Soper D E, Mayhall C G, Froggatt J W
Department of Internal Medicine, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, USA.
Am J Obstet Gynecol. 1996 Aug;175(2):304-9; discussion 309-10. doi: 10.1016/s0002-9378(96)70139-4.
Our purpose was to determine (1) whether risk factors for intraamniotic infection were similar in women delivered of preterm infants versus term infants and (2) whether infection control techniques could decrease the incidence of intrapartum fever on a labor and delivery unit.
A total of 5409 consecutive patients (group 1) admitted to the Medical College of Virginia's labor and delivery unit were followed up prospectively to determine the development of intraamniotic infection. Demographic and intrapartum data were collected by use of a standard data form by infection control practitioners. An additional 2549 consecutive patients (group 2) were followed up after institution of infection-control measures.
Intraamniotic infection occurred in 416 of 5399 (7.7%) women (group 1) admitted to the labor and delivery suite. Odds ratios for term and preterm patients having intraamniotic infection with rupture of membranes > or = 12 hours compared with < 12 hours were 5.81 (95% confidence interval 512 to 6.59 and 2.49 (95% confidence interval 1.77 to 3.50), respectively. Odds ratios for term and preterm patients with internal monitors having intraamniotic infection compared with patients in whom internal monitors were not used were 2.01 (95% confidence interval 1.7 to 2.4) and 1.42 (95% confidence interval 0.99 to 2.04), respectively. Odds ratios for term and preterm patients having intraamniotic infection with more than four vaginal examinations compared with four or fewer vaginal examinations was 3.07 (95% confidence interval 2.53-3.73) and 1.59 (95% confidence interval 1.11-2.27), respectively. Intrapartum fever occurred in 475 (8.8%) women in group 1 and in 252 (9.8%) women in group 2 (not significant).
Risk factors (duration of ruptured membranes, use of internal monitoring, number of vaginal examinations) were similar in both term and preterm women with intraamniotic infection. Infection control measures failed to decrease the incidence of intrapartum fever in our patient population.
我们的目的是确定：（1）早产和足月产女性羊膜腔内感染的危险因素是否相似；（2）感染控制技术能否降低产房内产时发热的发生率。
对弗吉尼亚医学院产房收治的5409例连续患者（第1组）进行前瞻性随访，以确定羊膜腔内感染的发生情况。感染控制人员使用标准数据表格收集人口统计学和产时数据。在采取感染控制措施后，对另外2549例连续患者（第2组）进行随访。
入住产房的5399例女性（第1组）中有416例（7.7%）发生羊膜腔内感染。足月和早产患者胎膜破裂≥12小时与<12小时相比发生羊膜腔内感染的比值比分别为5.81（95%可信区间5.12至6.59）和2.49（95%可信区间1.77至3.50）。使用内部监护仪的足月和早产患者与未使用内部监护仪的患者相比发生羊膜腔内感染的比值比分别为2.01（95%可信区间1.7至2.4）和1.42（95%可信区间0.99至
