Riggs J W, Blanco J D
Department of Obstetrics and Gynecology, University of Texas Medical School-Houston, Lyndon B. Johnson General Hospital 77026, USA.
Semin Perinatol. 1998 Aug;22(4):251-9. doi: 10.1016/s0146-0005(98)80013-x.
Intraamniotic infection (IAI) is a term used to describe a clinically diagnosed infection of the contents of the uterus. It is found most often after rupture of the membranes. The most useful diagnostic tests are physical examination, amniotic fluid glucose determination, and amniotic fluid Gram's stain. There is no clearly established means for the prevention of IAI, but cervical examinations and cervical manipulation can increase the risk, so caution with their use is still warranted. Treatment for this infection should be initiated when the diagnosis is made to provide the lowest risk of neonatal and maternal complications. Ampicillin or penicillin plus gentamicin are the most extensively tested antibiotics for treatment before delivery. Clindamycin or metronidazole should be added if a cesarean section is performed. As a general rule, antibiotics should be continued postpartum until the patient has been afebrile and asymptomatic for a minimum of 24 hours. Neonatal complications of IAI may be substantial especially for the premature fetus. Women with this infection have a greater risk for dysfunctional labor and cesarean section.
羊膜腔内感染（IAI）是一个用于描述临床诊断的子宫内容物感染的术语。它最常发生在胎膜破裂后。最有用的诊断测试是体格检查、羊水葡萄糖测定和羊水革兰氏染色。目前尚无明确确立的预防IAI的方法，但宫颈检查和宫颈操作会增加风险，因此仍需谨慎使用。一旦确诊，就应开始针对这种感染的治疗，以降低新生儿和产妇并发症的风险。氨苄西林或青霉素加庆大霉素是分娩前治疗中测试最广泛的抗生素。如果进行剖宫产，应加用克林霉素或甲硝唑。一般来说，产后应持续使用抗生素，直到患者至少24小时无发热且无症状。IAI的新生儿并发症可能很严重，尤其是对早产胎儿而言。患有这种感染的女性发生产程异常和剖宫产的风险更高。
