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The Possible Role of Intrauterine Infections in Unexplained Second Trimester Abortions and Macerated Stillbirths: A Study from a Single Center

Abstract

OBJECTIVE: To investigate the role of intrauterine infections in unexplained second trimester abortions and stillbirths.

STUDY DESIGN: Histopathologic and microbiologic evidence of intrauterine infection in the placentas, fetal membranes and fetal lung tissues of 18 unexplained second trimester abortions and macerated stillbirth cases as well as the placentas and fetal membranes of 10 healthy term neonates were investigated in a prospective study conducted in Ankara University School of Medicine, Turkey.

RESULTS: Histopathologic chorioamnionitis and placental culture positivity rates in the study and control groups were 64.7 vs 0%. Bacteria were recovered from 90.9% of placentas and 36.4% of fetal lungs of the cases with histopathologic chorioamnionitis. Intrauterine infection was found in 66.7% of the whole study group, in 85.7% of the unexplained second trimester abortions, and in 54.5% of the macerated stillbirths.

CONCLUSION: Intrauterine infection may be an important factor in unexplained stillbirths and second trimester abortions in centers where pregnancy follow-ups lack evaluation for asymptomatic infection.

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References

  1. Alessandri LM, Stanley FJ, Newnham J, Walters BNJ . The epidemiological characteristics of unexplained antepartum stillbirths. Early Hum Dev 1992;30:147–161.

    Article  CAS  Google Scholar 

  2. Incerpi MH, Miller DA, Samadi R, Settlage RH, Goodwin TM . Stillbirth evaluation: what tests are needed? Am J Obstet Gynecol 1998;178:1121–1125.

    Article  CAS  Google Scholar 

  3. Donald DD . Pre-term labor: an intrauterine inflamattory response syndrome? J Reprod Immun 1997;36:93–109.

    Article  Google Scholar 

  4. Folgosa E, Gonzalez C, Osman NB, Hagerstrand I, Bergstrom S, Ljungh A . A case control study of chorioamniotic infection and histological chorioamnionitis in stillbirth. APMIS 1997;105:329–336.

    Article  CAS  Google Scholar 

  5. Krohn MA, Hillier SL, Kiviat NB, Eschenbach DA . The severity of fetal membrane infection and pregnancy complications. Ann Epidemiol 1993;3:78–85.

    Article  CAS  Google Scholar 

  6. Quinn PA, Butany J, Taylor J, Hannah W . Chorioamnionitis: its association with pregnancy outcome and microbial infection. Am J Obstet Gynecol 1987;156:379–387.

    Article  CAS  Google Scholar 

  7. Zlatnik FJ, Gellhaus TM, Benda JA, Koontz FP, Burmeister L . Histologic chorioamnionitis, microbial infection and prematurity. Obstet Gynecol 1990;76:355–359.

    CAS  PubMed  Google Scholar 

  8. Goldstein I, Zimmer EZ, Merzbach D, Peretz BA, Paldi E . Intraamniotic infection in the very early phase of the second trimester. Am J Obstet Gynecol 1990;163:1261–1263.

    Article  CAS  Google Scholar 

  9. Horowitz S, Mazor M, Romero R, Horowitz J, Glezerman M . Infection of the amniotic cavity with ureaplasma urealyticum in the midtrimester of pregnancy. J Reprod Med 1995;40:375–379.

    CAS  PubMed  Google Scholar 

  10. McDonald HM, Chambers HM . Intrauterine infection and spontaneous midgestation abortion: is the spectrum of microorganisms similar to that in preterm labor? Infect Dis Obstet Gynecol 2000;8:220–227.

    Article  CAS  Google Scholar 

  11. Moyo S R, Hagerstrand I, Nyström L, et al. Stillbirths and intrauterin infection, histologic chorioamnionitis and microbiological findings. Int J Gynec Obstet 1996;54:115–123.

    Article  Google Scholar 

  12. Axemo P, Ching C, Machungo NB, Bergström S . Intrauterine infections and their association with stillbirth and preterm birth in Maputo, Mozambique. Gynecol Obstet Invest 1993;35:108–113.

    Article  CAS  Google Scholar 

  13. Tolockiene E, Morsing E, Holst E, et al. Intrauterine infection may be a major cause of death in Sweden. Acta Obstet Gynecol Scand 2001;80:511–518.

    Article  CAS  Google Scholar 

  14. Goncalves LF, Chaiworapongsa T, Romero R . Intrauterine infection and prematurity. Ment Retard Dev Res Rev 2002;8:3–13.

    Article  Google Scholar 

Download references

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Supported by Ankara University Research Fund (Grant no: 98-09-00-27), Ankara, Turkey.

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Atay, G., Arsan, S., Atasay, B. et al. The Possible Role of Intrauterine Infections in Unexplained Second Trimester Abortions and Macerated Stillbirths: A Study from a Single Center. J Perinatol 24, 679–685 (2004). https://doi.org/10.1038/sj.jp.7211167

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