Document Detail

Emphysematous chorioamnionitis diagnosed by ultrasonography.
MedLine Citation:
PMID:  9259946     Owner:  NLM     Status:  MEDLINE    
Preterm labor, cervical cerclage (especially when performed as an emergency procedure), and diabetes mellitus are all associated with an increased risk of chorioamnionitis. It might be expected that the combination of all 3 could lead to especially severe infection. We report such a case. A woman with a history of two spontaneous midtrimester abortions had had cervical cerclage performed at 13 weeks. She was referred at 24 weeks' gestation with preterm labor, and the cervix was found to be dilated. An emergency repeat cerclage was performed. The following day, ultrasonography revealed the presence of intra-amniotic gas. Infection was confirmed by the presence of a purulent cervical discharge, a neutrophilia with a left shift, and an elevated C-reactive protein level. The cervical stitch was removed and labor induced. The infant was liveborn, but succumbed to the complications of prematurity and sepsis. E. coli was isolated. In her subsequent pregnancy, severe gestational diabetes was diagnosed and following pregnancy, permanent diabetes mellitus was confirmed. The combination of infection, diabetes, and intact membranes may lead to a particularly severe form of chorioamnionitis, with the production of gas within the amniotic cavity. Infection should be excluded before emergency cervical cerclage, especially in the woman with diabetes mellitus.
P Wein; C Bass
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of perinatology     Volume:  14     ISSN:  0735-1631     ISO Abbreviation:  Am J Perinatol     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-09-04     Completed Date:  1997-09-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  289-91     Citation Subset:  IM    
University of Melbourne, Department of Obstetrics and Gynecology, Australia.
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MeSH Terms
Chorioamnionitis / etiology,  ultrasonography*
Emphysema / etiology,  ultrasonography*
Escherichia coli Infections / diagnosis
Gestational Age
Infant, Newborn
Pregnancy Complications, Infectious / diagnosis
Pregnancy Outcome
Pregnancy in Diabetics / diagnosis
Ultrasonography, Prenatal / methods*

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