2009, Number 4
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Perinatol Reprod Hum 2009; 23 (4)
Bacterial infection and death
Hernández-Trejo M, Aguayo-González P, Beltrán-Zúñiga M
Language: Spanish
References: 22
Page: 207-213
PDF size: 110.07 Kb.
ABSTRACT
Objective: Recognize the frequency with which bacterial infection caused death in a group of cases of stillbirth before the labor began, carrying out microbiological studies of the fetal cadavers and its correlation with autopsies and placental histopathological tests.
Material and methods: We performed a transversal study on fetal death cases with no signs of autolysis and the respective placentae, as the placental tissue is a predictor for determining fetal infection status. Prior authorization was received for the autopsies and the placental analyses. Bacterial cultures were taken from the blood and the cerebrospinal fluid, in addition to the biopsies taken from the lungs, the liver and the thin intestine of the fetal cadavers using strict sterile technique. Results from the fetal bacterial cultures and autopsies were then compared with the histopathological tests results.
Results: There were 35 available stillbirths cases in the period, 24 cadavers fulfilled the inclusion criteria and were chosen for the study. In nine of these cases (37.5%) pure bacterial cultures were obtained from the 24 fetal autopsies: six
Escherichia coli, two
Streptococcus agalactiae, and one
Proteus mirabilis. Five of the nine bacterial cultures (56%) correlated positively with the placental diagnosis of chorioamnionitis, subchorionitis or villitis and/or pneumonitis in the fetus, three
E. coli and two
S. agalactiae. For these five cases, systemic fetal infection of maternal origin was declared as the cause of death. Negative or contaminated cultures were detected in the remaining 15 cases.
Conclusion: Bacterial infection
in utero was found as the cause of death in 21% of the stillbirth cases, where
E. coli was the most isolated agent followed by
S. agalactiae. These all cases positively corresponded with histological findings of fetal systemic infection derived from ascending origins.
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