Yamada Tetsuo, Atsuki Yusuke, Wakasaya Atsushi, Kobayashi Mami, Hirano Yuki, Ohwada Michitaka
Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara, Japan.
J Obstet Gynaecol Res. 2012 Jan;38(1):180-4. doi: 10.1111/j.1447-0756.2011.01665.x. Epub 2011 Oct 14.
The aim of this study was to investigate the etiological characteristics of patients diagnosed with subchorionic hematoma.
A case-controlled study was performed to compare characteristics of patients and controls. Via ultrasound examination, 47 pregnant patients were found to have subchorionic hematomas and 1075 had no evidence of subchorionic hematomas (controls). In the second trimester, patients were compared with regard to endocervical Chlamydia trachomatis and other vaginal microorganisms.
The overall incidence of subchorionic hematomas in this pregnant population was 4.2%. Maternal clinical characteristics did not differ between cases and controls. Evaluation of the vaginal flora revealed that the positive rates of coagulase-negative staphylococci (cases: 12.8%; controls: 4.1%; P<0.01) and Gardnerella vaginalis (cases: 12.8%; controls: 2.5%; P<0.001) in the cases were significantly higher than those of the controls. The negative rate of Lactobacillus in the cases was significantly higher than that of the controls (cases: 42.6%; controls: 27.6%; P<0.05).
Pregnant women with subchorionic hematoma in the first trimester showed changes in vaginal flora in the second trimester, which suggests a possible association with subchorionic hematoma and vaginal flora change.
本研究旨在调查诊断为绒毛膜下血肿患者的病因特征。
进行一项病例对照研究以比较患者和对照的特征。通过超声检查，发现47例孕妇有绒毛膜下血肿，1075例无绒毛膜下血肿迹象（对照）。在孕中期，比较患者宫颈沙眼衣原体和其他阴道微生物情况。
该孕妇群体中绒毛膜下血肿的总体发生率为4.2%。病例组和对照组的产妇临床特征无差异。阴道菌群评估显示，病例组中凝固酶阴性葡萄球菌（病例组：12.8%；对照组：4.1%；P<0.01）和阴道加德纳菌（病例组：12.8%；对照组：2.5%；P<0.001）的阳性率显著高于对照组。病例组中乳酸杆菌的阴性率显著高于对照组（病例组：42.6%；对照组：27.6%；P<0.05）。
孕早期有绒毛膜下血肿的孕妇在孕中期显示阴道菌群变化，这提示绒毛膜下血肿与阴道菌群变化可能存在关联。
