Treatment of erythema migrans in pregnancy.
The course of the illness and the outcome of pregnancy were investigated in a prospective study of 58 consecutively enrolled pregnant women with typical erythema migrans at the University Medical Centre of Ljubljana, Slovenia. Thirteen patients (22.4%) acquired borrelial infection in the first trimester of pregnancy, 27 (46.6%) in the second trimester, and 18 (31%) in the third trimester. All patients were treated for 14 days: 2 (3.4%) with phenoxymethylpenicillin (1 million IU thrice per day), 3 (5.2%) with benzylpenicillin (10 million units twice per day), and 53 (91.4%) with ceftriaxone (2 g daily). For 51 of the 58 women (87.9%), the pregnancies were normal and the infants were born at term, were clinically healthy, and had normal psychomotor development. Of the remaining 7 pregnancies, 1 ended with a missed abortion and 5 with preterm birth; 1 of the preterm babies had heart abnormalities. One child born at term was found to have urologic abnormalities at 7 months of age. A causal relationship between borrelial infection and fetal adverse effects has not been proven, and for at least some such cases a reasonable explanation (not associated with Lyme borreliosis) was found.
Maraspin
V
V
Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia.
Cimperman
J
J
Lotric-Furlan
S
S
Pleterski-Rigler
D
D
Strle
F
F
D000030:Abortion, Missed / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D015787:Erythema Chronicum Migrans / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006330:Heart Defects, Congenital / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010400:Penicillin G / Q000627:therapeutic use; D010404:Penicillin V / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D014551:Urinary Tract / Q000002:abnormalities
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010406:Penicillins; D002443:Ceftriaxone; D010400:Penicillin G; D010404:Penicillin V