【摘要】 目的：分析孕晚期胎膜早破(PROM)孕妇阴道内菌群变化与不良妊娠结局关系。方法：回顾性收集2022年5月-2023年9月本院收治的孕晚期PROM孕妇128例(PROM组)、产前检查健康孕妇90例(对照组)临床资料，比较两组一般资料、孕妇阴道分泌物微生物分布构成及阴道微生态情况，比较不同阴道微生态情况孕妇不良妊娠结局。结果：PROM组革兰阳性杆菌、乳酸杆菌和革兰阳性球菌均低于对照组，变形杆菌、阴沟肠杆菌和溶血葡萄球菌均高于对照组(均P<0.05),其余阴道微生物分布无差异(P>0.05);两组菌群密集度、阴道菌群多样性有差异，PROM组微生态失调占比(46.9%)高于对照组(32.2%)(P<0.05),pH值无差异(P>0.05)。PROM患者阴道微生态失调患者早产(15.0%)及新生儿感染率(15.0%)高于阴道微生态正常患者(2.9%、4.4%)(均P<0.05)。结论：孕晚期PROM孕妇阴道菌群密度、多样性以及微生态与健康孕妇比较出现异常，PROM孕妇阴道微生态失衡增加不良妊娠结局风险。更多还原

【Abstract】 Objective:To analyze the correlation between the vaginal flora changes of pregnant women with premature rupture of membranes(PROM) during the third trimester of pregnancy and their adverse pregnancy outcomes.Methods:The clinical data of 128 pregnant women with PROM during the third trimester of pregnancy(in study group)and 90 healthy pregnant women with normal prenatal examination(in control group) from May 2022 to September2023 were collected retrospectively.The general data,the microbial distribution and constituent in vaginal secretions and the vaginal microecology of the women were compared between the two groups.The pregnancy outcomes were compared among the women with different vaginal microecology status.Results:The levels of the vaginal gram-positive bacilli,lactobacillus and Gram-positive cocci of the women in the study group were significantly lower than those of the women in the control group,but the levels of the vaginal proteusbacillus vulgaris,enterobacter cloacae and staphylococcus haemolyticus of the women in the study group were significantly higher than those of the women in the control group(all P<0.05).There was no significant difference in the distribution of other vaginal microorganisms of the women between the two groups(P>0.05).There were significant differences in the density of vaginal flora and the diversity of vaginal flora of the women between the two groups.The proportion of the microecological imbalance(46.9%) of the women in the study group was significantly higher than that(32.2%) of the women in the control group(P<0.05),but there was no significant difference in the vaginal PH value of the women between the two groups(P>0.05).In the study group,the preterm birth rate(15.0%) and the neonatal infection rate(15.0%) of the women with the vaginal microecology disorder were significantly higher than those(2.9% and 4.4%) of the women with normal vaginal microecology(all P<0.05).Conclusion:The vaginal flora density and diversity,and the vaginal microecology of the pregnant women with PROM during the third trimester of pregnancy are abnormal comparing to those of the normal pregnant women.The vaginal microecological imbalance of the pregnant women with PROM will increase the risk of their adverse pregnancy outcomes.更多还原