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Infections, preterm delivery, and perinatal death in midgestation
1Department of Pathology and Laboratory Medicine, Women and Infants Hospital, Providence, Rhode Island.
Rhode Island Medical Journal
|January 1, 1991
Summary
Amniotic fluid infection is a significant cause of pregnancy loss in mid-gestation. Coagulase-negative staphylococcus and streptococcus species were the most frequent bacterial culprits identified in these cases.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Pathology
- Infectious Diseases
Background:
- Amniotic fluid infection contributes significantly to pregnancy wastage during the second and early third trimesters.
- Mid-gestation fetal and neonatal deaths are often linked to intra-amniotic infections.
Purpose of the Study:
- To investigate the association between amniotic sac infection and perinatal mortality in mid-gestation.
- To identify common pathogens responsible for amniotic fluid infections leading to fetal and neonatal demise.
Main Methods:
- A retrospective analysis of 1119 perinatal autopsies was conducted.
- Cases of amniotic sac infection associated with fetal or neonatal death were identified and analyzed.
- Pathogen identification was performed through microbiological cultures.
Main Results:
- Amniotic sac infection was associated with death in 133 fetuses and neonates during mid-gestation.
- These cases represented approximately 12% of all perinatal autopsies and 20% of mid-gestation perinatal autopsies over a decade.
- Gram-positive organisms, particularly coagulase-negative staphylococcus, group B Streptococcus, and Streptococcus viridans, were the most frequently isolated pathogens.
Conclusions:
- Amniotic fluid infection is a critical factor in mid-gestation perinatal mortality.
- Effective management and prevention strategies are crucial to reduce pregnancy wastage.
- Gram-positive bacteria are the predominant pathogens in mid-gestation intra-amniotic infections.