Karowicz-Bilińiska Agata, Kuś Ewa, Kazimiera Wojciech, Maścidło Aleksandra, Brzozowski Michał, Niedźwiecka Beata, Kowalska-Koprek Urszula
Klinika Patologii Ciaźy I Katedry Ginekologii i Połoznictwa Uniwersytetu Medycznego w Lodzi.
Ginekol Pol. 2007 Oct;78(10):787-91.
Chlamydia trachomatis (CT) infection during pregnancy might be the reason of an increased risk of preterm delivery and premature rupture of membranes. CT could also be responsible for the presence of intrauterine growth restriction, chorionamnionitis and post partum endometritis. It is the most common sexually transmitted disease. The infection may be the reason for PID and consequently even sterility. CT infection could be asymptomatic and the most frequently seen symptom is cervicitis in Pap smears.
The main aim of the study was to estimate the frequency of CT infection in pregnant women, the presence of inflammatory symptoms in Pap-smears, abnormal bacterial status of the vagina and the risk of preterm delivery.
The study was conducted between the years 2005 and 2007 on hospitalized women in The Clinic of High Risk Pregnancy. The first group consisted of 200 pregnant women in II trimester and the second of 200 pregnant women in III trimester of pregnancy. In case of each patient the indication for hospitalization was as increased risk of preterm delivery. The Pap-smears, bacterial smear and immunochromatographic test for CT were done on the first day of the treatment from the border line of the cervical epithelium. The immunochromatographic method, despite its low specificity, lower than PCR (polymerase chain reaction), is useful because of low costs, simplicity of the method and ease of the diagnosis. In case of positive immunochromatographic Ct test, PCR CT analysis should be conducted to make sure the diagnosis is correct. The Pap-smear result suggesting inflammatory process of dysplastic changes was the reason for local antibacterial treatment after which a control smear was done. Bacterial analysis done from external ostium showed patogenic and cohabitants bacteria and resistance to antibiotics. The written consent for the study was obtained.
In the group of pregnant women there were no pathological-alert bacteria smears. In the second group the alert bacteria was found in 3 cases (1.5). In 32% of the first group in 27% of cases inflammatory changes in Pap-smears were found. No positive result of CT was found in either of the groups. The symptoms of preterm delivery were found in 78% members of the first group and in 84% cases of the second group. Preterm delivery occurred in 4 cases in the first group (2%) and 6 cases in the second group (3%).
孕期沙眼衣原体（CT）感染可能是早产和胎膜早破风险增加的原因。CT还可能导致胎儿宫内生长受限、绒毛膜羊膜炎和产后子宫内膜炎。它是最常见的性传播疾病。该感染可能是盆腔炎的病因，甚至会导致不孕。CT感染可能无症状，巴氏涂片检查中最常见的症状是宫颈炎。
本研究的主要目的是评估孕妇CT感染的发生率、巴氏涂片检查中的炎症症状、阴道细菌状态异常以及早产风险。
该研究于2005年至2007年在高危妊娠诊所对住院妇女进行。第一组由200名妊娠中期的孕妇组成，第二组由200名妊娠晚期的孕妇组成。每位患者住院的指征均为早产风险增加。在治疗的第一天，从宫颈上皮边界处进行巴氏涂片、细菌涂片和CT免疫层析检测。免疫层析法尽管特异性低于聚合酶链反应（PCR），但因其成本低、方法简单且诊断容易而有用。如果免疫层析CT检测呈阳性，应进行PCR CT分析以确保诊断正确。巴氏涂片结果提示发育异常改变的炎症过程是进行局部抗菌治疗的原因，治疗后进行对照涂片检查。从外口进行的细菌分析显示有致病菌和共生菌以及对抗生素的耐药性。获得了研究的书面知情同意书。
孕妇组未发现病理性警示细菌涂片。第二组有3例（1.5%）发现警示细菌。第一组32%的病例和第二组27%的病例在巴氏涂片中发现炎症改变。两组均未发现CT阳性结果。第一组78%的成员和第二组84%的病例出现早产症状。第一组有4例（2%）发生早产，第二组有6例（3%）发生早产。
