纵向研究妊娠期妇女的阴道微生态状况

目的分析妊娠期妇女阴道微生态状况的纵向变化。方法选择健康无症状单胎妊娠期妇女50例,分别于孕早期（10.2±2.1）周、孕中期（24.6±3.7）周、孕晚期（33.2±3.4）周,取其阴道分泌物,进行pH、H2O2含量检测及细菌培养,并经革兰染色后在油镜下观察,进行阴道微生态（阴道菌群的密集度、多样性、优势菌、炎症反应状况等）状况评价。结果 （1）50例孕妇中,孕早期38例（76%）阴道微生态正常,其中31例（81.58%）整个孕期维持阴道微生态正常,7例（18.42%）孕妇于孕中期或孕晚期转变为阴道微生态失调;12例（24%）孕早期阴道微生态失调,其中6例（50%）于孕中期或孕晚期转变为阴道微生态正常。（2）无症状性细菌性阴道病随着孕周增加部分可自然消退40%（2/5）。（3）H2O2阳性、阴道pH低者易从阴道微生态失调转为阴道微生态正常。结论妊娠期阴道微生态是动态变化的,部分细菌性阴道炎可自然消退,H2O2阳性及低阴道pH为维持正常阴道微生态的重要因素。

Longitudinal analysis of the vaginal microecology in pregnancy

Objective To describe the longitudinal variation of vaginal microecology in pregnancy.Method Vaginal swabs were obtained from 50 enrolled women who were healthy asymptomatic and in singleton pregnancy at average gestational age of(10.2±2.1) weeks,(24.6±3.7) weeks,and(33.2±3.4) weeks,respectively.The vaginal secretions were examined in terms of the pH value,the hydrogen peroxide test,bacterial culture,and Gram dyeing inspection of vaginal bacteria and microecology appraisal for colony′s density,the multiplicity,predominant fungus,and the inflammatory response.Result(1) 38 women had normal vaginal microecosystem during the first trimester,of which 31(81.58%) maintained normal vaginal microecosystem throughout pregnancy,7(18.42%) converted to abnormal vaginal microecosystem in the second or third trimester.Conversely,of the 12 women with abnormal vaginal microecosystem in the first trimester,6(50%) reconverted to normal vaginal microecosystem in the second or third trimester.(2) As the pregnancy progressed,almost 40% of untreated women in our study had spontaneous regression of asymptomatic bacterial vaginosis.(3) Women with positive hydrogen peroxide and low acidity predisposed to convert from abnormal vaginal microecosystem to normal vaginal microecosystem.Conclusion The vaginal microecosystem of healthy asymptomatic pregnant women change dynamically.Some bacterial vaginosis can regress spontaneously.To maintain the normal vaginal microecosystem,it is very important to keep positive hydrogen peroxide and low acidity.