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Fetal wastage as a consequence of Mycoplasma pulmonis infection in mice.

The effect of Mycoplasma pulmonis, strain JB, on the outcome of pregnancy in TO mice was studied. The mice were infected intravenously before or after mating and the fetuses were examined at autopsy just before parturition. An increase in the number of abnormal pregnancies was noted in mice infected about 2 weeks before mating, and there was a significant increase in the number of fetuses which died mid-way through pregnancy. Mycoplasmas were not isolated from any of the fetuses although the organisms reached the joints of the pregnant mice and caused arthritis. It is possible, therefore, that maternal upset was a factor in these abnormal pregnancies. In mice infected at various times after mating, abnormal pregnancies were most frequently seen in those infected 9 days after mating. There was an increase in the number of both mid- and late-stage fetal deaths in these mice and also an increase in the number of late-stage fetal deaths in mice infected 5 days after mating. Mycoplasmas were isolated not only from most of the dead fetuses but also from living ones which suggests that in most instances death was probably due to maternal infection and disturbance rather than fetal infection per se. The possibility of modifying this mouse model by establishing a chronic genital tract infection is discussed as a means of investigating the role of mycoplasmas in human abortion.

Animals↗

Toxoplasmosis and other causes of abortions in sheep from north central United States.

Between 1983 and 1989, we examined 1,201 aborted fetuses and dead lambs from the north central United States. Toxoplasmosis was diagnosed in 17.5%, campylobacteriosis in 9.9%, chlamydiosis in 4.7%, and miscellaneous infections in 15.1%. Inflammatory lesions suggestive of infectious causes were seen in 13%. Noninfectious causes were identified in 6.1%, and a diagnosis was not reached in 33.3%. An agglutination test was used to detect Toxoplasma gondii-specific antibodies in ovine fluids. Toxoplasma gondii antibodies were detected in 223 of 1,064 (20.9%) fluids from fetuses and dead lambs. Of 201 seropostive (greater than or equal to 16) fetuses and lambs, T gondii antibody titers (reciprocal) were 16 (21 fetuses and lambs), 32 (10 fetuses and lambs), 64 (2 fetuses and lambs), 128 (7 fetuses and lambs), 256 (9 fetuses and lambs), 512 (5 fetuses and lambs), 1,024 (15 fetuses and lambs), 2,048 (13 fetuses and lambs), 4,096 (13 fetuses and lambs), 8,196 (13 fetuses and lambs), 16,392 (19 fetuses and lambs), and greater than or equal to 32,784 (74 fetuses and lambs).

Abortion, Habitual↗

[No consensus on the definition, diagnosis and treatment of habitual abortion in the Netherlands].

OBJECTIVE: To review the current policy in diagnosis and treatment of recurrent miscarriage in the Netherlands. DESIGN: Cross-sectional survey. METHOD: A printed questionnaire was sent in 1996 to all 125 departments of gynaecology in the Netherlands with questions about definition, investigation and therapy of recurrent miscarriage. RESULTS: The response rate was 90% (n = 112). Twenty-nine per cent of the respondents defined recurrent miscarriage as having two or more abortions and 71% as three or more abortions. In 42% of the departments a diagnostic protocol for recurrent miscarriage was present. Diagnostic investigations most frequently performed were vaginal ultrasound (79%), parental chromosome analysis (78%), thyroid-stimulating hormone (72%), lupus anticoagulant (69%), blood glucose (65%), hysterosalpingography (56%) and anticardiolipin antibodies (IgG, IgM) (56%). Therapy most frequently applied was prescription of folic acid (53%). CONCLUSION: The definition of recurrent miscarriage differed. Uncertainty about a rational diagnostic approach was evident from the large number of tests requested by 20-50% of the respondents. Some diagnostic tests like immunological investigation and search for infectious factors were not followed by a therapeutical intervention.

Abortion, Habitual↗

[Complications of illegal induced abortions at Bamako (Mali) between December 1997 and November 1998].

