Intrauterine Infections

  • Dagmar K. Kalousek
  • Naomi Fitch
  • Barbara A. Paradice

Abstract

Our understanding of the role of intrauterine infection in the etiology of pregnancy loss has been seriously hampered by the large number of microorganisms associated with placental and fetal pathology. Difficulties in accurately diagnosing clinical disease in the mother, due to the fact that many infections have nonspecific symptoms or that the mother may have an asymptomatic disease, have also interfered with our investigations. Microbiologic diagnoses are further complicated by the fact that many putative fetal pathogens may reside normally in the maternal genital tract as commensal flora (e.g., group B streptococci, mycoplasmas). To make it more complex, obtaining appropriate, noncontaminated embryonic, fetal, and placental samples for culture in both early and late pregnancy loss is difficult. Special culture or detection techniques are required for some organisms (e.g., Chlamydia, Mycoplasma) and interpretations of microbial growth in cultures are often complicated by the presence of other microorganisms.

Keywords

Human Immunodeficiency Virus Amniotic Fluid Spontaneous Abortion Amniotic Membrane Rubella Virus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Anand A, Gray E, Brown T, Clewley PJ, Cohen BJ: Human parvovirus infection in pregnancy and hydrops fetalis. New Engl J Med 316: 183–186, 1987.PubMedCrossRefGoogle Scholar
  2. Blanco JD, Gibbs RS, Malherbe H, Strickland-Cholmley M, St. Clair Pi, Castaneda YS: A controlled study of genital mycoplasmas in amniotic fluid from patients with intra-amniotic infection. J Infect Dis 147: 650–653, 1983.PubMedCrossRefGoogle Scholar
  3. Boué A, Loffredo V: Avortment cause par le virus dl’herpes type H. Isolement du virus à partir de cultures de tissues zygotiques. Presse Med 78: 103–106, 1970.PubMedGoogle Scholar
  4. Cassell GM, Davis OR, Waites KB, Brown MB, Marriott PA, Stagus S, Davis JK: Isolation of Mycoplasma hominis and Ureaplasma urealyticum from amniotic fluid at 16–20 weeks of gestation. Sex Trans Dis 10: 294–302, 1983.Google Scholar
  5. Cooperman NR, Kasin M, Rajaschekazaiah KR: Clinical significance of amniotic fluid, amniotic membranes and endometrial biopsy cultures at the time of caesarean section. Am J Obstet Gynecol 137: 936–941, 1980.Google Scholar
  6. Cradock-WatsonJE, Miller E, Ridehalgh MKS, Terry GM, Ho Terry L: Detection of rubella virus in fetal and placental tissues and in the throats of neonates after serologically confirmed rubella in pregnancy. Prenat Diag 9: 91–96, 1989.CrossRefGoogle Scholar
  7. Desmonts G, Couvreur J: Congenital toxoplasmosis: A prospective study of the offspring of 542 women who acquired toxoplasmosis during pregnancy. Pathophysiology of congenital disease, in Thalhammer O, Baumgarten K, Pollack A (eds): Proceedings of the Sixth European Congress on Perinatal Medicine, Vienna. Stuttgart, Thieme, 1979, pp 51–60.Google Scholar
  8. Feinkind L, Minkoff HL: HIV in pregnancy. Clin Perinatol 15: 189–202, 1988.PubMedGoogle Scholar
  9. Freiberg J: Mycoplasmas and ureaplasmas in infertility and abortion. Fertil Steril 33: 351–359, 1980.Google Scholar
  10. Hameed S, Tejani N, Verma VL, Archibald F: Silent chorioamnionitis as a cause of preterm labour refractory to tocolytic therapy. Am J Obstet Gynecol 149: 726, 1984.PubMedGoogle Scholar
  11. Hanshaw JB, Dudgeon JA, Marshall WC (eds): Herpes simplex infection of the fetus and newborn, in Viral Diseases of the Fetus and Newborn, ed 2. Philadelphia, WB Saunders, 1985, vol 17, pp 132–153.Google Scholar
  12. Holzel M: Infection in pregnancy and the neonatal period, in Keeling JW (ed): Fetal and Neonatal Pathology. Berlin Heidelberg New York, Springer-Verlag, 1987, pp 265–293.Google Scholar
