Kabiri Doron, Hants Yael, Yarkoni Tom Raz, Shaulof Esther, Friedman Smadar Eventov, Paltiel Ora, Nir-Paz Ran, Aljamal Wesam E, Ezra Yossef
Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Neonatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
PLoS One. 2015 Dec 31;10(12):e0145905. doi: 10.1371/journal.pone.0145905. eCollection 2015.
Stripping of the membranes is an established and widely utilized obstetric procedure associated with higher spontaneous vaginal delivery rates, reduced need for formal induction of labor and a lower likelihood of post-term pregnancy. Due to the theoretical concern of bacterial seeding during the procedure many practitioners choose not to sweep the membranes in Group B Streptococcus (GBS) colonized patients. We conducted 'the STRIP-G study' in order to determine whether maternal and neonatal outcomes are affected by GBS carrier status in women undergoing membrane stripping.
We conducted a prospective study in a tertiary referral center, comparing maternal and neonatal outcomes following membrane stripping among GBS-positive, GBS-negative, and GBS-unknown patients. We compared the incidence of composite adverse neonatal outcomes (primary outcome) among the three study groups, while secondary outcome measure was composite adverse maternal outcomes.
A total of 542 women were included in the study, of which 135 were GBS-positive, 361 GBS-negative, and 46 GBS-unknown status. Demographic, obstetric, and intra-partum characteristics were similar for all groups. Adverse neonatal outcomes were observed in 8 (5.9%), 31 (8.6%), and 2 (4.3%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.530), (Odds Ratio between GBS-Positive vs. GBS-Negative groups 0.67 (95%, CI = 0.30-1.50)); while composite adverse maternal outcomes occurred in 9 (6.66%), 31 (8.59%), and 5 (10.87%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.617).
Antepartum membrane stripping in GBS carriers appears to be a safe obstetrical procedure that does not adversely affect maternal or neonatal outcomes.
胎膜剥离术是一种成熟且广泛应用的产科操作，与较高的自然阴道分娩率、减少正式引产需求以及降低过期妊娠可能性相关。由于该操作过程中存在细菌植入的理论担忧，许多从业者选择不对B族链球菌（GBS）定植的患者进行胎膜清扫。我们开展了“STRIP - G研究”，以确定GBS携带状态是否会影响接受胎膜剥离术女性的母婴结局。
我们在一家三级转诊中心进行了一项前瞻性研究，比较GBS阳性、GBS阴性和GBS状态未知患者胎膜剥离术后的母婴结局。我们比较了三个研究组中复合不良新生儿结局（主要结局）的发生率，次要结局指标是复合不良母亲结局。
共有542名女性纳入研究，其中135名GBS阳性，361名GBS阴性，46名GBS状态未知。所有组的人口统计学、产科和产时特征相似。GBS阳性组、GBS阴性组和未知组分别有8例（5.9%）、31例（8.6%）和2例（4.3%）出现不良新生儿结局（P = 0.530），（GBS阳性组与GBS阴性组之间的比值比为0.67（95%，CI = 0.30 - 1.50））；而GBS阳性组、GBS阴性组和未知组分别有9例（6.66%）、31例（8.59%）和5例（10.87%）出现复合不良母亲结局（P = 0.617）。
GBS携带者的产前胎膜剥离术似乎是一种安全的产科操作，不会对母婴结局产生不利影响。
