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[Infected chorionic hematoma as a cause of infection in the 2nd trimester]
M Weigel1, K Friese, W Schmitt
1Frauenklinik am Klinikum Mannheim, Fakultät für klinische Medizin, Universität Heidelberg.
Abstract:
Superinfected subchorionic haematomas are a rare septic focus in the 2nd trimenon. Symptoms being unspecific, the diagnosis has to be made by exclusion, in most cases. As the changes of a successful treatment of the manifest infection is poor, antibiotic prophylaxis as well as close laboratory controls and early antibiotic therapy should be discussed after sonographic diagnosis of an intrauterine haematoma. Two of our three patients reported on having suffered a miscarriage; only one pregnancy could be maintained after spontaneous depletion of the infected haemorrhage.
Insights
Superinfected subchorionic hematomas are a rare, difficult-to-diagnose infection in the second trimester. Early antibiotics and monitoring are crucial, as treatment outcomes for established infections are poor, impacting pregnancy viability.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Infectious Diseases in Pregnancy
Background:
- Subchorionic hematomas can become superinfected, presenting a rare septic focus during the second trimester.
- Unspecific symptoms often necessitate diagnosis by exclusion for superinfected hematomas.
Observation:
- Three cases of superinfected subchorionic hematomas were observed.
- Two patients had a history of miscarriage.
- Only one pregnancy was successfully maintained after spontaneous resolution of the infected hemorrhage.
Findings:
- Diagnosis of superinfected subchorionic hematomas is challenging due to non-specific symptoms.
- Established infections have a poor treatment response.
- Sonographic diagnosis warrants discussion of antibiotic prophylaxis, laboratory monitoring, and early antibiotic therapy.
Implications:
- Close monitoring and prompt intervention are essential for managing superinfected subchorionic hematomas.
- Antibiotic prophylaxis and early treatment may improve pregnancy outcomes.
- Further research is needed to optimize diagnostic and therapeutic strategies for this rare obstetric complication.