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目的研究乳酸杆菌阴道胶囊治疗低危的妊娠期细菌性阴道病(BV)的转阴率及其与不良妊娠结局间的关系,评估双疗程方案对治疗后持续BV阳性患者的意义。方法选用唾液酸酶法对孕16～20周的低危患者进行BV筛查,追踪比较乳酸杆菌阴道胶囊单疗程治疗组、双疗程组和对照组3组病人治疗后1周及孕晚期的转阴率及妊娠结局。结果 BV总检出率为17.6%。在治疗后1周及孕晚期,对照组的转阴率分别为1.2%和62.3%,两治疗组的BV转阴率均高于80%,对照组与两治疗组间的差异有统计学意义(P<0.01)。对照组较两治疗组的胎膜早破发生率高、分娩孕周短、产后出血量多、新生儿出生体重轻、产妇产后第1天的体温高。对于持续性BV阳性的病人,双疗程组与单疗程组在BV转阴率、不良妊娠结局间的差异无统计学意义。结论低危妊娠期BV患者予乳酸杆菌阴道胶囊治疗能使BV有效转阴,并可改善妊娠结局。对于治疗后持续性BV阳性的病人,暂无证据支持予第二疗程治疗。
Objective To study the relationship between the negative conversion rate of low-risk bacterial vaginosis (BV) during pregnancy and the outcome of adverse pregnancy in lactobacillus vaginal capsule and to evaluate the significance of double-treatment regimen in patients with persistent BV positive after treatment. Methods The sialidase method was used to screen the low risk patients who were pregnant for 16 to 20 weeks and compared with the Lactobacillus vaginal capsule single treatment course, double treatment course and control group. Yin rate and pregnancy outcome. Results The total detection rate of BV was 17.6%. In the first and third trimester of pregnancy, the negative conversion rates of the control group were 1.2% and 62.3%, respectively. The BV negative rates of the two treatment groups were both higher than 80%, and the differences between the two groups were statistically significant (P <0.01). Compared with the two treatment groups, the control group had a higher incidence of premature rupture of membranes, shorter gestational weeks for delivery, more postpartum hemorrhage, lower birth weight and higher body temperature on the first postnatal day. For patients with persistent BV-positive, there was no significant difference between the double-treatment group and the single-treatment group in the BV negative conversion rate and the adverse pregnancy outcome. Conclusions The treatment of vaginal capsule by Lactobacillus in BV patients with low-risk pregnancy can effectively reduce BV and improve pregnancy outcomes. For patients with persistent BV positive after treatment, there is no evidence to support the second course of treatment.