The Impact Of Reproductive Tract Infection On Pregnancy Outcome In Preterm Premature Rupture Of Membrane

Preterm premature rupture of the membranes(PPROM)is a serious perinatal complication.The incidence of premature delivery due to premature rupture of fetal membrane before term is about 30% ～ 40%.If not treated in time,it will seriously affect the life safety and health of mother and baby.Therefore,it has been a concern of obstetrics and gynecology in recent years.The purpose of this study was to explore the influence of genital tract infection on the pregnancy outcome of premature rupture of fetal membrane,so as to provide theoretical basis and clinical experience for the prevention and treatment of clinical patients with premature rupture of fetal membrane,so as to promote perinatal health care and improve maternal and infant outcomes.Objective:To investigate the effect of genital tract infection on pregnancy outcome in patients with premature rupture of membranes before term.Methods:A retrospective analysis was conducted on 138 cases of premature rupture of membranes in the department of obstetrics and gynecology of our hospital from January2016 to January 2017.Those with gestational age between 28 and 37 weeks,aged between 20 and 35 years old,who were first-born pregnant women,had not received antibiotics treatment before admission,and the rupture time was no more than 12 hours.According to the detection results of pathogens in the lower genital tract of patients with premature rupture of fetal membranes before term,the patients with detected pathogens were divided into the infection group,and the patients without detected pathogens were divided into the uninfected group.A total of 130 patients without premature rupture of membranes who were hospitalized in the department of obstetrics and gynecology of our hospital at the same time were randomly selected as the control group.The infection status and pregnancy outcomes of the two groups of patients werecompared.Results:1.The infection rates of chlamydia,urea-mycoplasma urealyticum,trichomonas,candida,bacterial vaginosis and group B streptococcus in 138 patients with premature rupture of membranes before term were 6.52%,58.70%,15.94%,42.75%,23.91% and30.43%,respectively.The infection rates of chlamydia,ureaplasma urealyticum,trichomoniasis,candida,bacterial vaginosis and group B streptococcus were 1.53%,29.23%,3.85%,13.08%,6.92% and 4.62%,respectively.The difference between the two groups was very significant and statistically significant(P <0.01).2.Compared with the group without premature rupture of membranes(P <0.05),the patients with premature rupture of membranes in the group without premature rupture of membranes were admitted to the hospital early in pregnancy,with a long time from rupture of membranes to delivery,a small average gestational age,a high cesarean section rate,and significantly higher rates of infection and postpartum hemorrhage in pregnant women(P <0.05).The incidence of complications such as chorioamnitis,neonatal pneumonia,puerperal infection and perinatal death in the group without premature rupture of membranes were all higher than that in the group without premature rupture of membranes,with statistically significant differences(P <0.05).There was no significant difference in the incidence of pathological jaundice between the two groups(P >0.05).The contents of c-reactive protein and white blood cells in the group without premature rupture of membranes were lower than those in the group without premature rupture of membranes,and the contents of c-reactive protein were significantly different between the two groups(P <0.05),while the contents of white blood cells were not significantly different(P >0.05).3.After the active application of antibiotics,compared with the uninfected group,there were no significant differences in fetal preservation time,gestational weeks,cesarean section rate,intrauterine infection rate and postpartum bleeding rate(P >0.05).The incidence of complications such as chorioamnitis,neonatal pneumonia,puerperal infection,pathological jaundice,and perinatal death in the uninfected group was not significantly different from that in the uninfected group(P >0.05).The c-reactive protein content of patients with premature rupture of membranes before and after antibiotic treatment decreased significantly,and the difference was significant compared with that before and after treatment(P <0.05).There was no significant difference in thewhite blood cell content before and after treatment(P >0.05).Conclusion:1.Lower genital tract infection is the main cause of premature rupture of the fetal membrane before term,and urea-mycoplasma and candida are the main pathogens of lower genital tract infection.2.Combined reproductive tract infection will lead to adverse pregnancy outcomes in patients with premature rupture of membranes before term.3.The bacterial culture and detection of the reproductive tract in patients with premature rupture of membranes before term and the active use of targeted antibiotics for treatment can effectively prolong the time of pregnancy preservation,reduce the incidence of infection in pregnant women and newborns,and improve the pregnancy outcome.