Endometrial microbial colonization and plasma cell endometritis after spontaneous or indicated preterm versus term delivery
Endometrial microbial colonization and plasma cell endometritis after spontaneous or indicated preterm versus term delivery
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DOI：
10.1016/j.ajog.2005.02.128
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发表时间：
2005-09-01
影响因子：
9.8
通讯作者：
Goepfert, AR
中科院分区：
文献类型：
--
作者：
Andrews, WW;Goldenberg, RL;Goepfert, AR
目的：本研究旨在确定自发性早产或自然足月分娩后子宫内膜微生物定植或浆细胞增生是否增加。产后，子宫内膜标本后，获得自发性（平均83，感染+/- 17.6天）或有指征（平均83，+/- 16.7天）早产在妊娠34周之前和自然足月分娩之后（平均82，+/- 15.7天; P = 0.980）。进行需氧菌和厌氧菌、阴道毛滴虫和生殖器支原体培养。组织学炎症被定义为存在浆细胞。结果：研究人群（n = 820）是71%的黑人，29%的白色，69%未婚，31%的教育少于12年。82%的妇女子宫内膜培养至少有一种微生物呈阳性。自发性早产与指征性早产（85% vs 79%，P = 0.102）或自发性早产与自然足月分娩（85% vs 81%，P = 0.123）的妇女子宫内膜培养阳性率无显著差异。浆细胞性子宫内膜炎存在于39%的506个标本足以进行组织学检查，也是相似的三组（P = 0.160）。结论：微生物定植的子宫内膜和浆细胞性子宫内膜炎是相似的3个月后自发或指示早产或足月分娩。因此，慢性感染和炎症的子宫内膜（记录在产后3个月）似乎不是风险因素，为后续交付的妇女先前自然分娩小于34周的妊娠。(c)2005 Mosby，Inc. All rights reserved.
Objective: This study was undertaken to determine whether endometrial microbial colonization or plasma cell endometritis is increased after spontaneous versus indicated preterm delivery or a spontaneous term delivery.Study design: Postpartum, endometrial specimens were obtained after a spontaneous (mean 83, Infection +/- 17.6 days) or indicated (mean 83, +/- 16.7 days) preterm delivery before 34 weeks' gestation and after a spontaneous term delivery (mean 82, +/- 15.7 days; P = .980). Cultures for aerobic and anaerobic bacteria, Trichomonas vaginalis, and genital mycoplasmas were performed. Histologic endometritis was defined as the presence of plasma cells.Results: The study population (n = 820) was 71% black, 29% white, 69% unmarried, and 31% had less than 12 years of education. Endometrial cultures were positive for at least 1 microorganism in 82% of the women. No significant difference in positive endometrial cultures were observed among women after a spontaneous versus an indicated preterm delivery (85% vs 79%, P = .102), or a spontaneous preterm, versus a spontaneous term delivery (85% vs 81%, P = .123). Plasma cell endometritis was present in 39% of 506 specimens sufficient for histologic examination and was also similar in the three groups (P = .160).Conclusion: Microbial colonization of the endometrium and plasma cell endometritis are similar 3 months after spontaneous or indicated preterm or term births. Therefore, chronic infection and inflammation of the endometrium (documented at 3 months postpartum) do not appear to be risk factors for subsequent delivery in women with a prior spontaneous delivery less than 34 weeks' gestation. (c) 2005 Mosby, Inc. All rights reserved.