[Infectious and hyperthermic diseases in early pregnancy].
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Mothers of anencephalic infants were asked about febrile illness and sauna bathing during their pregnancies. In 7 of 63 affected pregnancies (11%), a history of maternal hyperthermia near the presumed time of anterior neural-groove closure was given. 5 had fever with a maximum recorded temperature ranging from 38.9 to 40.0 degrees C, each case being secondary to a different type of illness. The other 2 had possible hyperthermia episodes as a consequence of sauna bathing, with no infectious agent involved. The frequencies of hyperthermia at the same period of gestation in two control groups were 0% and 0.1%. This excess frequency of maternal hyperthermia at the period of anterior neural-groove closure, and the differing natures of its causes, imply that hyperthermia itself may be an aetiological factor in anencephaly.
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Listeriosis during pregnancy is generally considered to result in an intrauterine infection which affects the fetus before birth or in the perinatal period. A case of listeriosis in a 38-yr-old diabetic woman with an influenza-like disease in her 32nd wk of pregnancy is presented. Two successive blood cultures were positive for Listeria monocytogenes type 4b and her serum showed a rising titer for agglutinins to this organism. After antibiotic treatment of the patient she gave birth to a healthy child.
The matched pair system of the Finnish Register of Congenital Malformations was used to search for association between defects of the central nervous system (CNS), and maternal diseases and/or drug consumption during pregnancy. The study material consisted of 710 cases with CNS defects and their controls. Significant associations were found for the following conditions: influenza, threatened abortion, depressive state, toxemia of pregnancy, diabetic mothers, and for the consumption of the following drugs: salicylates, pyrazolones/anilines, euphoristic analgesics, sympathomimetics, barbiturates, and cough medicines. 259 cases with polydactyly and their controls were also compared, with a view to demonstrating what biases might be introduced by the case-control method. After utilizing the possibilities of this design for examining the above mentioned significant associations, the factors to be seriously considered were reduced to the following ones: influenza, depressive state, toxemia of pregnancy, diabetic mothers and cough medicines.
Evidenc of first-trimester fetal syphilis was sought in the products of conception in a therapeutic abortion clinic. During two collection periods of one week, five patients with serologic and clinical data consistent with recent syphilitic infection were identified. Their conceptuses were carefully examined by silver and immunofluorescent stains for the presence of Treponema pallidum. Two of these five conceptuses (9 and 10 weeks' gestation) were found to contain T. pallidum by these methods. The literature supporting the Langhans layer/five months' placental barrier theory is reviewed and discussed in view of these two first-trimester cases.
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In 23 out of 290 perinatal deaths in Addis Ababa, mycoplasma T strains were the only organisms responsible for congenital pneumonia and death. All but 2 of the infants were stillborn, 16 dying during the last six weeks of gestation. Infections apparently occurred through intact fetal membranes.
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Kapos's varicelliform eruption usually occurs in persons with active skin disease of various types; however, in atopic dermatitis the condition may occur when the underlying disease is inactive. Two cases of widespread herpes simplex infection associated with Darier's disease are reported. In both cases, infection occurred in the absence of preexisting Darier skin lesions. In one case there was no previous history of Darier's disease. The infection occurred in the third trimester of pregnancy, but it did not appear to affect the infant or the placenta. In the second case, the Darier's disease was in remission at the time of onset of the virus infection.
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In a population of pregnant women, the prevalence of group-B streptococcal carriage was relatively low. During the 3rd trimester of pregnancy 5-6% of women haboured group-B streptococci and 8-3% were positive at the onset of labour. Some 42% of women who gave positive cultures in labour had given negative cultures during the 3rd trimester and 19% of women who were positive during late pregnancy were culture-negative in labour. The conversion of culture status observed in these women suggests that carriage may be intermittent or that new acquisition of genital-tract streptococci may occur in late pregnancy. The unpredictability of conversion diminishes the reliability of a single culture taken during the 3rd trimester of pregnancy.
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A total of 244 pregnant women, 172 in the first and 72 in the third trimester, were screened for genital herpes simplex (HSV) and cytomegalovirus (CMV) infections using virus isolation, cytological examination and serological studies. In addition, immuno-fluorescence staining of exfoliated cervical cells was used for the detection of HSV infections. Herpes simplex virus (HSV) could not be isolated and no characteristic HSV altered cells were found in cytological (PAPA) smears. Cytomegalovirus was isolated four times but PAPA smears obtained from these patients were also normal. In 34 (14%) patients HSV antiserum detected immunofluorescence positive exfoliated cervical cells. Overall, 14% of patients had HSV-2 antibodies and 71% CMV antibodies. No differences between the first or third trimesters in these respects were noted.