Ying Xia, Chen Lin, Wang Danxiao, Yi Songjia, Yang Xiaofu, Wang Xiaomin, Yu Leiyuan, Chen Yuan, Luo Qiong
Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China.
Department of Gynecology and Obstetrics, Haiyan County Maternal And Child Care Service Centre, Haiyan, Zhejiang, P.R. China.
Medicine (Baltimore). 2024 Dec 20;103(51):e40985. doi: 10.1097/MD.0000000000040985.
Group B Streptococcus is a bacterium that colonizes in approximately 20% of pregnant women and can be vertically transmitted to newborns, leading to maternal-neonatal adverse outcomes, such as chorioamnionitis, neonatal sepsis, and pneumonia. However, there is currently no agreement on the optimal induction method for this specific population. This study aims to evaluate the safety of a single balloon catheter (BC) in comparison to dinoprostone for labor induction in term pregnant women with group B Streptococcus colonization. In this retrospective cohort study, a total of 321 term pregnancies with positive group B Streptococcus requiring Induction of labor (IOL) were included. Out of these, 80 pregnancies were induced with a single BC, while the remaining 241 were induced with dinoprostone. The study compared the safety outcomes between the 2 groups, specifically focusing on maternal and neonatal adverse events. It is important to note that all women in the study received prophylactic antibiotics. When prophylactic antibiotics were administered, no significant differences were observed in terms of mode of delivery, clinical chorioamnionitis, puerperal infection, fetal distress, neonatal asphyxia, neonatal infection, neonatal sepsis, NICU admission, and neonatal pneumonia between the 2 induction methods (all P > .05). Additionally, there were no reported cases of neonatal group B Streptococcus infection following balloon induction in pregnant women with vaginal GBS colonization. In relation to maternal and neonatal adverse events, the study findings indicated that labor induction using a BC was deemed safe for women who were colonized with group B Streptococcus, provided that prophylactic antibiotics were administered either at the onset of labor or when the membranes ruptured.
B族链球菌是一种定植于约20%孕妇体内的细菌，可垂直传播给新生儿，导致母婴不良结局，如绒毛膜羊膜炎、新生儿败血症和肺炎。然而，目前对于这一特定人群的最佳引产方法尚无共识。本研究旨在评估单球囊导管（BC）与地诺前列酮相比，用于引产B族链球菌定植的足月孕妇的安全性。在这项回顾性队列研究中，共纳入321例需要引产（IOL）且B族链球菌检测呈阳性的足月妊娠。其中，80例妊娠采用单球囊导管引产，其余241例采用地诺前列酮引产。该研究比较了两组之间的安全性结果，特别关注母婴不良事件。需要注意的是，研究中的所有女性均接受了预防性抗生素治疗。当使用预防性抗生素时，两种引产方法在分娩方式、临床绒毛膜羊膜炎、产褥感染、胎儿窘迫、新生儿窒息、新生儿感染、新生儿败血症、新生儿重症监护病房（NICU）入院率和新生儿肺炎方面均未观察到显著差异（所有P>0.05）。此外，在阴道B族链球菌定植的孕妇中，未报告球囊引产术后发生新生儿B族链球菌感染的病例。关于母婴不良事件，研究结果表明，对于B族链球菌定植的女性，使用球囊导管引产被认为是安全的，前提是在临产后或胎膜破裂时给予预防性抗生素。
