Candida chorioamnionitis after serial therapeutic amniocenteses: a possible association.
BACKGROUND
Reduction amniocentesis is used in cases of severe polyhydramnios to decrease maternal discomfort and the risk of preterm labor. In a MEDLINE search (1966 to present, English language, keywords: amniocentesis, chorioamnionitis), no report of Candida chorioamnionitis after serial reduction amniocentesis exists.


METHODS
A 29-year-old primigravida with a history of four therapeutic amniocenteses for idiopathic polyhydramnios developed preterm labor at 30 and 5/7 weeks' gestation, rupture of membranes, and Candida albicans chorioamnionitis. Despite aggressive therapy with amphotericin B, the neonate succumbed to overwhelming systemic candidiasis.


CONCLUSIONS
Serial amniocentesis may place patients at elevated risk for Candida chorioamnionitis and subsequent preterm delivery. Clinicians should consider early diagnostic amniocentesis in patients in preterm labor with a history of prior amniocentesis, and the routine Gram stain and culture of amniotic fluid.
Division of Maternal-Fetal Medicine, University of Pennsylvania Health System, Philadelphia 19104, USA. mrode@mail.obgyn.upenn.edu
M E
ME
Rode
M A
MA
Morgan
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Ruchelli
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Forouzan
D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000188:drug therapy / Q000209:etiology* / Q000635:transmission; D002821:Chorioamnionitis / Q000382:microbiology*; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D006831:Polyhydramnios / Q000628:therapy*; D011247:Pregnancy
D000900:Anti-Bacterial Agents