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Histologic manifestations of perinatal genital mycoplasmal infection
E Madan1, M P Meyers, A J Amortegui
1Department of Pathology, Marshall University School of Medicine, Huntington, WVa 25704.
Abstract:
Genital mycoplasmas are controversial gynecologic and obstetric pathogens; their role in perinatal morbidity and mortality is ill defined. This retrospective study was conducted to identify autopsy manifestations of perinatal genital mycoplasmal infection. Bacterial and mycoplasmal cultures were obtained from multiple organ sites, along with detailed clinical, autopsy, and histologic information. All materials were screened by two pathologists. Twenty-nine cases were included in the study. In 17 only a genital mycoplasma was isolated, and in 12 cases a genital mycoplasma plus another bacterial pathogen were identified. Significant histologic findings included subpericardial and pleural hemorrhages, polymorphonuclear leukocytes in alveolar spaces, hemorrhage, and tubulocytic changes in the adrenal glands. The placentas revealed villous edema, deciduitis, and funicitis. The changes identified as significant suggest that mycoplasmas either cause hypoxia or promote histologic changes that mimick hypoxia.
Insights
Genital mycoplasmas, often debated gynecologic pathogens, were studied in perinatal infections. Autopsy findings revealed specific histologic changes in organs and placentas, suggesting mycoplasmas may cause or mimic hypoxia.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Pathology
- Infectious Diseases
Background:
- Genital mycoplasmas are controversial pathogens in gynecology and obstetrics.
- Their precise role in perinatal morbidity and mortality remains unclear.
Purpose of the Study:
- To identify specific autopsy manifestations associated with perinatal genital mycoplasmal infections.
- To elucidate the pathological impact of genital mycoplasmas in perinatal outcomes.
Main Methods:
- Retrospective analysis of 29 perinatal cases with genital mycoplasmal cultures.
- Inclusion of clinical, autopsy, and histologic data, with dual pathologist screening.
- Microbiological cultures from multiple organ sites and placental examination.
Main Results:
- Histologic findings included subpericardial/pleural hemorrhages, alveolar polymorphonuclear leukocytes, and adrenal gland changes.
- Placentas showed villous edema, deciduitis, and funicitis.
- Genital mycoplasmas were isolated alone in 17 cases and with other bacteria in 12.
Conclusions:
- Perinatal genital mycoplasmal infection is associated with distinct autopsy findings.
- These findings suggest mycoplasmas may induce hypoxia or mimic hypoxic changes.
- Further research is needed to define the exact pathogenic mechanisms.