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Infectious Diseases in Obstetrics and Gynecology
Volume 2007, Article ID 51689, 3 pages
http://dx.doi.org/10.1155/2007/51689
Case Report

Morbidly Obese Woman Unaware of Pregnancy until Full-Term and Complicated by Intraamniotic Sepsis with Pseudomonas

1Department of Obstetrics and Gynaecology, Royal Albert Edward Infirmary, Wigan Lane, Wigan WN1 2NN, Lancashire, UK
2Department of Obstetrics and Gynaecology, Delaunays Road, Crumpsall M8 5RB, Manchester, UK
3Women's Health Directorate, Blackpool Victoria Hospital, Whinney Heys Road, Blackpool FY3 8NR, Lancashire, UK

Received 18 September 2007; Accepted 30 November 2007

Copyright © 2007 H. Muppala et al. 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.

Abstract

A 32-year-old Caucasian woman of body mass index (BMI) 46 presented with urinary symptoms to accident and emergency (A&E). Acute pyelonephritis was the diagnosis. Transabdominal scan revealed a live term fetus. Both the partners were unaware of the ongoing pregnancy until diagnosed. She underwent emergency cesarean under general anaesthesia (GA) for nonreassuring CTG, severe chorioamnionitis, and moderate preecclampsia. A live male baby weighing 4400 grams delivered in poor condition. Placental tissue on culture exhibited scanty growth of pseudomonas aeruginosa. Chorioamnionitis due to pseudomonas is rare, with high neonatal morbidity and mortality. It is mostly reported among preterm prelabor rupture of membranes (PPROM). Educating the community especially morbidly obese women if they put on excessive weight or with irregular periods should seek doctor's advice and exclude pregnancy. For the primary care provider, it is of great importance to exclude pregnancy in any reproductive woman presenting with abdominal complaints. This case also brings to clinicians notice that pseudomonas can be community-acquired and can affect term pregnancies with intact or prolonged rupture of membranes.