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Coccidioidal placentitis with normal umbilical artery velocimetry
S A Nickisch1, L Izquierdo, M A Vill
1Divisions of Maternal Fetal Medicine and Reproductive Endocrinology Department of Obstetrics and Gynecology University of New Mexico School of Medicine, Albuquerque, NM, USA.
Infectious Diseases in Obstetrics and Gynecology
|January 1, 1993
Summary
Coccidioidal placentitis in pregnancy can be serious, but treatment with amphotericin B and monitoring with umbilical artery velocimetry allowed for a healthy full-term delivery.
Area of Science:
- Medical Mycology
- Obstetrics
- Maternal-Fetal Medicine
Background:
- Disseminated coccidioidomycosis during pregnancy poses significant risks for maternal and neonatal mortality.
- Coccidioidal placentitis is a rare complication with uncertain effects on placental function.
- This case report details the management of coccidioidal placentitis and its impact on placental function.
Purpose of the Study:
- To describe the management of a case of coccidioidal placentitis in pregnancy.
- To evaluate the utility of serial umbilical artery velocimetry in monitoring placental function in this condition.
- To report the outcome of pregnancy following treatment for coccidioidal placentitis.
Main Methods:
- Histological confirmation of coccidioidal placentitis.
- Treatment initiated at 28 weeks gestation with systemic and intrathecal amphotericin B.
- Serial monitoring of umbilical artery velocimetry (systolic/diastolic ratios).
Main Results:
- Successful treatment of coccidioidal placentitis with amphotericin B.
- Umbilical artery velocimetry revealed persistently normal systolic/diastolic ratios throughout monitoring.
- Reassuring fetal parameters were observed, supporting continuation of the pregnancy.
Conclusions:
- Amphotericin B is an effective treatment for coccidioidal placentitis during pregnancy.
- Serial umbilical artery velocimetry is a valuable tool for assessing placental function in pregnancies complicated by coccidioidal placentitis.
- Successful management allowed for a normal term delivery, indicating a positive fetal outcome.
