Abstract: Objective　 To analyze the relationship between perinatal intrauterine infection and adverse outcomes of mother and fetus.Methods　We retrospectively analyzed the clinical data of 46 pregnant women with perinatal intrauterine infection who delivered from January 2011 to July 2017 in Beijing Shijitan Hospital，Capital Medical University.Pathogenic bacteria，main causes and routes，and clinical manifestations of intrauterine infection and maternal and infant outcomes were analyzed by clinical data.Results　Among 46 cases with intrauterine infection during the study period，29 cases were infected by Escherichia coli，5 cases by group B streptococcus，3 cases by cytomegalovirus，2 cases by Listeria monocytogenes，1 case by staphylococcus aureus，1 case by Enterococcus faecalis，1 case by Klebsiella pneumoniae and 4 cases by other causes.Intrapartum Escherichia coli infection was mainly associated with multiple vaginal examinations during childbirth or history of uterine cavity operation，premature rupture of membranes and unclean diet Escherichia coli infection was the main cause of intrauterine infection.The main clinical symptoms of perinatal intrauterine infections were fever.Perinatal intrauterine infections caused by Escherichia coli and Listeria bacteria produced clinical manifestations of high fever and shivering.Perinatal intrauterine infections caused by group B Streptococcus and cytomegalovirus had no obvious fever symptoms.Thirty-eight out of 46 cases（82.6%） with perinatal intrauterine infection were accompanied by fever.Perinatal intrauterine infection caused by Escherichia coli resulted in postpartum high fever，sepsis in 12 pregnant women.There were 7 perinatal deaths，including 3 cases of cytomegalovirus infection，2 cases of Escherichia coli infection and 2 cases of Listeria infection；3 cases by infectious pneumonia.Conclusion　Perinatal intrauterine infection is closely related to intestinal bacterial infection.It is one of the main reasons leading to poor maternal and fetal outcomes.The main clinical symptoms of parturient women are fever，and neonatal infection can lead to toxic shock and death.We should do disinfection measures during childbirth and minimize unnecessary vaginal operations to reduce intrauterine infection in perinatal period.

Key words: Peripartum period, Escherichia coli infections, Cytomegalovirus infections, Lester bacteria

摘要： 目的　分析发生围生期宫内感染患者的临床资料，了解围生期宫内感染与母婴不良结局的关系。方法　回顾性分析2011年1月—2017年7月于首都医科大学附属北京世纪坛医院产科分娩并诊断为围生期宫内感染的46例患者的临床资料，分析其发生围生期宫内感染的致病菌、主要原因、主要途径、临床表现及母婴结局。结果　46例围生期宫内感染患者中29例感染大肠杆菌、5例感染B族链球菌、3例感染巨细胞病毒、2例感染李斯特菌、1例感染金黄色葡萄球菌、1例感染粪肠球菌、1例感染肺炎克雷伯杆菌、4例为其他菌感染。产时大肠杆菌感染是围生期宫内感染的主要原因，其主要途径为反复多次阴道检查或存在宫腔操作、胎膜早破、不洁饮食史等；围生期宫内感染的主要临床症状为发热，由大肠杆菌、李斯特菌感染导致的围生期宫内感染会出现高热、寒战的临床表现；B族链球菌、巨细胞病毒引发的围生期宫内感染没有明显发热症状。46例围生期宫内感染产后82.6%（38例）的患者伴有发热。由大肠杆菌引发的围生期宫内感染造成12例孕妇发生产后高热、败血症。共7例围产儿死亡，其中3例感染巨细胞病毒、2例感染大肠杆菌、2例感染李斯特菌；新生儿感染性肺炎3例。结论　围生期宫内感染与肠道细菌感染关系密切，其是导致母婴不良结局的主要原因之一，产妇主要临床症状为发热，新生儿感染可导致中毒性休克、死亡等。分娩过程中应做好消毒措施，尽量减少不必要的阴道操检查、宫腔作次数，减少围生期宫内感染。

关键词: 围产期, 大肠杆菌感染, 巨细胞病毒, 李斯特菌