絨毛羊膜炎
絨毛羊膜炎,又名為內羊膜炎(intra-amniotic inflammation,IAI),是胎膜、羊水或胎盤的炎症,常由感染引起[2] [3]。症狀通常包括發燒、腹痛、母親或胎兒心率過快、或異常的陰道分泌物[4]。新生兒併發症可能包括肺炎、腦膜炎、敗血症、早產和腦性麻痺[3] [5]。母親的併發症可能包括產後出血、子宮內膜炎、敗血症和急性呼吸窘迫症候群[3]。
絨毛羊膜炎 | |
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顯微圖顯示急性絨毛膜羊膜炎,絨毛膜中有中性粒細胞。還有纖維蛋白血栓,代表嚴重的胎兒發炎反應。[1]。蘇木精-伊紅染色. | |
分類和外部資源 | |
醫學專科 | 婦產科學 |
ICD-10 | O41.1、P02.7 |
DiseasesDB | 31882 |
eMedicine | 973237 |
危險因子包括分娩時間較長、胎膜早破、既往妊娠次數少、產道內有B 組鏈球菌移生和胎膜破裂後頻繁地進行陰道檢查[3] [6]。可能的機轉通常是細菌由陰道進入子宮[4] [7]。引起發炎,並造成子宮收縮,並可能早產[7]。若出現單次體溫超過39.0 °C(102.2 °F)或持續在38.0 °C(100.4 °F)和39.0 °C(102.2 °F)間,就需高度懷疑患者是否有這個診斷 [3]。
使用抗生素治療,常用氨苄西林和慶大黴素[3] [6]。可用乙酰氨基酚(對乙酰氨基酚)降低體溫[6]。有早產風險的患者,也可能使用皮質類固醇[5]。雖然通常應該及時進行生產,但通常不需剖腹產[3] [6]。羊膜囊早期破裂的患者,通常會預防性使用抗生素[5]。
絨毛膜羊膜炎的發生率,在足月產約為 4%,在早產則約在 40% 至 70%,而懷孕不足 24 周的生產中則約為 94%[2] [8]。分娩時的發燒,有 10% 至 40% 是由此引起[9]。
參見
參考文獻
- ^ Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance. American Journal of Obstetrics and Gynecology. October 2015, 213 (4 Suppl): S29–S52. PMC 4774647 . PMID 26428501. doi:10.1016/j.ajog.2015.08.040.
- ^ 2.0 2.1 Kim, Chong Jai; Romero, Roberto; Chaemsaithong, Piya; Chaiyasit, Noppadol; Yoon, Bo Hyun; Kim, Yeon Mee. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance. American Journal of Obstetrics and Gynecology. 2015, 213 (4): S29–S52. ISSN 0002-9378. PMC 4774647 . PMID 26428501. doi:10.1016/j.ajog.2015.08.040.
- ^ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Committee Opinion No. 712: Intrapartum Management of Intraamniotic Infection.. Obstetrics and gynecology. August 2017, 130 (2): e95-e101 [17 January 2024]. PMID 28742677. doi:10.1097/AOG.0000000000002236. (原始內容存檔於26 September 2023).
- ^ 4.0 4.1 Fowler, JR; Simon, LV. Chorioamnionitis.. StatPearls. January 2023 [17 January 2024]. PMID 30335284. (原始內容存檔於31 January 2021).
- ^ 5.0 5.1 5.2 Ericson JE, Laughon MM. Chorioamnionitis: implications for the neonate. Clinics in Perinatology. March 2015, 42 (1): 155–65, ix. PMC 4331454 . PMID 25678002. doi:10.1016/j.clp.2014.10.011.
- ^ 6.0 6.1 6.2 6.3 Intraamniotic Infection - Gynecology and Obstetrics. Merck Manuals Professional Edition. [17 January 2024]. (原始內容存檔於2 October 2023) (加拿大英語).
- ^ 7.0 7.1 Galinsky R, Polglase GR, Hooper SB, Black MJ, Moss TJ. The consequences of chorioamnionitis: preterm birth and effects on development. Journal of Pregnancy. 2013, 2013: 412831. PMC 3606792 . PMID 23533760. doi:10.1155/2013/412831 .
- ^ Radswiki, The. Chorioamnionitis | Radiology Reference Article | Radiopaedia.org. Radiopaedia. [18 January 2024]. (原始內容存檔於16 December 2023).
- ^ Gravett, Michael G. Intra-amniotic and Postpartum Infections. The Global Library of Women's Medicine. 2009 [18 January 2024]. doi:10.3843/GLOWM.10176. (原始內容存檔於24 September 2023).
- Verani JR, McGee L, Schrag SJ. Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010. MMWR. Recommendations and Reports. November 2010, 59 (RR-10): 1–36. PMID 21088663.