第二阶段：接受胎儿脊柱裂修复手术的女性的阴道菌群及其与胎膜早破和早产的潜在关联。
Stage 2: The Vaginal Flora in Women Undergoing Fetal Spina Bifida Repair and Its Potential Association with Preterm Rupture of Membranes and Preterm Birth.
作者信息
Tevaearai Fanny, Sachs Maike Katja, El-Hadad Samia, Vonzun Ladina, Moehrlen Ueli, Mazzone Luca, Meuli Martin, Krähenmann Franziska, Ochsenbein-Kölble Nicole
机构信息
Department of Obstetrics, University Hospital Zurich, 8091 Zurich, Switzerland.
Department of Obstetrics, Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland.
出版信息
J Clin Med. 2022 Nov 28;11(23):7038. doi: 10.3390/jcm11237038.
INTRODUCTION
Vaginal dysbiosis affects pregnancy outcomes, however, the relevance of abnormal findings on pre/post-surgical vaginal culture in women undergoing fetal spina bifida (fSB) repair is unknown.
OBJECTIVES
To describe the incidence of normal and abnormal pre- and post-surgical vaginal microorganisms in fSB patients and to investigate potential associations between the type of vaginal flora and the occurrence of preterm prelabour rupture of membranes (PPROM) and preterm birth (PTB).
METHODS
99 women undergoing fSB repair were eligible (2010-2019). Pre-surgical vaginal culture was routinely taken before surgery. Post-surgical cultures were taken on indication. Vaginal flora was categorized into four categories: healthy vaginal flora (HVF), bacterial vaginosis (BV), desquamative inflammatory vaginitis (DIV), and yeast infection.
RESULTS
The incidence of HVF, BV, DIV, or yeast infections was not statistically different between the pre- and postoperative patients. Furthermore, an abnormal pre/post-surgical vaginal flora was not associated with PPROM (OR 1.57 (0.74-3.32), = 0.213)/OR 1.26 (0.62-2.55), = 0.515), or with PTB (OR 1.19 (0.82-1.73), = 0.315)/(OR 0.86 (0.60-1.24), = 0.425).
CONCLUSIONS
Abnormal vaginal microbiome was not associated with PPROM and PTB when appropriate treatment was performed.
引言
阴道微生物群失调会影响妊娠结局，然而，胎儿脊柱裂（fSB）修复手术前后阴道培养异常结果的相关性尚不清楚。
目的
描述fSB患者手术前后阴道微生物正常和异常的发生率，并调查阴道菌群类型与胎膜早破（PPROM）和早产（PTB）发生之间的潜在关联。
方法
99例接受fSB修复手术的女性符合条件（2010 - 2019年）。术前常规进行阴道培养。术后根据指征进行培养。阴道菌群分为四类：健康阴道菌群（HVF）、细菌性阴道病（BV）、脱屑性炎性阴道炎（DIV）和酵母菌感染。
结果
术前和术后患者中HVF、BV、DIV或酵母菌感染的发生率无统计学差异。此外，手术前后阴道菌群异常与PPROM（比值比1.57（0.74 - 3.32），P = 0.213）/比值比1.26（0.62 - 2.55），P = 0.515）或PTB（比值比1.19（0.82 - 1.73），P = 0.315）/（比值比0.86（0.60 - 1.24），P = 0.425）均无关联。
结论
在进行适当治疗时，阴道微生物群异常与PPROM和PTB无关。
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