Onderdonk Andrew B, Hecht Jonathan L, McElrath Thomas F, Delaney Mary L, Allred Elizabeth N, Leviton Alan
Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.
Am J Obstet Gynecol. 2008 Jul;199(1):52.e1-52.e10. doi: 10.1016/j.ajog.2007.11.068. Epub 2008 Mar 7.
The overtly healthy, nonpregnant uterus harbors bacteria, Mycoplasma and Ureaplasma. The extent of colonization remains elusive, as are relationships between isolated microorganisms, preterm labor and fetal inflammation.
Biopsy specimens of chorion parenchyma from 1083 placentas delivered before the beginning of the 28th week of gestation were cultured, and the placentas were examined histologically. The frequencies of individual microorganisms and groups of microorganisms were evaluated in strata of processes leading to preterm delivery, routes of delivery, gestational age, and placenta morphology.
Placentas delivered by cesarean section with preeclampsia had the lowest bacterial recovery rate (25%). Preterm labor had the highest rates, which decreased with increasing gestational age from 79% at 23 weeks to 43% at 27 weeks. The presence of microorganisms in placenta parenchyma was associated with the presence of neutrophils in the fetal stem vessels of the chorion or in the vessels of the umbilical cord.
The high rate of colonization appears to coincide with phenomena associated with preterm delivery and gestational age. The presence of microorganisms within placenta parenchyma is biologically important.
表面健康的未孕子宫中存在细菌、支原体和脲原体。其定植程度仍不清楚,分离出的微生物、早产和胎儿炎症之间的关系也不明确。
对妊娠28周前分娩的1083份胎盘的绒毛膜实质活检标本进行培养,并对胎盘进行组织学检查。在导致早产的过程、分娩途径、孕周和胎盘形态分层中评估单个微生物和微生物组的频率。
剖宫产分娩且患有子痫前期的胎盘细菌回收率最低(25%)。早产的胎盘细菌回收率最高,随着孕周增加而降低,从23周时的79%降至27周时的43%。胎盘实质中微生物的存在与绒毛膜胎儿主干血管或脐带血管中中性粒细胞的存在有关。
高定植率似乎与早产和孕周相关的现象一致。胎盘实质内微生物的存在具有生物学重要性。