Verma Indu, Avasthi Kumkum, Berry Vandana
Christian Medical College & Hospital, Ludhiana, 141008 India ; 56 F, Rishi Nagar, Ludhiana, 141001 Punjab India.
Christian Medical College & Hospital, Ludhiana, 141008 India.
J Obstet Gynaecol India. 2014 Aug;64(4):274-8. doi: 10.1007/s13224-014-0523-6. Epub 2014 Apr 12.
Preterm labor is a leading cause of neonatal morbidity and mortality. Ascending lower genital tract infection leads to preterm labor and adverse pregnancy outcomes. This prospective case-control study was performed to see the association between preterm labor and urogenital infections.
A total of 104 women were observed for urogenital infections and their association with preterm labor. Case Group I included 52 women with preterm labor after 26 weeks and before 37 completed weeks of gestation with or without rupture of membranes. Control Group II included 52 women at completed or more than 37 weeks of gestation with no history of preterm labor, matched to the case group with respect to age and parity. Midstream urine was sent for cytology and culture sensitivity. Samples from posterior fornix of vagina were taken with two sterilized swabs under direct vision using Cusco/Sims speculum before first vaginal examination and were studied for gram stain characteristics and culture sensitivity by standard methods. Microorganisms isolated on culture were noted, and antibiotics were given according to sensitivity. Data collected were analyzed according to the groups by χ(2) test for categorical variables.
In our study, urogenital infection was seen in 19 women in Case Group I (36.54 %) compared with 9 women in Control Group (17.3 %), and the difference was statistically significant (p 0.027).
Recognizing and treating the women having urogenital infections at a stage, when it has not become clinically evident, will decrease the percentage of women going into preterm labor and will improve the perinatal outcome.
早产是新生儿发病和死亡的主要原因。下生殖道上行感染会导致早产及不良妊娠结局。本前瞻性病例对照研究旨在观察早产与泌尿生殖系统感染之间的关联。
共观察了104名女性的泌尿生殖系统感染情况及其与早产的关联。病例组I包括52名妊娠26周后至37周整周前发生早产的女性，胎膜有无破裂均可。对照组II包括52名妊娠37周及以上且无早产史的女性，在年龄和胎次方面与病例组匹配。采集中段尿进行细胞学检查和培养药敏试验。在首次阴道检查前，使用库斯科/辛姆斯窥器在直视下用两根消毒棉签从阴道后穹窿取样，采用标准方法研究革兰氏染色特征和培养药敏试验。记录培养分离出的微生物，并根据药敏结果给予抗生素。收集的数据按组通过χ²检验对分类变量进行分析。
在我们的研究中，病例组I中有19名女性（36.54%）发生泌尿生殖系统感染，而对照组中有9名女性（17.3%）发生感染，差异具有统计学意义（p = 0.027）。
在泌尿生殖系统感染尚未在临床上显现的阶段识别并治疗这些女性，将降低早产女性的比例，并改善围产期结局。
