关键词: 催引产时阴道检查, 阴道微生态, 妊娠结局

Abstract:

Objective To observe the effect of multiple vaginal examinations on vaginal microecology during induced labor. Methods 150 cases of parturients admitted to our hospital from June 2017 to June 2018 were randomly selected as samples to investigate the frequency of vaginal examination during induction of labor in full-term (healthy asymptomatic single pregnancy). They were divided into three groups: group A (examination<2 times), group B (3-6 times), group C (more than 6 times). Vaginal secretions were taken for pH examination and the content of hydrogen peroxide. Detection and bacterial culture, observation under oil microscope after gram staining, vaginal microecology (vaginal flora density, diversity, dominant bacteria, inflammatory reaction status, etc.) were performed to compare the results of three groups of vaginal microecology examination. Results In group A, 8% (4/50) of Candida albicans, 6% (3/50) of Escherichia coli, 0 (0/50) of Gardnerella vaginalis, 0 (0/50) of E.coli, 4% (2/50) of Lactobacillus, 0 (0/50) of Staphylococcus epidermidis, 4% (2/50) of bacterial vaginitis, 4% (2/50) of microecological disorder, 4.01±0.11 of vaginal pH value and 10% of soft birth canal injury rate in group A (5/50), premature rupture of membranes rate was 0 (0/50), neonatal infection rate was 4% (2/50). In the cases of premature rupture of membranes, 0 (0/0) had micro ecological imbalance. In group B, the detection rate of Candida albicans was 16% (8/50), Escherichia coli was 14% (7/50), Gardnerella vaginalis was 10% (5/50), E.coli was 4% (2/50), Lactobacillus was 2% (1/50), Staphylococcus epidermidis was 0 (0/50), bacterial vaginitis rate was 20% (10/50), microecological imbalance rate was 28% (14/50), vaginal pH value (4.08±0.22), soft birth canal damage The injury rate was 26% (13/50), premature rupture of membranes rate was 4% (2/50), neonatal infection rate was 6% (3/50). In the cases of premature rupture of membranes, 100% (2/2) of the patients had microecological disorders. In group C, the detection rate of Candida albicans was 60% (30/50), Escherichia coli was 46% (23/50), Gardnerella vaginalis was 46% (23/50), E.coli was 8% (4/50), Lactobacillus was 0 (0/50), Staphylococcus epidermidis was 2% (1/50), bacterial vaginitis rate was 80% (40/50), microecological imbalance rate was 80% (40/50), vaginal pH value (4.80±0.14), soft birth canal The injury rate was 50% (25/50), premature rupture of membranes rate was 10% (5/50), neonatal infection rate was 12% (6/50). In the cases of premature rupture of membranes, 100% (5/5) of the patients had microecological disorders. Conclusion Multiple vaginal examinations during induced labor can lead to vaginal microecological disorders. Candida albicans infection rate ranks first, followed by Escherichia coli and Gardnerella vaginalis. Vaginal microecological disorders also lead to changes in vaginal pH values, increase the incidence of vaginitis, and increase the possibility of adverse pregnancy outcomes such as premature rupture of membranes.

Key words: vaginal examination during induced labor, vaginal microecology, pregnancy outcome