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第712号委员会意见摘要:羊膜腔内感染的产时管理

Committee Opinion No. 712 Summary: Intrapartum Management of Intraamniotic Infection.

出版信息

Obstet Gynecol. 2017 Aug;130(2):490-492. doi: 10.1097/AOG.0000000000002230.

DOI:10.1097/AOG.0000000000002230
PMID:28742671
Abstract

Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician-gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death. Maternal morbidity from intraamniotic infection also can be significant, and may include dysfunctional labor requiring increased intervention, postpartum uterine atony with hemorrhage, endometritis, peritonitis, sepsis, adult respiratory distress syndrome and, rarely, death. Recognition of intrapartum intraamniotic infection and implementation of treatment recommendations are essential steps that effectively can minimize morbidity and mortality for women and newborns. Timely maternal management together with notification of the neonatal health care providers will facilitate appropriate evaluation and empiric antibiotic treatment when indicated. Intraamniotic infection alone is rarely, if ever, an indication for cesarean delivery.

摘要

羊膜腔内感染,也称为绒毛膜羊膜炎,是一种感染,可导致羊水、胎盘、胎儿、胎膜或蜕膜中任何组合发生炎症。羊膜腔内感染是早产和足月产妇中常见的情况。然而,产科医生或其他产科护理人员检测和处理的大多数羊膜腔内感染病例将出现在足月分娩的患者中。羊膜腔内感染可伴有急性新生儿发病,包括新生儿肺炎、脑膜炎、败血症和死亡。羊膜腔内感染导致的产妇发病也可能很严重,可能包括需要增加干预的产程异常、产后子宫收缩乏力伴出血、子宫内膜炎、腹膜炎、败血症、成人呼吸窘迫综合征,很少会导致死亡。识别产时羊膜腔内感染并实施治疗建议是有效降低妇女和新生儿发病率和死亡率的关键步骤。及时的产妇管理以及通知新生儿医疗保健人员将有助于在有指征时进行适当的评估和经验性抗生素治疗。仅羊膜腔内感染很少(如果有的话)是剖宫产的指征。

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