Infectious Diseases in Obstetrics and Gynecology

Infectious Diseases in Obstetrics and Gynecology / 2000 / Article

Open Access

Volume 8 |Article ID 425139 | https://doi.org/10.1155/S1064744900000314

Helen M. McDonald, Helen M. Chambers, "Intrauterine Infection and Spontaneous Midgestation Abortion: Is the Spectrum of Microorganisms Similar to That in Preterm Labor?", Infectious Diseases in Obstetrics and Gynecology, vol. 8, Article ID 425139, 8 pages, 2000. https://doi.org/10.1155/S1064744900000314

Intrauterine Infection and Spontaneous Midgestation Abortion: Is the Spectrum of Microorganisms Similar to That in Preterm Labor?

Received23 Aug 2000
Accepted06 Nov 2000

Abstract

Objective: To determine whether microorganisms associated with intrauterine infection and preterm labor play a contributing role in midgestation abortion.Methods: A 4 year retrospective review of spontaneous midgestation abortions for which autopsy and microbiological cultures of placental and fetal tissue were performed was conducted for a tertiary obstetrics hospital, which included a regional referral service for perinatal and fetal pathology. One hundred twenty-nine spontaneously delivered, nonmacerated, midgestation fetuses or stillbirths (of between 16 and 26 weeks' gestation) and placentas were examined and cultured for aerobic and anaerobic bacteria, yeasts, and genital mycoplasmas.Results: Microorganisms were recovered in 85 (66%) cases (57% placentas, 49% fetuses). Among the culture positive cases, 81% had histological chorioamnionitis, 28% fetal pneumonitis, 38% clinical signs of infection, and 62% ruptured membranes at the time of miscarriage. These differed significantly from culture-negative cases (44%, 5%, 13%, and 34%, respectively). Group B streptococcus (GBS) was the most significant pathogen, recovered in 21 cases, 13 as the sole isolate, 94% with chorioamnionitis, and 47% in women with intact membranes. Escherichia coli and Ureaplasma urealyticum (22 and 24 cases, respectively) occurred mostly as mixed infections, with ruptured membranes. GBS, U. urealyticum, and Streptococcus anginosus group were individually associated with chorioamnionitis, Bacteroides/Prevotella and S. anginosus with fetal pneumonitis. The spectrum of microorganisms was similar to that in preterm labor at later gestations; however, GBS appeared to be the most significant pathogen in midgestation miscarriage, especially with intact membranes.Conclusions: Unsuspected intrauterine infection underlies many spontaneous midgestation abortions. GBS is a key pathogen in this setting. Infect. Dis. Obstet. Gynecol. 8:220–227, 2000.

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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