1.400038 重庆,陆军军医大学(第三军医大学)第一附属医院:药学部
2.400038 重庆,陆军军医大学(第三军医大学)第一附属医院:妇产科
3.400037 重庆,陆军军医大学(第三军医大学)第二附属医院药学部
Received:07 August 2019,
Revised:2019-09-15,
Published:30 January 2020
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Mingyu ZHENG, Lili CAO, Shuhua YI, et al. Influence of timing of prophylactic antibiotics for premature rupture of membranes on maternal and infant outcomes[J]. Journal of Third Military Medical University, 2020, 42(2): 197-201.
Mingyu ZHENG, Lili CAO, Shuhua YI, et al. Influence of timing of prophylactic antibiotics for premature rupture of membranes on maternal and infant outcomes[J]. Journal of Third Military Medical University, 2020, 42(2): 197-201. DOI: 10.16016/j.1000-5404.201908053.
目的
2
探讨产前预防使用抗生素的时机对于足月胎膜早破孕妇母婴结局的影响。
方法
2
回顾性分析2016年1月至2017年12月在我院产科住院分娩的246例低危足月胎膜早破孕妇病例,以预防用药距破膜时间8 h为界将病例分为A组(< 8 h)和B组(≥8 h);再以12 h为界行亚组分析,分为C亚组(8~12 h)和D亚组(> 12 h);以18 h为界行亚组分析,分为E组(12~18 h)和F组(> 18 h)。收集母婴感染指标及结局。
结果
2
A组与B组孕妇分娩前、后感染指标及母婴不良结局发生率,差异无统计学意义;C组新生儿脐动脉血pH值高于D组,差异有统计学意义(
P
<
0.05),但均在正常范围;其余感染指标及母婴不良结局发生率差异无统计学意义。E组产前WBC值及Neu%均高于F组,E组产后PCT值低于F组,WBC值和PCT值差异有统计学意义(
P
<
0.05),其余感染指标及母婴不良结局发生率差异无统计学意义。
结论
2
对于低危的足月胎膜早破孕妇分娩前可适当推迟抗生素使用时间,即 > 18 h。
Objective
2
To explore the influence of the timing of prophylactic antibiotic treatment for premature rupture of membranes on maternal and infant outcomes.
Methods
2
We retrospectively analyzed the data of 246 cases of low-risk premature rupture of membranes in our hospital between January
2016 and December
2017. According to the timing of prophylactic antibiotic treatment
the cases were divided into groups A and B with the antibiotics administered within 8 h and over 8 h
groups C and D with drug administration in 8–12 h and > 12 h
and groups E and F with administration in 12-18 h and > 18 h prior to premature rupture of membranes
respectively. The incidence of maternal infections and the maternal and infant outcomes were compared among the groups.
Results
2
No significant differences were found between groups A and B in the indicators of maternal infection either before or after the delivery or in the occurrence of adverse maternal and infant outcomes. The pH value of umbilic
al arterial blood was significantly higher in group C than in group D (
P
<
0.05)
but all within the normal range. The prenatal WBC count and Neu% was significantly higher in group E than in group F (
P
<
0.05)
and the postpartum PCT was significantly higher in group F than in group E (
P
<
0.05); the other infection indicators or the occurrence of adverse maternal and infant outcomes did not differ significantly between the 2 groups.
Conclusion
2
In pregnant women with low-risk full-term premature rupture of membranes
prophylactic administration of antibiotics can be delayed to > 18 h before delivery.
American College of Obstetricians and Gynecologists. Prevention of early-onset group B streptococcal disease in newborns[J]. Obstet Gynecol, 2011, 117(4): 1019-1027. DOI: 10.1097/AOG.0b013e318219229b.
时春艳, 漆洪波, 杨慧霞.胎膜早破的诊断与处理指南(2015)[J].中华妇产科杂志, 2015, 50(1): 161-167.
SHI C Y, QI H B, YANG H X. Guidelines for diagnosis and management of PROM (2015)[J]. Chin J Obstetr Gynecol, 2015, 50(1): 161-167.
