Document Detail


Infection and labor. VI. Prevalence, microbiology, and clinical significance of intraamniotic infection in twin gestations with preterm labor.
MedLine Citation:
PMID:  2403156     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to establish the prevalence, microbiology, and outcome of microbial invasion of the amniotic cavity in twin gestation presenting with preterm labor and intact membranes. Amniocenteses were performed on both sacs of 46 women with twin gestations, preterm labor, and intact membranes. Indigo carmine was injected to ensure sampling of both amniotic sacs. Amniotic fluid was cultured for aerobic and anaerobic bacteria, Mycoplasma hominis, and Ureaplasma urealyticum. A positive amniotic fluid culture of at least one sac was noted in 10.8% (5/46) of patients admitted in preterm labor and in 11.9% (5/42) of women delivered of preterm neonates. Of the five patients with microbial invasion of the amniotic cavity, three had microorganisms isolated from both sacs. The presenting sac was involved in all cases, supporting an ascending route for microbial invasion of the amniotic cavity in twin gestation. Polymicrobial infection was found in three of the eight amniotic sacs with positive cultures. In two cases different organisms were isolated from each sac. All patients with positive amniotic fluid cultures were delivered of preterm infants within 48 hours of amniocentesis. Patients with positive amniotic fluid cultures presented with preterm labor at an earlier gestational age and with more advanced cervical dilatation than did women with negative amniotic fluid cultures. Clinical evidence of chorioamnionitis subsequently developed in two of five women with positive amniotic fluid cultures. The interval between amniocentesis and delivery was shorter in women with positive amniotic fluid cultures than in women with negative amniotic fluid cultures (median: 3.5 vs 168 hours, p less than 0.0001). Infants born to women with microbial invasion of the amniotic cavity had a lower median birth weight and a higher incidence of respiratory distress syndrome than those born to women with negative amniotic fluid cultures (birth weight: 1085 vs 1975 gm, p = 0.024; respiratory distress syndrome: 37.5% vs 8.3%, p = 0.04).
Authors:
R Romero; F Shamma; C Avila; C Jimenez; R Callahan; J Nores; M Mazor; C A Brekus; J C Hobbins
Related Documents :
20519696 - The severity of chorioamnionitis in pregnant sheep is associated with in vivo variation...
9165446 - Effect of the environment on fetal skin wound healing.
6496126 - Possible origin of amniotic fluid constituents affecting thromboplastic activity.
3544656 - Intrauterine volume in pregnancy.
18249146 - Mitochondrial respiratory chain complex assembly and function during human fetal develo...
7479596 - Ultrasound diagnosis of the pena shokeir phenotype at 14 weeks of pregnancy.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  163     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1990 Sep 
Date Detail:
Created Date:  1990-10-24     Completed Date:  1990-10-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  757-61     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT 06510.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Amniotic Fluid / microbiology*
Bacteria / isolation & purification
Birth Weight
Chorioamnionitis / complications,  microbiology*
Female
Humans
Obstetric Labor, Premature / etiology*
Pregnancy
Pregnancy, Multiple
Prevalence
Twins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Catastrophic complications of previous cesarean section.
Next Document:  Magnesium sulfate and promethazine do not interact to cause hypotension in gravid ewes.