1/40. chorioamnionitis with intact membranes caused by capnocytophaga sputigena.We report a case of chorioamnionitis with intact membranes caused by capnocytophaga sputigena. The pregnant woman was hospitalised in preterm labor without fever, neither tenderness, just regular contractions. In spite of the tocolitic treatment the patient gave birth to a girl at 29 weeks' gestation, weighing 1220 g and transferred to intensive care. The newborn had clinical and biological signs of infections and was initially treated by ampicillin, cephalosporin and metronidazol. capnocytophaga sputigena was found on membranes, cord, amniotic fluid and placenta. It was also identified in maternal endocervix culture. Histologic findings showed a focal chorioamnionitis. This was the fourteenth reported case of infection due to capnocytophaga species occurring in pregnancy. All the cases are reviewed.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/40. Fatal early onset infection in an extremely low birth weight infant due to morganella morganii.OBJECTIVE: This paper reports a case of chorioamnionitis due to morganella morganii in a mother who presented with ruptured membranes at 24 weeks' gestation and was treated with dexamethasone and prophylactic ampicillin. Her premature infant developed severe early onset infection due to the same organism and expired. STUDY DESIGN: A clinical case report of M. morganii infection complicating preterm rupture of membranes is presented. Possible risk factors for maternal and neonatal infection with this organism as well as the therapy of neonatal M. morganii infection are discussed. RESULTS: risk factors in the mother included having a cervical cerclage in place and treatment with dexamethasone and prophylactic ampicillin. The major risk factors in the infant were maternal chorioamnionitis and extreme prematurity. The mother responded to treatment with ampicillin, metronidazole, and gentamicin following delivery and had an uncomplicated recovery. Her infant developed severe early onset M. morganii infection complicated by neutropenia, thrombocytopenia, and severe acidosis and expired. Postmortem cultures of pleural fluid, peritoneal fluid, and blood were positive despite treatment with gentamicin, an antibiotic to which the organism was sensitive. CONCLUSION: M. morganii may cause serious infection in pregnancy and in the neonatal period. The use of dexamethasone and prophylactic ampicillin may have increased the risk of infection with this ampicillin-resistant organism. The failure of gentamicin to sterilize the infant's blood and body fluids emphasizes the necessity of treating such infections with a combination of an aminoglycoside and a third-generation cephalosporin, such as cefotaxime.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
3/40. Does amniotomy influence the prognosis of babies in cases with severe chorioamnionitis? Report of a twin pregnancy with varying outcome.We report our experience in a woman with a twin pregnancy. The patient suffered severe escherichia coli chorioamnionitis and the outcomes were different between the two babies after birth. The first baby had only a mild infection, but the second suffered sepsis and subsequent perinatal death. These differences in outcome appeared to be due to amniotomy performed for the first baby after late labor stage I to augment uterus contractions. Removal of infectious amniotic fluid from the amniotic cavity might thus have prevented the spread of the chorioamnionitis. E. coli sometimes causes severe infection during pregnancy and the perinatal period. In this case, a large number of enteropathogenic E. coli (serotype O-6) was cultured from blood, stool, pharyngeal swab, gastric juice and puncture fluid from the thoracic cavity of the second baby. O-6 is classified an enterotoxigenic strain mainly causing diarrhea because of endotoxin released from bacteria. O-6 has not hitherto been reported as a cause of severe infection in chorioamnionitis and perinatal sepsis.- - - - - - - - - - ranking = 6keywords = pregnancy (Clic here for more details about this article) |
4/40. Acardiac fetus in a triplet pregnancy: ultrasound pitfalls. A case report.This communication aims at illustrating ultrasound diagnostic difficulties in early pregnancy with acardiac fetus. Our case concerns a spontaneously conceived triplet pregnancy. It was diagnosed as a twin pregnancy at 11 weeks of amenorrhea. One and a half months later the patient was referred to our center for spontaneous premature rupture of membranes with the diagnosis of a fetal demise in a triplet pregnancy. The definite diagnosis of acardia was assessed sonographically by the presence of a reverse blood flow through the umbilical cord, reflex movements, limbs anomalies and discordance between femoral and crown-rump length. Two days after admission, the patient developed chorioamnionitis and the three fetuses were expelled.- - - - - - - - - - ranking = 8keywords = pregnancy (Clic here for more details about this article) |