Royal College of Obstetricians and Gynaecologists. Prevention of early-onset neonatal group B streptococcal disease[J]. BJOG: Int J Obstet Gy, 2017, 124(12): e280-e305. DOI: 10.1111/1471-0528.14821.
刘晓丽, 邓飞越, 钟巧玲.足月胎膜早破抗生素的应用时机及临床效果观察[J].海峡药学, 2018, 30(8): 184-185.
LIU X L, DENG F Y, ZHONG Q L. Application time and clinical effect of antibiotics for prom[J]. Strait Pharm J, 2018, 30(8): 184-185.
郑玉敏.胎膜早破对母儿的影响及预防方式分析与研究[J].继续医学教育, 2018, 32(10): 112-113. DOI: 10.3969/j.issn.1004-6763.2018.10.058.
ZHENG Y M. Analysis on the effect of PROM on mother and infant and the preventive methods[J]. Continuing Med Educ, 2018, 32(10): 112-113. DOI: 10.3969/j.issn.1004-6763.2018.10.058.
董晓静, 常青, 李力, 等.重庆市危重孕产妇预警管理、救治和转诊系统构建与实施[J].中国实用妇科与产科杂志, 2017, 33(5): 539-543. DOI: 10.19538/j.fk2017 050124.
DONG X J, CHANG Q, LI L, et al . Construction and implementation of early warning management, treatment and referral system for critical pregnant women in Chongqing[J ] . Chin J Pract Gynecol Obstet, 2017, 33(5): 539-543. DOI: 10.19538/j.fk2017050124.
BOYER K M, GOTOFF S P. Strategies for chemoprophylaxis of GBS early-onset infections[J]. Antibiot Chemother, 1985, 35: 267-280. DOI: 10.1159/000410380.
SCHRAG S, GORWITZ R, FULTZ-BUTTS K, et al . Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC[J ] . MMWR Recomm Rep, 2002, 51(RR-11): 1-22.
American College of Obstetricians and Gynecologists. Committee opinion No.712: intrapartum management of intraamniotic infection[J]. Obstet Gynecol, 2017, 130(2): e95-e101.
VORNHAGEN J, ADAMS WALDORF K M, RAJAGOPAL L. Perinatal group B streptococcal infections: virulence factors, immunity, and prevention strategies[J]. Trends Microbiol, 2017, 25(11): 919-931. DOI: 10.1016/j.tim.2017.05.013.
彭兰, 柴利强, 陈大立, 等.预防胎膜早破孕妇B族链球菌感染的临床方案效果分析[J].国际生殖健康/计划生育杂志, 2016, 35(5): 387-389.
PENG L, CHAI L Q, CHEN D L, et al . Effectiveness of clinical protocol for prevention of group B streptococcal infection in women with premature rupture of membranes[J ] . J Int Reprod Health Plan, 2016, 35(5): 387-389.
BAUER M E, BAUER S T, RAJALA B, et al . Maternal physiologic parameters in relationship to systemic inflammatory response syndrome criteria: a systematic review and meta-analysis[J ] . Obstet Gynecol, 2014, 124(3): 535-541.DOI: 10.1097/AOG.0000000000000423.
LI A W, YANG S, ZHANG J, et al . Establishment of reference intervals for complete blood count parameters during normal pregnancy in Beijing[J ] . J Clin Lab Anal, 2017, 31(6): e22150. DOI: 10.1002/jcla.22150.
BOOKSTAVER P B, BLAND C M, GRIFFIN B, et al . A review of antibiotic use in pregnancy[J ] . Pharmacotherapy, 2015, 35(11): 1052-1062. DOI: 10.1002/phar.1649.
STENSBALLE L G, SIMONSEN J, JENSEN S M, et al . Use of antibiotics during pregnancy increases the risk of asthma in early childhood[J ] . J Pediatr, 2013, 162(4): 832-838.e3. DOI: 10.1016/j.jpeds.2012.09.049.
MUELLER N T, WHYATT R, HOEPNER L, et al . Prenatal exposure to antibiotics, cesarean section and risk of childhood obesity[J ] . Int J Obestet (Lond), 2015, 39(4): 665-670. DOI: 10.1038/ijo.2014.180.
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