We carried out a descriptive retrospective study over a period of one year, in the Gynecology and Obstetrics Referrals Department of Gabriel-Touré Hospital at Bamako. We analyzed 1,081 files of patients presenting at the department with complications of spontaneous or induced abortion. We identified and studied 189 cases of illegal induced abortions. The patients were young (mean age 21.8 years), of a low socioeconomic level and most (71.4%) had no living child. The gestational age of the fetus was less than 12 weeks for 19.5% of the women and between 13 and 16 weeks for 47.6%. The abortions were carried out by traditional practitioners (3.7%), general practitioners (9%), trainee nurses (10.5%) and state nurses and midwives (57.1%). In more than half the cases (71.4%), the abortion took place at the home of the practitioner. Several methods of abortion were used (e.g. curettage, uterine probes). In 44.4% of the cases, the woman refused to comment on the reasons for the abortion. The other women cited mostly academic reasons (20.63% of cases) and fear of their parents (13.22%). The main reasons for consultation were bleeding (51.3%), hyperthermia (35.4%), pain (9. 52%) and neurological problems (3.1%). Three types of complication were identified: bleeding (47%), infectious complication (33.3%) and drug poisoning (4.2%). The rate of maternal mortality was 10% and the management of the patients required surgical (from curettage to hysterectomy) and medical treatment, with a mean stay in hospital of 10 days.

Abortion, Illegal↗

[Positive HIV (human immunodeficiency virus) serology in the pregnant woman: current data on its management. Apropos of a continuous series of 56 cases].

56 cases of pregnant women with a positive HIV serology were reported in 20 months at the Maternity of the Nice Hospital Center. In 10 cases, there were clinical signs of the disease (9 ARC-Syndrome, one case of AIDS). The predisposing factor was most of the time drug addiction, 53 cases (94.5%) and one case occurred after a blood transfusion. In the majority of the cases (52%) the pregnancy was pursued because of the late term or the patient's decision. A therapeutic abortion was performed in 12 instances (25%) and an interruption before 12 weeks of amenorrhea in 15 cases. 24 women delivered. The obstetrical complications were frequent with especially a fetal death in utero, five premature deliveries and fifteen hypotrophies. A severe infectious complication (septicemia, pneumopathy secondary to Pneumocystis carinii) was observed in 9 cases, a marked thrombopenia causing profuse post-partum haemorrhages in one case. Finally, one woman died 35 days after delivery. The study of the consequences on the child is incomplete because of insufficient follow-up: all children were sero-positive at birth and among thirteen children aged between 12 to 20 months, there were one death, one AIDS syndrome, 4 ARC-syndrome, 4 sero-positive and 3 sero-negative. The notion of HIV sero-positivity in a pregnant woman presents serious problems for the obstetrician. Decompensation of the disease during the pregnancy is uncertain but it is now confirmed that the child is affected, and this is a well established fact. These important consequences lead to propose, at this time a therapeutic interruption of pregnancy when possible, depending on the term, and when accepted by the patient.

AIDS-Related Complex↗

Toxoplasma antibodies and spontaneous abortion.

One hundred and fifty-two women with spontaneous abortion were investigated by hemagglutination (HA) and immunofluorescence antibody (IFA) tests for toxoplasmosis. In 48 cases, quantitive immunoglobulin (Ig) studies and mouse inoculation with gestational material were performed. Positive toxoplasma antibody titers were observed in 62 cases (40.8%) using HA and in 52 cases (38.2%) using IFA. This prevalence was significantly higher than that observed in 80 normal women who served as controls. Toxoplasma gondii was isolated in two cases. No correlation was found between antibody titers and IgG, IgM or IgA levels. We conclude that toxoplasmosis should be considered as the cause of abortion when a patient's antibody titer exceeds 1:256.

Abortion, Spontaneous↗

Detection of rubella virus in fetal and placental tissues and in the throats of neonates after serologically confirmed rubella in pregnancy.

From 35 therapeutic abortions performed because rubella had occurred at 2-19 weeks of pregnancy, 120 fetal organs, 12 specimens of mixed products of conception, and 15 placentae were tested for rubella virus. Virus was isolated from 10 out of 11 fetuses (91 per cent) from women infected at 2-8 weeks, from 5 out of 8 (63 per cent) infected at 9-10 weeks, and from 2 out of 16 (13 per cent) infected at 11-19 weeks. Hybridization tests for viral RNA on 39 fetal organs from eight cases revealed infection in four additional fetuses. Virus was isolated from only 3 out of 15 aborted placentae, but hybridization tests on six placentae revealed infection in three additional specimens. Hybridization was superior to virus isolation for detecting rubella infection in products of conception and is therefore potentially the better method for examining chorionic villus biopsies. Rubella virus was isolated from the throats of 4 out of 9 infants (44 per cent) infected during the first 12 weeks of gestation, but from none of 13 infected after 17 weeks. Infants in the latter group are unlikely to infect susceptible contacts.

