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Ureaplasma/Mycoplasma-infected amniotic fluid: pregnancy outcome in treated and nontreated patients
T G Berg1, K L Philpot, M S Welsh
1Division of Maternal-Fetal Medicine, Nebraska Medical Center, Omaha 68198-3255, USA.
Objective:
To determine if treatment of a positive amniotic fluid culture for mycoplasmal colonization obtained at genetic amniocentesis is associated with improved pregnancy outcome.
Study Design:
A retrospective analysis of 2718 genetic amniocentesis specimens cultured for Ureaplasma/Mycoplasma was undertaken. Specimens were obtained between March 1993 and January 1997. The Irvine culture kit was used to culture all specimens. Data collected included indication for amniocentesis, gestational age at amniocentesis, karyotype, gestational age at delivery, pregnancy outcome, and any antimicrobial treatment.
Results:
During this time period 44 patients were found to be culture-positive for Ureaplasma/Mycoplasma. Thirty-five were treated with oral erythromycin. Mid-trimester loss was 11.4% and 44.4% (p = 0.04) in the treated and untreated groups, respectively. Preterm delivery was similar in the two groups, 19.4% and 20% (p = NS).
Conclusion:
Treatment of an amniotic mycoplasmal colonization with erythromycin was associated with fewer mid-trimester losses after genetic amniocentesis. Preterm delivery rates between the two groups were similar, which may indicate recolonization.
Insights
Treating mycoplasma in amniotic fluid after genetic amniocentesis with erythromycin reduced mid-trimester pregnancy loss. Preterm delivery rates remained similar, suggesting potential recolonization.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Infectious Diseases in Pregnancy
Background:
- Mycoplasmal colonization of amniotic fluid can occur during genetic amniocentesis.
- The impact of treating such colonization on pregnancy outcomes is not well-established.
Purpose of the Study:
- To investigate the association between treating positive amniotic fluid cultures for mycoplasma and pregnancy outcomes following genetic amniocentesis.
Main Methods:
- Retrospective analysis of 2718 genetic amniocentesis specimens cultured for Ureaplasma/Mycoplasma.
- Comparison of pregnancy outcomes between treated (oral erythromycin) and untreated culture-positive patients.
Main Results:
- 44 patients had positive amniotic fluid cultures for Ureaplasma/Mycoplasma.
- Treated group (n=35) had significantly lower mid-trimester loss (11.4%) compared to the untreated group (44.4%, p=0.04).
- Preterm delivery rates were similar between treated (19.4%) and untreated (20%) groups (p=NS).
Conclusions:
- Erythromycin treatment for amniotic mycoplasma colonization after genetic amniocentesis is linked to reduced mid-trimester pregnancy loss.
- Similar preterm delivery rates may suggest a need for further investigation into recolonization or other factors.