Colonização endocervical em gestantes com trabalho de parto prematuro e/ou ruptura prematura de membranas

AUTOR(ES)

Giuliane Jesus Lajos Pinto

DATA DE PUBLICAÇÃO

2005

RESUMO

Objective: to study cervical colonization in women with preterm labor and/or premature rupture of membranes. Method: 212 pregnant women with preterm labor and/or premature rupture of membranes (PROM), admitted at Hospital Estadual Sumaré, during the period between July 2002 and January 2004, were studied. Two cervical samples from each woman were collected and bacterioscopy and culture in blood-agar or chocolate-agar plates were performed. Association of cervical microorganisms and urinary infection, chorioamnionitis, antibiotics use, prematurity, neonatal infection and neonatal death were evaluated. Results: the population evaluated consisted of 74 women with preterm labor (35%) and 138 women with PROM (preterm and term). The prevalence of cervical colonization was 14.2% (CI=9.5-18.9%), with similar results in preterm labor or PROM. Group B streptococcus was the most prevalent organism in this population (9.4%). Other organisms isolated were Candida sp, Streptococcus sp, Streptococcus pneumoniae, Escherichia coli and Enterococcus sp. The most common findings of bacterioscopy were a reduced number of lactobacilli and a great number of leukocytes. Endocervical colonization was associated with a higher occurrence of urinary tract infection (23.8% versus 5.4%; p<0.01), early-onset of neonatal infection (25.0% versus 7.3%; p<0.01) and neonatal mortality (2 cases in colonizated women; p<0.02) when compared with a negative culture of endocervical mucus. Conclusions: this study showed high prevalence of endocervical colonization despite of the use of a nonselective culture media. The main microorganism isolated was Group B streptococcus but other organisms were present in one third of studied population. More studies are needed to evaluate the influence of endocervical colonization in obstetrical outcome and in neonatal sepsis and mortality

ASSUNTO(S)

cervical mucus muco cervical premature rupture of membranes preterm labor neonatal infections infecções neonatais trabalho de parto prematuro ruptura prematura de membranas fetais

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