Abortion, Therapeutic↗

Experimental Q fever in sheep.

The aim of the present investigation is the complex study of experimental infection in pregnant ewes by means of clinical, serological, biological, histological and Electron microscopy methods. Four ewes, pregnant from the 2nd to 5th month, were infected by intravenous (in one case by intraperitoneal) routes with a C. burnetii strain at 10(6) ID 50/ml. The clinical illness in all of the animals was characterized by fever and two-phase temperature reaction on the 5th and 12th days. The clinical symptoms were as follows: torpidity, reduced appetite, thirst, conjuctivitis, rhinitis, rapid breathing. As a result of the developed latent infection, after the acute stage, the animals gave birth to three unviable lambs who died within 24 h. Another lamb was still-born. The lambs showed cachexia, arthritis, ataxia, wrinkled skin. The highest CF-titers (1:256-1:512) were reached on the 40th day, but serum antibodies (1:8-1:32) first appeared on the 8th day. The titers began to decrease on the 60th day. The pathomorphological changes testify to a latent infection characterized by placentitis, lymphocellular proliferation of the lamb's parenchymal organs and lymph nodes, multiple thromboses, interstitial pneumonia and plural proliferative changes. The EM exam showed rickettsiae in placentas mainly in the form of inclusions in cytoplasm of leukocytes and epithelial cells.

Abortion, Veterinary↗

Experimental treatment of Brucella melitensis infection in sheep with oxytetracycline alone or combined with streptomycin.

The efficacy of oxytetracycline (OTC) alone or combined with streptomycin in the treatment of 118 Najdi ewes believed to have been naturally infected with Brucella melitensis, was evaluated by culture of selected tissues and organs at slaughter. Groups of sheep were given 250, 500 or 1,000 mg of OTC intraperitoneally (i/p) daily for six weeks and in the respective groups at necropsy 52, 69 and 100% of sheep were found to be Brucella-free. Treatment with 250 mg OTC (daily for six weeks i/p) combined with 1,000 mg streptomycin (daily for three weeks intramuscularly) increased the percentage of Brucella-free sheep to 82%. When a group of sheep were each inoculated i/p with 1,000 mg of long-acting OTC every three days over a period of six weeks, 75% of them were Brucella-free at necropsy. B. melitensis was isolated from all (24) non-treated (control) sheep. The results showed that long-term treatment with a high dose of OTC alone had succeeded in eliminating B. melitensis from a group of 16 naturally infected sheep.

Abortion, Veterinary↗

First demonstration of protective immunity against foetopathy in cattle with latent Neospora caninum infection.

The parasite Neospora caninum is an important cause of abortion in cattle world-wide. Chronically infected dams transmit the parasite transplacentally and infected foetuses may be aborted or born chronically infected but clinically normal. Chronically infected cows repeatedly transmit the parasite to foetuses in several pregnancies and some may abort more than once suggesting that the immune response in these cattle is compromised during pregnancy. To investigate the nature of the immune response in chronically infected cattle, five naturally, chronically infected cows were challenged with N. caninum tachyzoites at 10 weeks of gestation. No foetopathy occurred and all five delivered live calves at full-term. In four naive pregnant cows challenged at the same time, all four foetuses died within 3-5 weeks of challenge. Of the five live calves born to the chronically infected challenged cows, three were transplacentally infected with N. caninum. The kinetics of the maternal anti-N. caninum antibody responses during gestation suggested that these transplacental infections were not the result of the superimposed challenge, but the result of the recrudescence of the maternal chronic infection-which occurred concurrently in non-challenged, chronically infected pregnant controls. These data provide the first experimental evidence that protective immunity occurs in neosporosis. They also suggest that whilst immunity to a pre-existing infection will protect against an exogenous challenge, this protective immunity will not prevent transplacental infection. This implies that a subtle form of concomitant immunity exists in chronically infected cattle and has important implications for vaccine development.

Abortion, Veterinary↗