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利用分子微生物学研究妊娠中期羊膜腔的微生物入侵情况。

Microbial invasion of the amniotic cavity in midtrimester pregnancies using molecular microbiology.

作者信息

Rowlands Shelley, Danielewski Jennifer A, Tabrizi Sepehr N, Walker Susan P, Garland Suzanne M

机构信息

Department of Maternity Services, Epworth Freemasons Hospital, East Melbourne, Victoria, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia.

Department of Microbiology and Infectious Diseases, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.

出版信息

Am J Obstet Gynecol. 2017 Jul;217(1):71.e1-71.e5. doi: 10.1016/j.ajog.2017.02.051. Epub 2017 Mar 6.

Abstract

OBJECTIVE

The objective of the study was to determine the frequency of microbial invasion of the amniotic cavity in the midtrimester of pregnancy in patients undergoing amniocentesis for clinical indications.

STUDY DESIGN

This was a prospective investigation of the amniotic fluid of 344 asymptomatic women recruited in midpregnancy for the presence of microbial DNA. Amniotic samples obtained at the time of amniocentesis for genetic testing on women between 15 and 22 weeks of gestation were tested specifically for the presence of Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, and Mycoplasma genitalium as well as for other bacteria and fungi using broad-range polymerase chain reaction only. Pregnancy outcomes were reviewed independent of all molecular test results.

RESULTS

Using broad-range polymerase chain reaction, the prevalence of microbial invasion of the amniotic cavity in women between 15 and 22 weeks of gestation was 0% (0 vs 344). Early preterm delivery occurred in only 4 women (1%); 1 delivered electively and 3 spontaneously. None were associated with Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, or Mycoplasma genitalium. In addition, broad range polymerase chain reaction did not reveal the presence of other bacterial or fungal microbes.

CONCLUSION

Microbial invasion of the amniotic cavity in midtrimester gestations of low-risk pregnant women was not detected using molecular methods in 344 patients.

摘要

目的

本研究的目的是确定因临床指征接受羊膜腔穿刺术的孕妇妊娠中期羊膜腔微生物入侵的频率。

研究设计

这是一项对344名妊娠中期招募的无症状女性羊水进行的前瞻性调查,以检测微生物DNA的存在。在妊娠15至22周的女性进行羊膜腔穿刺术进行基因检测时获取的羊水样本,仅使用广谱聚合酶链反应专门检测解脲脲原体、微小脲原体、人型支原体和生殖支原体以及其他细菌和真菌的存在。独立于所有分子检测结果对妊娠结局进行回顾。

结果

使用广谱聚合酶链反应,妊娠15至22周女性羊膜腔微生物入侵的患病率为0%(0例vs 344例)。仅4名女性(1%)发生早产;1例为选择性分娩,3例为自然分娩。均与解脲脲原体、微小脲原体、人型支原体或生殖支原体无关。此外,广谱聚合酶链反应未发现其他细菌或真菌微生物的存在。

结论

在344例患者中,使用分子方法未检测到低风险孕妇妊娠中期羊膜腔的微生物入侵。

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