D'Angelo L J, Sokol R J
Am J Obstet Gynecol. 1980 Mar 1;136(5):575-8. doi: 10.1016/0002-9378(80)91005-4.
Identification of the type and concentration of bacterial organisms in the amniotic fluid (AF) during labor might allow for earlier and more effective treatment of postpartum infections. Previous studies have identified organisms typically associated with postpartum endometritis, but the relationship to intrapartum findings has been disappointing. The purpose of this prospective study was to reassess any relationships between the bacteriology of the AF during labor and the postpartum course in the high-risk, noninfected, monitored gravid patient. The intrapartum AF bacterial flora was similar in 70 patients delivered vaginally and 80 patients delivered abdominally. In patients who did not receive prophylactic antibiotics, a total AF organism count of greater than or equal to 10(4) colonies/ml and the presence of any streptococcal or Bacteroides organism, gram-negative bacillus, or Staphylococcus aureus were significantly related to postpartum morbidity. Under these conditions, cesarean section considerably increased the risk of clinical endometritis. These results suggest that semiquantitative culture of AF obtained through the intrauterine pressure catheter prior to delivery may be of value in the postpartum management of patients delivered by cesarean section.
分娩期间羊水（AF）中细菌种类和浓度的鉴定可能有助于产后感染的早期和更有效治疗。先前的研究已经确定了通常与产后子宫内膜炎相关的微生物，但与分娩期发现的关系并不理想。这项前瞻性研究的目的是重新评估高危、未感染、接受监测的孕妇分娩期间羊水细菌学与产后病程之间的任何关系。70例经阴道分娩的患者和80例经腹分娩的患者的分娩期羊水细菌菌群相似。在未接受预防性抗生素治疗的患者中，羊水微生物总数大于或等于10⁴菌落/毫升以及存在任何链球菌、拟杆菌属微生物、革兰氏阴性杆菌或金黄色葡萄球菌与产后发病率显著相关。在这些情况下，剖宫产显著增加了临床子宫内膜炎的风险。这些结果表明，在分娩前通过宫内压力导管获取的羊水半定量培养可能对剖宫产分娩患者的产后管理有价值。
