Department of Obstetrics & Gynaecology, Dr Y S Parmar Medical College Nahan, Nahan, India.
Department of Obstetrics & Gynaecology, Dr Radhakrishnan Govt Medical College, Hamirpur, India.
J Obstet Gynaecol. 2021 Jul;41(5):721-725. doi: 10.1080/01443615.2020.1789955. Epub 2020 Oct 12.
The objective was to determine the relationship of histological chorioamnionitis (HCA) with genital tract cultures in preterm birth. Among two hundred women recruited for the study, 100 were taken as cases with gestational age between ≥28 and <37 weeks and 100 women with gestational age >37 weeks were taken as controls. Vaginal swabs were taken for culture sensitivity and vaginal smears were made for performing whiff test and heat dry gram stained smear was examined for growth of microorganisms. Histopathologic examination of the placenta was done after delivery. 49 cases and 26 controls had evidence of histological chorioamnionitis. A significant difference was observed in relation to the presence of , presence of clue cells, positive whiff test and occurrence of bacterial vaginosis in subjects with and without histological chorioamnionitis. Thus, we conclude that the presence of histological chorioamnionitis is closely related to the presence of pathogenic microorganisms in the cervicovaginal region.IMPACT STATEMENT Histologic chorioamnionitis has been regarded to reflect amniotic fluid infection and there are studies showing an association between histologic chorioamnionitis, amniotic fluid, and subchorionic plate cultures. Nevertheless, studies of the correlation of the cervical swab cultures with intrauterine infection in preterm birth remain inconclusive. Histologic chorioamnionitis is closely related to the presence of pathogenic microorganisms in the cervicovaginal region. High vaginal swab cultures and gram staining of vaginal smear is useful in detecting antenatal patients who are at a higher risk for preterm labour. After detection, early intervention may be done to avoid preterm deliveries in these high-risk pregnancies.
目的是确定组织学绒毛膜羊膜炎（HCA）与早产时生殖道培养物的关系。在招募的 200 名女性中，100 名被纳入研究对象，其孕周在 28 至 <37 周之间，100 名孕周>37 周的女性被纳入对照组。采集阴道拭子进行培养敏感性检查，阴道涂片进行嗅试验和热干燥革兰氏染色涂片检查微生物生长。分娩后进行胎盘组织病理学检查。49 例病例和 26 例对照组有组织学绒毛膜羊膜炎的证据。在有和没有组织学绒毛膜羊膜炎的受试者中，观察到微生物存在、线索细胞存在、嗅试验阳性和细菌性阴道病的发生率存在显著差异。因此，我们得出结论，组织学绒毛膜羊膜炎的存在与宫颈阴道区域致病性微生物的存在密切相关。
组织学绒毛膜羊膜炎一直被认为反映了羊水感染，有研究表明组织学绒毛膜羊膜炎、羊水和子体面培养物之间存在关联。然而，关于早产时宫颈拭子培养物与宫内感染的相关性研究仍尚无定论。组织学绒毛膜羊膜炎与宫颈阴道区域致病性微生物的存在密切相关。阴道拭子培养物和阴道涂片革兰氏染色在检测有早产风险的产前患者方面很有用。检测后，可以对这些高风险妊娠进行早期干预，以避免早产。
