McGregor J A, French J I, Seo K
Department of Obstetrics and Gynecology, University of Colorado Health Center.
Am J Obstet Gynecol. 1993 Aug;169(2 Pt 2):463-6. doi: 10.1016/0002-9378(93)90342-g.
Critically review obstetric, epidemiologic, microbiologic, and pathophysiologic information regarding the possible casual associations of bacterial vaginosis with premature rupture of membranes.
Observational and experimental studies are reviewed and correlated with in vitro and clinical, microbiologic, and pathophysiologic experiments in an effort to define possibly casual relationships with bacterial vaginosis and premature rupture of membranes and its maternal and perinatal sequelae.
Considerable information shows that bacterial vaginosis, a common vaginal microbe-associated condition of reproductive age women, can be strongly (risk ratios up to 7.3, confidence interval 95%, 1.8 to 29.4) associated with preterm premature rupture of membranes as well as preterm labor and birth. Microorganisms of bacterial vaginosis produce factors including proteases (IgAse, collagenase, etc.) that can facilitate transport of bacteria to fetal membranes and impair fetal membrane integrity in experimental models.
Controlled investigations are required to evaluate if treatment of bacterial vaginosis is associated with reduction of premature rupture of membranes and preterm birth.
严格审查关于细菌性阴道病与胎膜早破可能存在的因果关系的产科、流行病学、微生物学和病理生理学信息。
对观察性和实验性研究进行综述，并与体外及临床、微生物学和病理生理学实验相关联，以确定细菌性阴道病与胎膜早破及其母婴围产期后遗症之间可能的因果关系。
大量信息表明，细菌性阴道病是育龄妇女常见的阴道微生物相关病症，与早产胎膜早破以及早产和分娩密切相关（风险比高达7.3，95%置信区间为1.8至29.4）。在实验模型中，细菌性阴道病的微生物会产生包括蛋白酶（IgA酶、胶原酶等）在内的因子，这些因子可促进细菌向胎膜的转运并损害胎膜完整性。
需要进行对照研究，以评估治疗细菌性阴道病是否与降低胎膜早破和早产有关。
