Progress in pathogenesis and management of clinical intraamniotic infection

Article Abstract:

Infection of the pregnant uterus and its contents is known as intraamniotic infection. Symptoms of this common and acute complication of pregnancy include bacteremia, or bacterial infection of the blood, and shock, or insufficient blood flow to the heart and other tissues. Intraamniotic infection differs from histologic chorioamnionitis, which is characterized by inflammation of the fetal membranes and accumulation of polymorphonuclear cells (a type of white blood cell) in the placenta and its membranes. The incidence (number of cases) of histologic chorioamnionitis is greater than that of intraamniotic infection. Histologic chorioamnionitis occurs in 20 percent of full-term pregnancies and is rarely associated with intraamniotic infection. Histologic chorioamnionitis affects as many as 60 percent of premature pregnancies associated with infant birth weights between 1,000 and 1,500 grams (2.2 to 3.3 pounds). The incidence of intraamniotic infection ranges from one to four percent of pregnancies. The disease may develop after prolonged rupture of the membranes, prolonged labor or may originate from the bloodstream. The most common infective agents in intraamniotic infection are anaerobes, genital mycoplasmas, group B streptococci, and Escherichia coli. Group B streptococci and E. coli often cause bacteremia associated with intraamniotic infection. Clinical evaluation and laboratory tests help to diagnose intraamniotic infection. Treatment consists of administering antibiotics to the mother at delivery. Drug therapy consists of a penicillin combined with an aminoglycoside; clindamycin may be added after cesarean delivery. Intraamniotic infection may be complicated by an increased rate of cesarean section, and bacteremia in the mother and newborn. The outcome of intraamniotic infection worsens with: (1) infection of the amniotic fluid with E. coli and group B streptococci; (2) low birth weight infants; and (3) delay of antibiotic treatment of the mother until after delivery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Amnion, Chorioamnionitis

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Evidence relating bacteria vaginosis to intraamniotic infection

Article Abstract:

Bacterial vaginosis (gardnerella vaginalis, non-specific vaginitis), is a common bacterial infection of the vagina. Two organisms, gardnerella vaginalis and mycoplasma hominis, are often found together in vaginal secretions. Bacterial vaginosis has been detected in women having early labor, early delivery, premature rupture of the membrane surrounding the fetus (amniotic membrane) and infections of the amniotic fluid which surrounds the fetus. The role of the two bacterial organisms in causing infections in amniotic fluid was evaluated in 408 patients. It was learned that women with vaginosis infections (69 percent) were more likely to develop amniotic fluid infections than patients without vaginosis infections (46 percent). Those women with infections in the amniotic fluid were more likely to be infected with G. vaginalis and M. hominis bacteria together. Women already at risk for amniotic fluid infection, namely those undergoing invasive internal monitoring and those experiencing premature rupture of membranes, are at an even higher risk if a vaginosis infection is present at the same time. It is suggested that preventive measures be taken in these high risk women.

Analysis, Bacterial vaginitis

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Detection of intra-amniotic infection in a rabbit model by proteomics-based amniotic fluid analysis

Article Abstract:

A study was conducted to identify intra-amniotic infection caused by several different organisms in a rabbit model by using proteomics. Amniotic fluid proteomic analysis was able to detect intra-amniotic infection in this experimental rabbit model, while S100 proteins might be involved in the host inflammatory response to intra-amniotic infection.

United States, Science & research, Health aspects, Premature labor, Proteomics, Premature labour

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