Acute chorioamnionitis and the disorders that produce placental insufficiency.
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This study was done in order to correlate the C-Reactive Protein levels (CRP) determined by nephelometric technique, with other infection indicators, and to know its exactness in early detection of chorioamnioitis. Thirty patients were prospectively studied with pregnancies from 28 to 35 weeks of gestation with diagnosis of premature rupture of membranes (PRM); and were compared to control group (30 patients) with similar gestation without PRM, infection, autoimmune diseases or chronic inflammation. The value for CRP was 2 mg/dl. The study group included 17 patients considered as positive, and 13 negative; the differences in CRP values in infected women was significant and not infected ones with a probability less than 0.001 (Fisher), with a sensitivity of 94.12%, and specificity of 100% positive predictive value of 100%, and a negative predictive value of 98.86%. The present data show that CRP is an early detector of amniotic infection.
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Interruption and expulsion of a stillborn fetus in patients with an IUD Candida albicans chorioamniotic infection is a very rare obstetrical event. Generally, the diagnosis is established in retrospect by the routine histological examination of the products of expulsion and the demonstration of a specific chorioamniotic infection. This infection occurs by upward dissemination in a pregnancy where the amniotic membrane is unbroken, with the IUD being the facilitating factor of infection. Prevention appears to be the withdrawal of an IUD at the beginning of pregnancy.
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A retrospective review of placental material derived primarily from preterm deliveries was conducted and inflammatory changes graded on a scale of 0-3. Reviewers were blind as to the clinical outcomes. Other reviewers, unaware of the pathologic results, surveyed the clinical data, and results were combined for analysis. The findings suggest that placental and membrane inflammation probably precedes preterm spontaneous rupture of membranes in 8-30% of cases without labor. The duration of ruptured membranes and labor enhance the frequency of inflammation. Inflammation is not associated with significant puerperal infection unless cesarean delivery occurs. Perinatal morbidity and mortality were not significantly enhanced nor associated with conservative management of spontaneous preterm rupture of membranes in this population beyond the influence of fetal weight and gestational age.
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A clinical case of a pregnant patient with chorioamniotis and E. coli sepsis during the third trimester, whose principal clinical symptom was an icteric syndrome, is presented. Jaundice during pregnancy represents many etiologic possibilities, nevertheless the most frequent causes are hepatic or biliary tract diseases, some systemic illness like infections or eclampsia can be associated to this syndrome. It is proposed that, although is not a common cause, chorioamniotis must be considered between the causes of jaundice during pregnancy.
In relation to a case of pulmonary candidiasis in a seventeen week fetus, the authors review the cases of fetal candidiasis not resulting from contamination during delivery.
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