Montuclard B, Guibert M, Ville Y, Frydman R, Fernandez H
Service de Gynécologie-Obstétrique, Hôpital A. Béclère, Clamart.
J Gynecol Obstet Biol Reprod (Paris). 1996;25(2):186-91.
Our purpose was to evaluate the incidence of asymptomatic amniotic fluid infection.
One hundred fifty-four amniotic fluid samples obtained at the second trimester between 14 and 27 weeks gestation were studied by Gram stain with bacteriological cultures and detection of mycoplasm species and Chlamydiae trachomatis. Transabdominal amniocentesis for caryotyping were carried out in 151 health patients with intact membranes and without preterm labor or signs of infectious (3 dizygotic twin pregnancies).
One hundred forty-seven complete microbiologic examinations were performed (Gram stain examination white-cell count, quantitative aerobic and anaerobic cultures). Commercial texts for Mycoplasma hominis, Ureaplasma urealyticum and Chlamydiae trachomatis were negative. Three patients had rare microorganisms, coagulase negative staphylococcus (30 and 50 bacteria per ml) and alpha-hemolytic streptococcus (5 x 10(2) bacteria per ml). White cell count on amniotic fluids in 50 cases (32%) was less than 30 per ml.
These findings appear to be in contradiction with recent data, suggesting the existence of intraamniotic infection in the early phase of the second trimester. Our data confirm the need for a cut-off level for white cell count to improve test sensibility.
我们的目的是评估无症状羊水感染的发生率。
对154份在妊娠14至27周中期获得的羊水样本进行革兰氏染色、细菌培养以及支原体和沙眼衣原体检测。对151例胎膜完整、无早产或感染迹象（3例双卵双胎妊娠）的健康患者进行经腹羊膜腔穿刺术以进行染色体核型分析。
进行了147次完整的微生物学检查（革兰氏染色检查白细胞计数、需氧和厌氧定量培养）。人型支原体、解脲脲原体和沙眼衣原体的商业检测均为阴性。3例患者发现罕见微生物，凝固酶阴性葡萄球菌（每毫升30和50个细菌）和α溶血性链球菌（每毫升5×10²个细菌）。50例（32%）羊水样本的白细胞计数低于每毫升30个。
这些发现似乎与近期数据相矛盾，近期数据提示妊娠中期早期存在羊膜腔内感染。我们的数据证实需要设定白细胞计数的临界值以提高检测敏感性。
