[Serological diagnosis of listeriosis in pregnant women].
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The risk of acquired toxoplasmosis during pregnancy (1.2% of susceptible women) and of transmission of Toxoplasma gondii to the fetus (1% of neonates) was estimated from results of serial serological tests done in 15 132 pregnant women from 1977 to 1982. Congenital toxoplasmosis was studied in the product of 47 induced abortions and in 34 neonates. In aborted fetuses, congenital toxoplasmosis was established by serological tests in 3 cases and based on histological findings in 4. Among the neonates, 11 cases are reported; the 5 severe cases are due to early contamination.
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Programs to prevent congenital toxoplasmosis based on the evaluation of serologic tests can be performed at three periods: 1. before pregnancy (serologic, epidemiologic screening of "at risk" women); 2. during pregnancy (detection by seroconversion); 3. at delivery (diagnosis of evident or latent congenital infection). The screening devices, the IHA, IFA, and IgM-IFA tests, should be performed first and after 3 weeks possibly repeated. During pregnancy the observation of seroconversion or, in any case, an increase in serologic titer at the second blood withdrawal and, at delivery, high serologic titers are signs of fetal risk. The significance of the data has furthermore to be evaluated by specific IgM quantification on pure serologic fractions and by in vivo isolation of Toxoplasma gondii from amniotic fluid, placenta, or the newborn CSF, blood, and/or tissue. This data may suggest the necessity of therapeutic termination of pregnancy or application of a specific chemoprophylaxis/chemotherapy.
118 late abortions were investigated at week 18-28 of pregnancy with the use of light and immunofluorescent microscopy. Intrauterine infections were found in 86 cases including 44 observations of mycoplasmosis, 16-M. hominis, 18-M. pneumoniae, 10-U. urealyticum. Histologically similar changes were found in the form of vacuolar degeneration of the amnion, trophoblast of the basal lamina and foetal coats, inner foetal organs and neuroepithelial cells in the central nervous system. Apart from this, focal leucocytic-lymphocytic infiltration was observed. Marked myeloid hematopoiesis was found in the liver. Maximum changes were found in the placenta and foetal organs in chronic placental deficiency.
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Inoculation of the udders of cows with the virus of enzootic abortion of ewes resulted in a severe acute mastitis. The mastitis was characterized clinically by pyrexia, anorexia, decreased milk production, swelling and marked alteration in the physical quality of the milk. The basic lesion was necrosis of alveolar and duct epithelial cells. Virus particles were demonstrated in all levels of the mammary gland three days after inoculation illustrating the rapid spread of the agent. Cells resembling Reed-Sternberg cells and similar to those seen in experimental mastitis produced by the virus of infectious bovine rhinotracheitis were seen in tissues collected six and nine days after inoculation.
Bacterial vaginosis is associated with adverse pregnancy outcomes across all gestational ages. It is linked to first and second trimester fetal loss, chorioamnionitis, preterm delivery, low-birthweight infants and maternal/neonatal infectious morbidity. Infants who survive preterm birth are at an increased risk of subsequent neurodevelopmental delays and handicap, more so if there was underlying choriomnionitis. The exact mechanisms and pathways through which bacterial vaginosis exerts these adverse effects are incompletely understood. Not surprisingly, intervention studies in bacterial vaginosis-positive pregnant women have shown conflicting results, both in women at high and low risk of preterm birth. A much better understanding of the pathobiology of bacterial vaginosis in pregnancy is required to focus the designs of intervention studies on the disturbed cellular and biochemical pathways. Such studies may address the benefits of the treatment of bacterial vaginosis before conception and during early pregnancy, to determine whether treatment in populations of pregnant women may be beneficial.
In 1980, 16 abortions or stillbirths occurred and 26 deformed calves were born in a beef herd of 115 Friesian cross Hereford cows mated to Charolais bulls. The deformities were principally arthrogryposes with contractures, particularly of the forelimbs, and various skull abnormalities. Following investigation it was considered highly unlikely that hereditary causes, infectious agents or a nutritional deficiency were responsible. The most likely cause was exposure to an unidentified teratogen early in pregnancy.
A broad variety of microorganisms are capable of causing fetal infections. Among viral agents prominent are the human cytomegaly virus (HCMV), herpes simplex virus (HSV), human immundeficiency virus (HIV), varicella, herpes zooster, rubella, parvovirus B19, measles and the hepatitis B and C viruses. Protozoa such as toxoplasma and spirocheta pallida, causing congenital syphilis are equally important. Bacterial infections are responsible for in uterus aquired listeriosis, tuberculosis, and group B streptococcus infections. Fungi including candida albicans complete the circle of infections pathogens. Infectious microrganisms may reach the fetus through the placenta are may ascend through the birth canal. The quoted pathological agents threaten the health and life of the fetus directly by the biological derangements they cause and also by inducing abortion or premature birth. The clinical manifestations include retarded growth, central nervous system damage and skin lesions. The invariable therapeutic measures vary but in general, are limited value in cases of in utero acquired infections.