Background: In obstetrical clinic the rate of incidence of chorioamnionitis(CAM) is more than half of causes of abortion and preterm deliveries in second trimester and third trimester of pregnancy.
Histologic CAM is present at 60% to 80% of placentas in deliveries at 16 to 36 weeks.
We want to introduce the results in experimental and clinical study for diagnosis and therapy on CAM in Koryo obstetric and gynecology department in Pyongyang medical college of
For the subject to study pathological examination of fetal membranes and umbilical cord, and to set up diagnostic index, risk factors of CAM we've chosen 62 cases of the patients with abortion, premature labor and 42 cases of the patients with PROM as trial group and 42 cases of the normal pregnant women and 27 cases of the artificial abortion in second trimester as control group.
The inpatients were about 23~40 weeks in gestational age in Pyongyang Matrernity Hospital.
Results was as following;
The cases and rate variability of CAM 3 stages in the abortion, premature labor and PROM [31(50%), 21(20%)] respectively was more statistically significant than them in normal labor group and the artificial abortion in second trimester [3(13.0%)] group.
The thickness of density layer in amnion was 128.7±13.5㎛ in PROM and they were statistically thin than in normal labor group of 158.0±14.4㎛ at the side of the ruptured fetal membranes.
The Lactobacilli have been detected in 7(14.6%) cases with CAM group and they were statistically significant smaller comparing with 38(95.3%) cases with the non-CAM group in cultivation.
Peptococcus, Peptostreptococcus, Gardnerella and Chlamydia trachomatis have been detected in 17(35.0%) cases, 10(20.8%) cases, 22(45.8%) cases and 23(47.0%) cases respectively and they were statistically significant more comparing with non-CAM group 9(22.5%) cases, 5(12.8%) cases, 6(15.0%) cases and 5(12.5%) cases in cultivation.
On cervical mucus the microbes, white blood cell(WBC) and granulocyte elastase(GE) were 110.13±30.39 per visual field, 1.33G/L and 178.06±16.3u/L in CAM phases 3, respectively and statistically significant higher than 18.00±4.95 per visual field, 0.50±1.17G/L and 99.00±15.56u/L in CAM phases 0.
A number of microbes, white blood cell(WBC) and granulocyte elastase(GE) activity on cervical mucus which the examinative marks to diagnose CAM had been negative after sexual topical treatment in 2 to 3 days one time per day with 0.1% Chlorhexidine(CH), 0.25% metronidazole(MD).
And the examinative marks for a number of microbes, white blood cell(WBC) and granulocyte elastase(GE) activity on cervical mucus had been negative after oral treatment of 5 days with α-aminobenzylpenicillin(ABPC, ampicillin), metronidazole(MD) and Ciprofloxacin(CPFX) in 5 days.
The rates of term labour were 71.8%, 80.0% after sexual topical treatment with 0.1% Chlorhexidine(CH), 0.25% metronidazole(MD) and then 56.6%, 76.2% and 70.0% after oral treatment with α-aminobenzylpenicillin(ABPC, ampicillin), metronidazole(MD) and Ciprofloxacin(CPFX).
The study on the advanced methods and universal introduction for diagnosis and therapy of CAM will be continued.
