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조기분만진통 산모에서 양수내 감염의 발생양상 및 임상적 의의
윤보현(BH Yoon),양순하(SH Yang),전종관(JK Jun),구자남(JN Koo),김경섬(KS Kim),이재훈(JH Lee),이동훈(DH Lee),신희철(HC Shin),김승욱(SW Kim) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.7
Objectives: To determine the prevalence and microbiology of intraamniotic infection and to compare maternal and neonatal outcomes according to amniotic fluid culture results in patients with preterm labor and intract membranes. Methods: Amniotic fluid was obtained by transabdominal amniocentesis in 75 patients with preterm labor and intact membrances, and cultured for aerobic and anaerobic bateria as well as for mycoplasmas. Fishers exact test, Students test, Mann-Whitney U test, and generalized Wilcoxon test for survival analysis were used for statictical comparisons. Results: 1) The prevalence of positive amniotic fluid cultures was 12.0% (9/75). 2) The most frequently isolated microorganism was Ureaplasma urealyticum(n=9). 3) Failure of tocolysis was more common in patients with positive amniotic fluid cultures than in those with negative amniotic fluid cultures(6/6 [100%] vs. 23/48 [47.9%], p<0.05), Moreover, the amniocentesis-to-deliver interval of patients with positive amniotic fluid cultures was significantly shorter than that of patients with negative amniotic fluid cultures (median 17 hr, range 1-385 hr vs. median 123 hr, range 1-1747 hr, respectively; p<0.005). 4) The newborn infants born to mothers with positive amniotic fluid cultures ahd lower gestational ages and birth weights than those born to mothers with negative amniotic fluid dultures. 5) Neonates of patients with positive amniotic fluid cultures had significantly higher rate of perinatal complications than those with negative cultures. Conclusion: Microbial invasion of amniotic cavity is a risk factor for failure of tocolysis, spontaneous preterm delivery, and perinatal morbidity and mortality in patients with preterm labor and intact membranes.
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