Mazor M, Furman B, Wiznitzer A, Shoham-Vardi I, Cohen J, Ghezzi F
Department of Obstetrics and Gynecology, Soroka Medical Center of Kupat Holim, Ben Gurion University of the Negev, Beer-Sheva, Israel.
Obstet Gynecol. 1995 Nov;86(5):830-3. doi: 10.1016/0029-7844(95)00265-S.
To determine the clinical significance of meconium-stained amniotic fluid (AF) observed at amniocentesis in patients with preterm labor.
A nested case-control study was constructed based on the color of AF during amniocentesis. Forty-five women admitted with preterm labor and meconium-stained AF were matched for gestational age at admission and compared with 135 women with preterm labor and clear AF. All AF samples were cultured for aerobic and anaerobic bacteria and mycoplasma.
The rates of positive AF cultures for microorganisms, overall preterm birth (before 36 weeks), preterm birth before 32 weeks, and clinical chorioamnionitis were all significantly higher in patients with meconium-stained AF than in those with clear AF (positive AF cultures, 38 versus 11%, P < .001; preterm delivery before 36 weeks, 73 versus 41%, P < .001; preterm delivery before 32 weeks, 51 versus 17%, P < .001; and clinical chorioamnionitis, 22 versus 6%, P = .003). In contrast, no significant differences were observed between groups with respect to maternal age, gravidity, parity, abruptio placentae, placenta previa, fetal distress, cesarean rate, or puerperal morbidity.
Patients with preterm labor and meconium-stained AF had higher rates of microbial invasion of the amniotic cavity, clinical chorioamnionitis, and premature deliveries than those with clear AF.
确定早产患者羊膜腔穿刺时观察到的胎粪污染羊水（AF）的临床意义。
根据羊膜腔穿刺时羊水的颜色构建一项巢式病例对照研究。45例因早产且羊水胎粪污染入院的女性与入院时孕周匹配，并与135例早产且羊水清亮的女性进行比较。所有羊水样本均进行需氧菌、厌氧菌和支原体培养。
羊水胎粪污染患者的羊水微生物培养阳性率、总体早产（36周前）、32周前早产及临床绒毛膜羊膜炎发生率均显著高于羊水清亮患者（羊水微生物培养阳性率，38%对11%，P<.001；36周前早产，73%对41%，P<.001；32周前早产，51%对17%，P<.001；临床绒毛膜羊膜炎，22%对6%，P=.003）。相比之下，两组在产妇年龄、孕次、产次、胎盘早剥、前置胎盘、胎儿窘迫、剖宫产率或产褥期发病率方面未观察到显著差异。
早产且羊水胎粪污染的患者比羊水清亮的患者羊膜腔微生物入侵、临床绒毛膜羊膜炎和早产的发生率更高。