  13. Jauniaux E, Nessmann C, Imbert MC, Meuris S, Puissant F, Hustin J: Morphological aspects of the placenta in HIV pregnancies. Placenta 9: 633–642, 1988.PubMedCrossRefGoogle Scholar
  14. Kucera J: Down’s syndrome and infectious hepatitis. Lancet i:569–570, 1970.Google Scholar
  15. Leck I: Incidence of malformations following influenza epidemics. Br J Prev Soc Med 17: 70–80, 1963.PubMedGoogle Scholar
  16. Martin DM, Koutsky L, Eschenbach DA, Daling RJ, Alexander RE, Benedetti JK, Holmes KK: Prematurity and perinatal mortality in pregnancies complicated by maternal Chlamydia trachomatis infections. JAMA 247: 1585–1588, 1982.PubMedCrossRefGoogle Scholar
  17. Miller E, Cradock-Watson JE, Pollock TM: Consequences of confirmed maternal rubella at successive stages of pregnancy. Lancet ii: 781–784, 1982.Google Scholar
  18. Naesseus A, Foulan W, Cammu H, Goossens A, Lauwers S: Epidemiology and pathogenesis of Ureaplasma urealyticum in spontaneous abortion and early preterm labor. Acta Obstet Gynecol Scand 66: 513–516, 1987.CrossRefGoogle Scholar
  19. Naeye RL: Factors that predispose to premature rupture of the fetal membranes. Obstet Gynecol 60: 93–97, 1982.PubMedGoogle Scholar
  20. Ogilvie MM, Tearne FC: Spontaneous abortion after hand-foot-and mouth disease caused by Coxsackie virus A16. Br Med J 281: 1527–1528, 1980.PubMedCrossRefGoogle Scholar
  21. Peckham C, Marshall WC: Infections in pregnancy, in Barron SL, Thompson AM (eds): Obstetric Epidemiology. London, Academic Press, 1983, pp 209–262.Google Scholar
  22. Quinn PA, Butany J, Taylor J, Hannah W: Chorioamnionitis: Its association with pregnancy outcome and microbial infection. Am J Obstet Gynecol 156: 379–387, 1987.PubMedGoogle Scholar
  23. Ransome-Kuti O. Malaria in childhood. Paediatrics 19:319–340, 1972.Google Scholar
  24. Remington JS: Toxoplasmosis, in Charles D, Finlaid L (eds): Obstetric and Perinatal Infections. Philadelphia, Lea and Febiger, 1973, p 27.Google Scholar
  25. Romero R, Emamian M, Quintero R, Wan H, Hobbins JC, Mitchell MD- Amniotic fluid prostaglandin levels and intra amniotic infections. Lancet i:1380, 1986.Google Scholar
  26. Schachter J: Chlamydial infections. N Engl J Med 298: 490–495, 1978.PubMedCrossRefGoogle Scholar
  27. Schweitzer IL, Moseley JW, Aschcavai M, et al.: Factors influencing neonatal infection by hepatitis B virus. Gastroenterology 65: 277–283, 1973.PubMedGoogle Scholar
  28. Siegal M, Greenberg M: Poliomyelitis in pregnancy: Effect on fetus and newborn infant. J Pediatr 49: 280–288, 1956.CrossRefGoogle Scholar
  29. Sprecher S, Soumenkoff G, Puissant F, Degueldre M: Vertical trans- mission of HIV in 15-week fetus. Lancet ii: 288–289, 1986.Google Scholar
  30. Stoller A, Collman RD: Evidence of infective hepatitis followed by Down’s syndrome nine months later. Lancet ii:1221–1223, 1965.Google Scholar
  31. Taylor-Robinson: The male reservoir of Ureaplasma urealyticum. Paed Infect Dis 6 (Suppl 5): S234, 1987.Google Scholar
  32. Thorp JM, Jr, Katz VL, Fowler LI, Kurtzman JT, Bowes WA, Jr: Fetal death from chlamydial infection across intact amniotic membranes. Am J Obstet Gynecol 161: 1245–1246, 1989.PubMedGoogle Scholar
  33. Whyte RK, Hussain Z, deSa D: Antenatal infections with Candida species. Arch Dis Child 57: 528–535, 1982.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Dagmar K. Kalousek
    • 1
  • Naomi Fitch
    • 2
  • Barbara A. Paradice
    • 3
  1. 1.Department of PathologyThe University of British Columbia and BC Children’s HospitalVancouverCanada
  2. 2.Department of Pathology, Lady Davis Institute, Sir Mortimer B. Davis Jewish General HospitalThe University of British ColumbiaMontrealCanada
  3. 3.Embryopathology UnitBC Children’s HospitalVancouverCanada

Personalised recommendations