Does amniotomy influence the prognosis of babies in cases with severe chorioamnionitis? Report of a twin pregnancy with varying outcome.
We report our experience in a woman with a twin pregnancy. The patient suffered severe Escherichia coli chorioamnionitis and the outcomes were different between the two babies after birth. The first baby had only a mild infection, but the second suffered sepsis and subsequent perinatal death. These differences in outcome appeared to be due to amniotomy performed for the first baby after late labor stage I to augment uterus contractions. Removal of infectious amniotic fluid from the amniotic cavity might thus have prevented the spread of the chorioamnionitis. E. coli sometimes causes severe infection during pregnancy and the perinatal period. In this case, a large number of enteropathogenic E. coli (serotype O-6) was cultured from blood, stool, pharyngeal swab, gastric juice and puncture fluid from the thoracic cavity of the second baby. O-6 is classified an enterotoxigenic strain mainly causing diarrhea because of endotoxin released from bacteria. O-6 has not hitherto been reported as a cause of severe infection in chorioamnionitis and perinatal sepsis.
Suzuki
Y
Y
Department of Obstetrics and Gynecology, Nagoya City University Medical School, Nagoya, Japan.
Shikada
T
T
Yamamoto
T
T
Kojima
K
K
Murakami
I
I
Okajima
K
K
Goshima
A
A
Suzumori
K
K
D000328:Adult; D000650:Amnion / Q000601:surgery*; D002821:Chorioamnionitis / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D018450:Disease Progression; D004200:Diseases in Twins; D004926:Escherichia coli / Q000145:classification; D004927:Escherichia coli Infections / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D005260:Female; D005313:Fetal Death; D006801:Humans; D007751:Labor, Induced / Q000379:methods; D010121:Oxytocin / Q000008:administration & dosage; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology; D011256:Pregnancy Outcome; D012703:Serotyping
D010121:Oxytocin