Gibbs R S, Blanco J D, Lipscomb K, St Clair P J
Am J Obstet Gynecol. 1985 Jul 15;152(6 Pt 1):650-4. doi: 10.1016/s0002-9378(85)80038-7.
This study describes the postpartum course of asymptomatic parturient women who had greater than or equal to 10(2) cfu of high-virulence (HV) bacteria per milliliter of amniotic fluid. Of 60 asymptomatic parturient women with greater than or equal to 10(2) cfu of HV bacteria per milliliter of amniotic fluid, 27 (48%) remained asymptomatic in the puerperium, 16 (27%) developed fever only, and 17 (28%) developed endometritis. In asymptomatic versus symptomatic women, there were no statistically significant differences in number or type of isolates or in length of membrane rupture or labor-to-collection interval. However, there were significant differences in the intervals from collection to delivery and in the rate of cesarean section delivery. For comparison, 40 of these patients were matched with women in whom only low-virulence organisms were detected in the amniotic fluid. In the HV group, 16 women (40%) remained asymptomatic, 15 (37.5%) developed fever only, and nine (22.5%) had endometritis. In the low-virulence group, 27 women (67.5%) remained asymptomatic, 10 (25%) developed fever only, one (2.5%) developed endometritis 10 days post partum, and two (5%) had other infections (p less than 0.01). Clinically evident uterine infection depends upon type and numbers of bacteria in utero, duration of bacteria in utero, and route of delivery.
本研究描述了羊水每毫升含有大于或等于10(2) cfu高毒力（HV）细菌的无症状产妇的产后病程。在60名羊水每毫升含有大于或等于10(2) cfu HV细菌的无症状产妇中，27名（48%）在产褥期仍无症状，16名（27%）仅出现发热，17名（28%）发生子宫内膜炎。在无症状与有症状的产妇中，分离菌的数量或类型、胎膜破裂时间或分娩至采集样本间隔时间均无统计学显著差异。然而，在采集样本至分娩的间隔时间以及剖宫产率方面存在显著差异。作为对照，其中40例患者与羊水仅检测到低毒力微生物的产妇进行匹配。在HV组中，16名女性（40%）仍无症状，15名（37.5%）仅出现发热，9名（22.5%）发生子宫内膜炎。在低毒力组中，27名女性（67.5%）仍无症状，10名（25%）仅出现发热，1名（2.5%）在产后10天发生子宫内膜炎，2名（5%）发生其他感染（p<0.01）。临床上明显的子宫感染取决于子宫内细菌的类型和数量、细菌在子宫内的持续时间以及分娩途径。
