Materno-fetal and Obstetrics Research Unit, Department of Obstetrics and Gynecology, University Hospital, Lausanne, Switzerland.
Curr Opin Infect Dis. 2013 Jun;26(3):231-40. doi: 10.1097/QCO.0b013e328360db58.
Mycoplasma hominis and Ureaplasma urealyticum may colonize the human genital tract and have been associated with adverse pregnancy outcomes. Chorioamnionitis, spontaneous preterm labour and preterm premature rupture of membranes are significant contributors to neonatal morbidity and mortality. However, as these bacteria can reside in the normal vaginal flora, there are controversies regarding their true role during pregnancy and thus the need to treat these organisms.
We review here the recent data on the epidemiology of mycoplasmas and their clinical role during pregnancy. The association of these organisms with preterm labour has been suggested by many observational studies, but proof of causality remains limited. PCR is an excellent alternative to culture to detect the presence of these organisms, but culture allows antibiotic susceptibility testing. Whether antimicrobial treatment of mycoplasma-colonized pregnant patients can effectively reduce the incidence of adverse pregnancy outcomes warrants further investigations.
The role of Mycoplasma spp. and U. urealyticum in adverse pregnancy outcomes is increasingly accepted. However, sole presence of these microorganisms in the vaginal flora might be insufficient to cause pathological issues, but their combination with other factors such as bacterial vaginosis or cervical incompetence may be additionally needed to induce preterm birth.
人型支原体和脲原体可能定植于人体生殖道，并与不良妊娠结局相关。绒毛膜羊膜炎、自发性早产和胎膜早破是导致新生儿发病率和死亡率的重要因素。然而，由于这些细菌可能存在于正常阴道菌群中，因此它们在妊娠期间的真正作用存在争议，因此是否需要治疗这些病原体也存在争议。
本文综述了支原体的流行病学及其在妊娠期间的临床作用的最新数据。许多观察性研究表明，这些病原体与早产有关，但因果关系的证据仍然有限。PCR 是检测这些病原体存在的一种很好的替代培养方法，但培养可以进行抗生素敏感性测试。抗微生物治疗定植支原体的妊娠患者是否能有效降低不良妊娠结局的发生率，这仍需要进一步研究。
人型支原体和脲原体在不良妊娠结局中的作用越来越被接受。然而，这些微生物仅存在于阴道菌群中可能不足以引起病理问题，但它们与细菌性阴道病或宫颈机能不全等其他因素的结合可能是导致早产的额外因素。
