of meconium-stained amniotic fluid (MSAF) and neonatal morbidity in near-term and term deliveries with histologic acute chorioamnionitis and/or funisitis compared to those with normal placental histology.

STUDY DESIGN

In a retrospective case-control design, we compared the incidence of MSAF and neonatal outcome in 45 cases of acute histologic chorioamnionitis and/or funisitis with 89 cases of normal placental histology. We reviewed the obstetric and neonatal records for perinatal complications and neonatal morbidity.

RESULTS

Mean birthweights (3372+/-473 vs 3287+/-518 g) were similar in infants born to mothers with histologic chorioamnionitis and/or funisitis compared to infants born to mothers with normal placental histology. The incidence of MSAF was significantly higher in the group with acute chorioamnionitis/funisitis (p<0.05). Similarly, the incidence of admissions to newborn intensive care unit, respiratory distress, meconium aspiration syndrome, and presumed sepsis was also significantly higher (p<0.05) in this group.

CONCLUSION

The incidence of MSAF and neonatal morbidity is higher in the presence of acute inflammation of placental membranes. The presence of meconium in the amniotic fluid should alert the physician to the potential for infection and increased neonatal morbidity.

摘要

目的

确定与胎盘组织学正常的近足月和足月分娩相比,组织学急性绒毛膜羊膜炎和/或脐带炎时羊水胎粪污染(MSAF)的发生率及新生儿发病率。

研究设计

采用回顾性病例对照设计,我们比较了45例急性组织学绒毛膜羊膜炎和/或脐带炎病例与89例胎盘组织学正常病例中MSAF的发生率及新生儿结局。我们查阅了产科和新生儿记录以了解围产期并发症及新生儿发病率。

结果

与胎盘组织学正常的母亲所生婴儿相比,组织学绒毛膜羊膜炎和/或脐带炎母亲所生婴儿的平均出生体重相似(分别为3372±473 g和3287±518 g)。急性绒毛膜羊膜炎/脐带炎组中MSAF的发生率显著更高(p<0.05)。同样,该组新生儿重症监护病房收治率、呼吸窘迫、胎粪吸入综合征及疑似败血症的发生率也显著更高(p<0.05)。

结论

胎盘膜急性炎症时MSAF及新生儿发病率更高。羊水存在胎粪应提醒医生注意感染可能性及新生儿发病率增加。

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