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Bacterial infections remain a major cause of morbidity and mortality in newbor n infants. Objective. -To determine the bacterial ecology and pathological stat us of the genital organs during the last trimester of pregnancy and the germs of the following early-onset neonatal sepsis, in order to evaluate the risk of ma terno-foetal infections and to find out a drug prophylaxis. Method. -Vaginal a nd endocervical samples, usually taken during the first trimester of pregnancy w ere delayed and taken during the last trimester of pregnancy. A macroscopic exam ination described the aspect of the vagina, the cervix uteri, leukorrhea and of possible inflammatory lesions or ulcerations. A microscopic examination searched for parasites, epithelial cells, clue cells and leukocytes. The appropriate bac teriological cultures were performed after reading the Gram stain and scoring th e vaginal flora. The clinical and cytobacteriological aspects were used to ident ify the bacterial ecology and the pathological genital states. An exploration wa s carried out in every newborn suspected of infection. Results. -Genital sample s were collected from 306 pregnant women. Among them, 118 were at 29-32 weeks o f gestation, 104 at 33-36, and 84 at 37-40. The most frequent germs were C. al bicans (33,5%), Enterbacteriaceae (20.3%) including E. coli (10.9%)-, S. aur eus (15.4%), Gardnerella (13.6%), and Trichomonas (10.6%), in monomicrobian ( 79.2%) and polymicrobian carriage (20.8%). Lower genital tract pathological st ates such as vaginitis (29.4%), bacterial vaginosis (21.5%) or endocervicitis (10.4%), asymptomatic bacterial carriage (23.5%) and normal genital flora (15 %) were identified. These pregnancies led to 334 live births with 27 cases of e arly-onset neonatal sepsis to which endocervicitis (25%) and vaginosis (19.7% ) were most often linked. Conclusion. -Genital samples at the last trimester of pregnancy could evaluate the risk of maternofoetal infections and allowto adapt a drug prophylaxis of Enterobacteriaceae, the most frequent germ of neonatal in fections, as it has been done for Streptococcus agalactiae. But larger studies a re required to evaluate the risk of maternofoetal infections and to state the dr ug prophylaxis.
Objectives -To determine the bacterial ecology and pathological stat us of the genital organs during the last trimester of pregnancy and the germs of the following early-onset neonatal sepsis, in order to evaluate the risk of ma terno-foetal infections and to find out a drug prophylaxis. Method. -Vaginal a nd endocervical samples, usually taken during the first trimester of pregnancy w ere delayed and taken during the last trimester of pregnancy. A macroscopic exam ination described the aspect of the vagina, the cervix uteri, leukorrhea and of possible inflammatory lesions or ulcerations. A microscopic examination searched for parasites, epithelial cells, clue cells and leukocytes. The appropriate bac teriological cultures were performed after reading the Gram stain and scoring th e vaginal flora. The clinical and cytobacteriological aspects were used to ident ify the bacterial ecology and the pat An exploration wa s carried out in every newborn suspected of infection. Results. -Genital samples were were from 306 pregnant women. Among them, 118 were at 29-32 weeks of gestation, 104 at 33-36, and 84 at 37-40. The most frequent germs were C. al bicans (33.5%), Enterbacteriaceae (20.3%) including E. coli (10.9%) -, S. aur eus (15.4%), Gardnerella ), and Trichomonas (10.6%), in monomicrobian (79.2%) and polymicrobian carriage (20.8%). Lower genital tract pathological st as such vaginitis (29.4%), bacterial vaginosis These pregnancies led to 334 live births with 27 cases of e arly-onset neonatal sepsis to which endocervicitis (25%) and vaginosis (19.7%) were most often linked. Conclusion. - Genital samples at the last trimester of pregnancy could evaluate the risk of maternofoetal infections and allow to adapt a drug prophylaxis of Enterobacteriaceae, the most frequent germ of neonatal in fections, as it has been done for Streptococcus agalactiae. But larger studies a re required to evaluate the risk of maternofoetal infections and to state the dr ug prophylaxis.