Boujenah J, Le S N V, Benbara A, Bricou A, Murtada R, Carbillon L
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, Bondy, France.
Eur J Obstet Gynecol Reprod Biol. 2017 May;212:65-68. doi: 10.1016/j.ejogrb.2017.03.018. Epub 2017 Mar 9.
OBJECTIVE(S): To study the clinical and bacterial characteristic of Bartholin gland abscesses during pregnancy and the obstetric and neonatal outcomes.
Retrospective cohort study of all patients with surgical treatment of Bartholin gland abscesses between 2004 and 2015 in our university center. Clinical and bacterial characteristics between pregnant and non-pregnant women were compared.
During the period study, 156 patients were included (40 pregnant and 116 non pregnant). The incidence of Bartholin gland abscesses during pregnancy was 0.13%. Eight (20%) abscesses occurred in the first, 18 (45%) in the second, 11 (47.5%) in the third trimester and 3 (7.5%) in the post-partum course. No severe perineal and neonatal infections occurred during pregnancy. One late miscarriage and one preterm delivery were observed. We found more multiparity in the pregnant woman group than in non-pregnant women (62.5% versus 45%, p<0.05). A history of Bartholin gland abscesses were also more frequent in pregnant women (55% versus 30.1%, p<0.05). First line antibiotic therapy was more frequent in non-pregnant women (20% versus 45%, p<0.05). The rate of positive culture did not differ between the two groups (70% versus 55.2%). Among negative pus cultures, no patient in the pregnant woman group had received a first line antibiotic therapy, in contrast with non-pregnant women (0% versus 25%, p<0.05). E. coli was the most common pathogen in the two groups (48.9% of positive cultures and 28.2% of the overall population). The distribution of bacterial taxa was not different between the two groups.
Bacterial characteristics did not differ from non-pregnant women. Pregnancy could increase the occurrence of Bartholin gland abscesses in patients with previous surgical treatment of abscesses. When appropriate management is applied, maternal and neonatal outcomes are favorable, and severe infections are not to be expected.
研究孕期巴氏腺脓肿的临床及细菌学特征以及产科和新生儿结局。
对2004年至2015年在我校中心接受巴氏腺脓肿手术治疗的所有患者进行回顾性队列研究。比较孕妇和非孕妇的临床及细菌学特征。
在研究期间，共纳入156例患者（40例孕妇和116例非孕妇）。孕期巴氏腺脓肿的发生率为0.13%。8例（20%）脓肿发生在孕早期，18例（45%）发生在孕中期，11例（47.5%）发生在孕晚期，3例（7.5%）发生在产后。孕期未发生严重会阴及新生儿感染。观察到1例晚期流产和1例早产。我们发现孕妇组经产妇的比例高于非孕妇组（62.5%对45%，p<0.05）。孕妇中巴氏腺脓肿病史也更常见（55%对30.1%，p<0.05）。非孕妇中一线抗生素治疗更常见（20%对45%，p<0.05）。两组的培养阳性率无差异（70%对55.2%）。在脓液培养阴性的患者中，孕妇组无患者接受一线抗生素治疗，而非孕妇组有（0%对25%，p<0.05）。大肠杆菌是两组中最常见的病原体（阳性培养物的48.9%和总体人群的28.2%）。两组细菌分类群的分布无差异。
细菌学特征与非孕妇无差异。妊娠可能会增加既往有脓肿手术治疗史患者巴氏腺脓肿的发生。当采取适当的管理措施时，母婴结局良好，预计不会发生严重感染。