5/40. Successful outcome after antibiotic treatment of postamniocentesis membrane rupture and chorioamnionitis in multiple pregnancy.Postamniocentesis chorioamnionitis is usually managed with induction of labor to prevent maternal sepsis and related morbidity and mortality. We report a case of chorioamnionitis in a triplet pregnancy after midtrimester genetic amniocentesis, in which multiple antibiotic treatment (ampicillin 2 g i.v. loading dose followed by 1 g i.v. every 6 hr; clindamycin 900 mg i.v. every 8 hr; gentamicin 120 mg i.v. loading dose followed by 100 mg i.v. every 8 hrs; and erythromycin 500 mg i.v. every 6 hr) for 7 days and delivery of the presumably infected triplet A successfully reversed the clinical symptomatology, allowing prolongation of pregnancy until 26 weeks and survival of the remaining fetuses. At age 2 years, both infants are doing well and are meeting their developmental milestones. The viable outcome of this management strategy suggests that antibiotic treatment and expectancy may be an option in selected cases of postamniocentesis chorioamnionitis in multiple pregnancies.- - - - - - - - - - ranking = 6keywords = pregnancy (Clic here for more details about this article) |
6/40. candida albicans chorioamnionitis associated with preterm labor and sudden intrauterine demise of one twin. A case report.BACKGROUND: Although cervicovaginal Candida infections occur in 20-25% of pregnancies, the incidence of ascending infection in these cases is only 0.8%, and such infection rarely causes chorioamnionitis. CASE: Sudden intrauterine fetal demise (IUFD) of twin A occurred in a diabetic primigravida presenting with a twin pregnancy and preterm labor at 33 weeks of gestation. Placental pathology and autopsy of the stillborn twin revealed extensive chorioamnionitis and fetal sepsis in the presence of candida albicans. Twin B was unaffected. CONCLUSION: In this case, C albicans chorioamnionitis seemed to be associated with sudden IUFD.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
7/40. Delayed delivery of second twin after chorioamnionitis and abortion of first twin at 21 weeks gestation.Delayed delivery is a relatively new term used to describe the delivery of one fetus after premature delivery of the first fetus. We describe a case where we used tocolysis and antibiotics to prolong a twin pregnancy for 35 days with excellent fetal outcome, after chorioamnionitis had caused the abortion of the first twin at 21 weeks gestation.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
8/40. Preventing recurrent second trimester group B streptococcus chorioamnionitis by intermittent prophylactic ampicillin.BACKGROUND: Whereas carrying group B streptococcus during pregnancy is common, second trimester group B streptococcus chorioamnionitis with intact membranes is rare, and recurrence of the latter problem even more so. CASE: A 38-year-old multipara with a history of recurrent second trimester group B streptococcus chorioamnionitis resulting in pregnancy loss was treated, beginning at 14 weeks' gestation, with monthly prophylactic ampicillin therapy throughout pregnancy and delivered a healthy male infant at term. CONCLUSION: In women with recurrent pregnancy loss due to second trimester group B streptococcus chorioamnionitis, an intermittent prophylactic antibiotic regimen throughout pregnancy might increase the probability of successful pregnancy.- - - - - - - - - - ranking = 6keywords = pregnancy (Clic here for more details about this article) |
9/40. sepsis due to clostridium perfringens after pregnancy termination with feticide by cordocentesis: a case report.We report a case of sepsis due to clostridium perfringens after termination of pregnancy at 22 weeks with feticide by cordocentesis. Three weeks earlier, the 41-year-old patient had undergone an amniocentesis and a full trisomy 13 karyotype had been discovered. Feticide was performed by injection of thiopental and potassium chloride after percutaneous umbilical foetal blood sampling through the same needle. The patient delivered vaginally with signs of chorioamnionitis and septicaemia. She recovered under broad-spectrum antibiotherapy. C. perfringens was present in maternal blood cultures, placental smears and foetal organs. We discuss the possible mechanisms of infection by C. perfringens, including inoculation of intestinal germs.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
10/40. Listeria infection during pregnancy: a 10 year experience.BACKGROUND: Although listeria monocytogenes is widely distributed in nature, it rarely causes clinical infection in previously healthy people. This microorganism, however, may cause severe invasive disease in pregnant women and newborns. OBJECTIVES: To investigate--in our pregnant population--the impact, severity and outcome of listeriosis on both mother and fetus. METHOD: The study was carried out at a level III, university two-hospital complex. In a retrospective chart review of 65,022 parturients during a 10 year period (1990-1999), we identified and evaluated 11 pregnant patients and their offspring with Listeria infection. RESULTS: chorioamnionitis with multiple placental abscesses were observed in all five placentae examined. Clinically, 4 of 11 parturients had a cesarean section for fetal distress (36.3%), as compared to the 14% mean CS rate in our general population. Two of 11 had a late abortion (18.1%), as compared with the 4% rate in our hospital. Four of 11 had premature labor (36%), which was about four times the rate in our population. Finally, although no intrauterine fetal death was recorded in our series, there was one neonatal death of a term infant (1/11, 9%), which is about 10 times higher than our corrected perinatal mortality rate. CONCLUSIONS: If not promptly and adequately treated, listeriosis in pregnancy may present serious hazards to the fetus and newborn through direct infection of the placenta and chorioamnionitis.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
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