Occult intraamniotic infection at the time of midtrimester genetic amniocentesis: a reassessment.
Occult intraamniotic infection at the time of midtrimester genetic amniocentesis: a reassessment.
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DOI：
10.1155/s1064744994000530
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发表时间：
1994-01-01
影响因子：
--
通讯作者：
Botti, J J
中科院分区：
文献类型：
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作者：
Cherouny, P H;Pankuch, G A;Botti, J J
目的：本研究的目的是重新评估无症状患者在进行遗传性羊膜穿刺术时，孕早期隐匿性羊膜内感染的发生率。方法：对月经后 15 至 20 周内转诊进行遗传性羊膜穿刺术的患者的总共 177 份羊水 (AF) 样本进行了评估，以检查是否存在细菌，经革兰氏染色和赖特染色后，通过详细的光学显微镜检查，并通过需氧和厌氧细菌、支原体和解脲支原体培养物。还通过趋白细胞生物测定法测试了 77 份 AF 样本是否存在生物活性白细胞引诱剂。 结果：所有液体的细菌和生物活性白细胞引诱剂均为阴性 [95% 置信区间 (CI)，0-1.9%；95% 置信区间 (CI)，0-1.9%； 99% CI，0-2.9%]。这明显低于最近报道的 5.09% 的发生率 (P = 0.002)。顺便说一句，在对平安无事的妊娠中的 2 个 (1.1%) AF 样本进行 AF 革兰氏染色的详细光学显微镜评估过程中，发现了与精子一致的光学显微镜形态的伪影，这是之前未报告的发现。使用扫描电子显微镜来证实光镜检查结果。结论：妊娠中期的隐匿性羊膜内感染并不像最近报道的那么高。并非所有妊娠中期羊膜穿刺术病例中都需要进行 AF 培养。妊娠中期 AF 标本革兰氏染色对精子的鉴定有待进一步证实。
OBJECTIVE: The objective of this study was to reevaluate the incidence of occult early midtrimester intraamniotic infection in asymptomatic patients at the time of genetic amniocentesis.METHODS: A total of 177 amniotic fluid (AF) specimens from patients referred for genetic amniocentesis between 15 and 20 postmenstrual weeks were evaluated for the presence of bacteria by detailed light microscopy, after Gram and Wright stain, and by cultures for aerobic and anaerobic baceria, Mycoplasma sp., and Ureaplasma urealyticum. Seventy-seven AF specimens were also tested for the presence of bioactive leukoattractants by a leukotaxis bioassay.RESULTS: All fluids were negative for bacteria and bioactive leukoattractants [95% confidence interval (CI), 0-1.9%; 99% CI, 0-2.9%]. This is significantly less than a recently reported incidence of 5.09% (P = 0.002). Incidentally, artifacts with light microscopic morphology consistent with spermatozoa were found during the detailed light microscopic evaluation of AF Gram stains from 2 (1.1%) AF samples in otherwise uneventful pregnancies, a previously unreported finding. Scanning electron microscopy was used to confirm the light microscopic findings.CONCLUSIONS: Occult intraamniotic infection in the second trimester is not as high as recently reported. AF culture in all cases of second-trimester amniocentesis is not necessary. The identification of spermatozoa on Gram stain of second-trimester AF specimens needs further confirmation.