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在子宫收缩期间,对第二或第三孕期羊水“胎粪”患者进行抗生素治疗。

Antibiotic treatment of amniotic fluid "sludge" in patients during the second or third trimester with uterine contraction.

机构信息

Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju, South Korea.

Department of Obstetrics and Gynecology, Yanbian University Hospital, Yanji, China.

出版信息

Int J Gynaecol Obstet. 2021 Apr;153(1):119-124. doi: 10.1002/ijgo.13425. Epub 2020 Nov 11.

Abstract

OBJECTIVE

To assess the effectiveness of antibiotic treatment in patients with amniotic fluid (AF) "sludge" during the second or third trimester with uterine contractions and intact membranes.

METHODS

A retrospective cohort study was conducted of women at 15-32 weeks of pregnancy with uterine contractions and intact membranes. Women with AF "sludge" were treated with an antibiotic regimen of ceftriaxone, clarithromycin, and metronidazole. Based on changes in AF "sludge," patients were divided into group A (disappearance of "sludge") and group B (persistent "sludge").

RESULTS

Women in group A (n=30) delivered later than those in group B (n=28). Group A showed a smaller initial size of "sludge" than group B (all P<0.05). Women in group A had a lower rate of preterm birth within 7 days, and before 28, 32, and 34 weeks of pregnancy, and composite neonatal morbidity and perinatal death than group B (all P<0.05).

CONCLUSION

The administration of antibiotics may eradicate AF "sludge" in women in the second or third trimester with uterine contractions and intact membranes, which are associated with the initial size of "sludge." Patients with disappearing "sludge" had more favorable pregnancy and neonatal outcomes than those with persistent "sludge."

摘要

目的

评估在伴有子宫收缩和胎膜完整的情况下,对妊娠 15-32 周的孕妇进行羊膜液(AF)“淤泥”抗生素治疗的效果。

方法

对伴有子宫收缩和胎膜完整的 15-32 周妊娠的妇女进行回顾性队列研究。对有 AF“淤泥”的妇女给予头孢曲松、克拉霉素和甲硝唑的抗生素治疗方案。根据 AF“淤泥”的变化,患者分为 A 组(“淤泥”消失)和 B 组(“淤泥”持续存在)。

结果

A 组(n=30)的分娩时间晚于 B 组(n=28)。A 组的“淤泥”初始大小小于 B 组(均 P<0.05)。A 组在 7 天内、28 周前、32 周前和 34 周前早产率以及复合新生儿发病率和围产儿死亡率均低于 B 组(均 P<0.05)。

结论

在伴有子宫收缩和胎膜完整的情况下,对妊娠中期和晚期的孕妇使用抗生素可能会消除 AF“淤泥”,这与“淤泥”的初始大小有关。“淤泥”消失的患者比“淤泥”持续存在的患者有更好的妊娠和新生儿结局。

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