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抗生素使用时机对胎膜早破及其对生殖道感染和胎膜细胞焦烧指标的影响。

Effect of timing of antibiotic use on premature rupture of membranes and its impact on reproductive tract infection and fetal membrane cell scorching indicators.

作者信息

Qian Yunying, Qian Guiying, Ni Haiyan, Zhu Danying, Gu Weiqun, Cai Ximei

机构信息

Department of Obstetrics and Gynecology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine,Changshu 215500, Jiang Su,China.

Department of Pharmacy, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu 215500,Jiang Su,China.

出版信息

Afr J Reprod Health. 2024 Dec 31;28(12):139-147. doi: 10.29063/ajrh2024/v28i12.15.

Abstract

The study was designed to appraise the effects of early antibiotic administration on reproductive tract infections and fetal membrane cell scorching in instances of premature rupture of membranes (PROM). A total of 107 pregnant women diagnosed with PROM between July 2020 and June 2022 were randomly assigned to two groups: the Intervention (n=54), where ampicillin were administered within 24 hours of PROM onset, and the control group (n=53), where ampicillin were given 24-48 hours after PROM. Maternal and neonatal outcomes, incidence of reproductive tract infections, and fetal membrane cell scorching indicators (Caspase-1, Caspase -3, Caspase-9 and IL-β) were compared. The intervention group had significantly fewer adverse maternal and neonatal outcomes (p<0.05). Post-treatment, rates of Chlamydia trachomatis, Mycoplasma solium, and genital tract infections decreased in both groups, with lower rates in the intervention group (p<0.05). Positive expression rates of Caspase-1, -3, -9, and IL-β in placental tissues were also lower in the intervention group (p<0.05). We conclude that administering antibiotics within 12 hours of PROM reduces reproductive tract infections, lowers fetal membrane cell scorching, and improves maternal and neonatal outcomes, supporting early antibiotic use in the management of PROM.

摘要

本研究旨在评估胎膜早破(PROM)病例中早期使用抗生素对生殖道感染和胎膜细胞焦亡的影响。2020年7月至2022年6月期间,共有107例诊断为PROM的孕妇被随机分为两组:干预组(n = 54),在PROM发作后24小时内给予氨苄西林;对照组(n = 53),在PROM后24 - 48小时给予氨苄西林。比较母婴结局、生殖道感染发生率和胎膜细胞焦亡指标(半胱天冬酶-1、半胱天冬酶-3、半胱天冬酶-9和白细胞介素-β)。干预组母婴不良结局显著较少(p<0.05)。治疗后,两组沙眼衣原体、猪支原体和生殖道感染率均下降,干预组更低(p<0.05)。干预组胎盘组织中半胱天冬酶-1、-3、-9和白细胞介素-β的阳性表达率也较低(p<0.05)。我们得出结论,在PROM后12小时内使用抗生素可减少生殖道感染,降低胎膜细胞焦亡,并改善母婴结局,支持在PROM管理中早期使用抗生素。

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