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胎盘培养在胎膜早破合并临床绒毛膜羊膜炎病例中是否有作用?

Is There a Role for Placental Cultures in Cases of Clinical Chorioamnionitis Complicating Preterm Premature Rupture of Membranes?

作者信息

Fouks Yuval, Many Ariel, Orbach Rotem, Shapira Udi, Amit Sharon, Grisaru-Soen Galia, Mandel Dror, Shinar Shiri

机构信息

Department of Obstetrics and Gynecology, Sourasky Medical Center, Tel Aviv University, Lis Maternity Hospital, Tel Aviv, Israel.

Neonatal Intensive Care Unit, Department of Neonatology, Dana Dwek Children's Hospital, Tel Aviv University, Tel Aviv, Israel.

出版信息

Am J Perinatol. 2017 Jul;34(9):867-873. doi: 10.1055/s-0037-1600128. Epub 2017 Mar 8.

Abstract

To assess the role of placental cultures in cases of preterm premature rupture of membranes (PPROM) complicated by chorioamnionitis and to determine the effect of positive cultures on short-term neonatal outcomes.  A retrospective single-center study. The medical records of all women with PPROM between January 1, 2011, and December 31, 2015, were reviewed. Cases were divided into placental culture positive (group A) and placental culture negative (group B) groups. Maternal and pregnancy characteristics as well as short-term neonatal outcomes were compared between groups.  During the 5-year study period, 61 cases of clinical chorioamnionitis complicating PPROM were diagnosed: 25 cases were culture positive (group A) and 36 were culture negative (group B). Neonatal outcome measures, including Apgar score at 5 minutes ( = 0.028; odds ratio [OR]: 5.27; confidence interval [CI]: 1.19-23.34), respiratory distress syndrome ( = 0.026; OR: 4.11; CI: 1.18-14.25), and neonatal infection ( < 0.0001; OR: 11.59; CI: 3.37-39.87) were significantly more common in group A newborns, regardless of gestational age at delivery as was the composite neonatal outcome ( = 0.017; OR: 7.35: CI: 1.42-37.79). Placental isolates were primarily and .  Placental cultures may be an essential predictor of neonatal morbidity in PPROM and may contribute to the modification of neonatal treatment.

摘要

评估胎盘培养在胎膜早破(PPROM)合并绒毛膜羊膜炎病例中的作用,并确定培养阳性对短期新生儿结局的影响。 一项回顾性单中心研究。回顾了2011年1月1日至2015年12月31日期间所有PPROM妇女的病历。病例分为胎盘培养阳性(A组)和胎盘培养阴性(B组)两组。比较两组之间的母亲和妊娠特征以及短期新生儿结局。 在5年的研究期间,诊断出61例临床绒毛膜羊膜炎合并PPROM病例:25例培养阳性(A组),36例培养阴性(B组)。无论分娩时的胎龄如何,A组新生儿的新生儿结局指标,包括5分钟时阿氏评分(P = 0.028;优势比[OR]:5.27;置信区间[CI]:1.19 - 23.34)、呼吸窘迫综合征(P = 0.026;OR:4.11;CI:1.18 - 14.25)和新生儿感染(P < 0.0001;OR:11.59;CI:3.37 - 39.87)以及综合新生儿结局(P = 0.01... 原文此处有误,应为P = 0.017;OR:7.35:CI:1.42 - 37.79)均明显更常见。胎盘分离株主要是…… 胎盘培养可能是PPROM新生儿发病的重要预测指标,并可能有助于调整新生儿治疗。

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