Perinatal Mortality Associated with Positive Postmortem Cultures for Common Oral Flora

Table 1

Autopsy diagnosis, placental pathology, and bacterial culture results.

Case	Main autopsy diagnosis	Placental finding of inflammation	Blood culture	Lung culture	Other cultures	Mode of delivery	GA	Fetal gender	Length of survival	Mat Age	Maternal medical or obstetric history
1	AFIS, dysmorphic features, and normal CG	Acute chorioamnionitis. Acute vasculitis of chorionic plate.	S. sanguis	None	None	Unk	17	F	0	35	Abnormal Thrombophilia. 3 pregnancy losses: first loss at 22 weeks; Turner’s syndrome; this is the 2nd loss. 3rd with normal CG.
2	Extreme prematurity, AFIS	Acute chorioamnionitis. Gram-positive cocci seen on Gram stain.	S. mitis	No growth	None	VD	20	M	15 min	35	Gestational diabetes mellitus
3	AFIS	Necrotizing acute chorioamnionitis. 3-vessel acute vasculitis and funisitis of the umbilical cord.	S. salivarius	S. salivarius	None	VD	19	F	0	29
4	IUFD cause cannot be determined	None	No growth	Enterococcus species, Peptostreptococcus	None	Unk	16	F	0	34	Maternal obesity
5	AFIS	Acute chorioamnionitis. 3-vessel acute vasculitis and funisitis of the umbilical cord. Acute vasculitis of chorionic plate.	S. mitis	S. mitis	None	VD	35	F	0	21
6	AFIS, extreme prematurity	Acute chorioamnionitis.	Prevotella species	No growth	None	VD	22	M	15 min	19
7	Dysmorphic features, AFIS	Necrotizing acute chorioamnionitis. 3-vessel acute vasculitis and funisitis of the umbilical cord. Acute vasculitis of chorionic plate.	Not taken	S. sanguis, S. viridans group, P. anaerobius	None	VD	19	F	0	37
8	Intrauterine infection	Acute chorioamnionitis. Acute vasculitis and funisitis of the umbilical cord.	Peptostreptococcus species	No growth	Prevotella from placenta	VD	22	M	0	20
9	Undetermined	None	S. mitis	No growth	None	VD	21	F	0	30
10	AFIS	Evidence of amniotic fluid infection with fetal inflammatory response.	Fusobacterium species	No growth	None	VD	22	M	0	24
11	Trisomy 18	No placenta submitted	S. epidermidis	S. epidermidis, S. mitis	None	C/S	36	F	22 days	31
12	Extreme prematurity, AFIS	Severe necrotizing acute chorioamnionitis. Acute vasculitis and funisitis of the umbilical cord.	Fusobacterium	None	None	VD	22	F	5 hours	22
13	AFIS	Necrotizing acute chorioamnionitis. 3-vessel acute vasculitis and funisitis of umbilical cord. Acute vasculitis of chorionic plate.	Not taken	1+Staphylococcus coagulase negative. 3+ Peptostreptococcus species and 4+ Lactobacillus species	None	VD	40+	F	0	20	No prenatal care (unaware of pregnancy). Renal failure and DVT. On weight loss medication.
14	AFIS	Acute chorioamnionitis. 3-vessel acute vasculitis and funisitis of the umbilical cord. Acute vasculitis of chorionic plate.	Anaerobic Gram(−) bacteria, fusiform type, fastidious	No growth	None	VD	38	F	0	30
15	Twin-twin transfusion syndrome	None	S. anginosus and Peptostreptococcus	Staphylococcus coagulase negative	None	C/S	30	Unk	0	24
16	IUGR, abruption, intrauterine infection, and no inflammation seen in fetal tissue	Evidence of intrauterine infection with fetal inflammatory response.	S. mitis and E. faecalis	None	None	VD	28	M	0	33	Previous pregnancy loss at 23 weeks of GA. Antiphospholipid syndrome, prophylactic heparin, and aspirin.
17	Intrauterine infection with fetal inflammatory response, no inflammation seen in fetal tissue	Acute chorioamnionitis. 1-vessel acute vasculitis of umbilical cord.	E. faecalis and S. mitis	None	GBS in urine	VD	27	F	0	35	Ampicillin for GBS in urine. Prior pregnancy-induced hypertension with full term delivery. Hypothyroidism, on levoxyl daily.
18	Intrauterine infection with fetal inflammatory response, no inflammation seen in fetal tissue	Acute chorioamnionitis. 1-vessel acute vasculitis of umbilical cord. Acute vasculitis of chorionic plate.	S. mutans	None	None	VD	15	F	0	23	G3P0. Cervical cerclage. Two previous second trimester losses
19	Extreme prematurity, no inflammation seen in fetal tissue	Acute chorioamnionitis. 1-vessel acute vasculitis and funisitis of umbilical cord. Acute vasculitis of chorionic plate.	S. mitis	None	None	VD	19+	M	3 hours 40 minutes	33
20	AFIS	Acute necrotizing chorioamnionitis of twin A	E. corrodens	E. corrodens	None	Unk	23	F	>10 minutes	14	Bleeding gums
21	AFIS	Acute chorioamnionitis. 3-vessel acute vasculitis and funisitis of umbilical cord. Acute vasculitis of chorionic plate.	S. mitis	S. mitis		Unk	36+	M	0	32
22	AFIS	Acute chorioamnionitis. 2-vessel acute vasculitis and funisitis of umbilical cord.		S. mitis, S. sanguis	None	VD	19+	F	2 hours	30	G4P0. Cervical cerclage. Prophylactic antibiotics
23	AFIS	Acute chorioamnionitis.	None	Prevotella bivia	None	Unk	21	M	2 hours	15
24	Fetal hypoxia	No placenta submitted	None	Prevotella bivia	None	C/S	31	M	0	20	Pregnancy-induced hypertension, treated with Labetalol

AFIS, amniotic fluid infection syndrome; CG, cytogenetics; C/S, cesarean section; F, female; GA, gestational age; GBS, group B streptococcus; IUFD, intrauterine fetal demise; M, male; Mat, maternal; Unk, unknown; VD, vaginal delivery.