Idiopathic vaginal bleeding during pregnancy as the only clinical manifestation of intrauterine infection

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dc.contributor.authorGomez, R
dc.contributor.authorRomero, R
dc.contributor.authorNien, JK
dc.contributor.authorMedina, L
dc.contributor.authorCarstens, M
dc.contributor.authorKim, YM
dc.contributor.authorChaiworapongsa, T
dc.contributor.authorEspinoza, J
dc.contributor.authorGonzalez, R
dc.date.accessioned2024-01-10T13:49:14Z
dc.date.available2024-01-10T13:49:14Z
dc.date.issued2005
dc.description.abstractObjective. To determine the frequency and clinical significance of microbial invasion of the amniotic cavity (MIAC) in patients with vaginal bleeding in the absence of placenta previa, preterm labor or preterm premature rupture of membranes (PROM).
dc.description.abstractStudy design. This retrospective cohort study included patients who presented with vaginal bleeding between 18 and 35 weeks, and underwent an amniocentesis shortly after admission for the assessment of the microbiologic status of the amniotic cavity and/or fetal lung maturity. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as genital mycoplasmas. Patients presenting with preterm labor, preterm PROM, placenta previa, overt placental abruption, and an intrauterine device in situ were excluded, as well as those with local cervical bleeding. MIAC was defined as a positive amniotic fluid culture. Analysis was conducted with non-parametric statistics.
dc.description.abstractResults. One hundred and fourteen patients met the entry criteria. MIAC was detected in 14% of cases (16/114). Patients with vaginal bleeding and a gestational age 528 weeks at the time of amniocentesis had a significantly higher frequency of MIAC than those with a gestational age 528 weeks [25% (13/52) vs. 4.8% (3/62), respectively; p < 0.01]. Ureaplasma urealyticum was the microorganism most frequently isolated from the amniotic fluid. Except for one case admitted at 33 weeks, all patients with MIAC had an early preterm delivery 432 weeks. Patients with vaginal bleeding and MIAC had a shorter procedure-to-delivery interval than those without MIAC [MIAC, median survival 19 days (95% CI 10-27 days) vs. no MIAC, median survival 50 days (95% CI 37-62 days); p < 0.0001]. Patients with vaginal bleeding and MIAC had a significantly lower gestational age at delivery and lower birth weight than those with vaginal bleeding and negative amniotic fluid cultures (for gestational age, median 25 weeks, range 21-33 weeks vs. median 37 weeks, range 19-42 weeks, respectively; p < 0.01, and for birth weight, median 750 grams, range 520-1820 grams vs. 2800 grams, range 520 4880 grams, respectively; p < 0.01), as well as a higher frequency of subsequent preterm PROM [81.3% (13/16) vs. 9.2% (9/98); p < 0.01].
dc.description.abstractConclusions. MIAC was detected in 14% of patients with 'idiopathic' vaginal bleeding and was associated with subsequent preterm PROM and early preterm delivery. Vaginal bleeding may be the only clinical manifestation of MIAC, and it predisposes to adverse outcome.
dc.description.funderEUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
dc.description.funderEUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH &HUMAN DEVELOPMENT
dc.fechaingreso.objetodigital2024-05-09
dc.format.extent7 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1080/14767050500217863
dc.identifier.eissn1476-4954
dc.identifier.issn1476-7058
dc.identifier.pubmedidMEDLINE:16105789
dc.identifier.urihttps://doi.org/10.1080/14767050500217863
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/79434
dc.identifier.wosidWOS:000231716900005
dc.information.autorucMedicina;Gómez R;S/I;80926
dc.issue.numero1
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final37
dc.pagina.inicio31
dc.publisherTAYLOR & FRANCIS LTD
dc.revistaJOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
dc.rightsacceso restringido
dc.subjectintraamniotic infection
dc.subjectchorioamnionitis
dc.subjectvaginal bleeding
dc.subjectpreterm premature rupture of membranes
dc.subjectpremature birth
dc.subjectPRETERM PREMATURE RUPTURE
dc.subjectPOLYMERASE-CHAIN-REACTION
dc.subjectTUMOR-NECROSIS-FACTOR
dc.subjectAMNIOTIC-FLUID
dc.subjectINTRAAMNIOTIC INFECTION
dc.subjectUREAPLASMA-UREALYTICUM
dc.subjectMICROBIAL INVASION
dc.subjectFETAL MEMBRANES
dc.subjectABRUPTIO PLACENTAE
dc.subjectINTACT MEMBRANES
dc.subject.ods03 Good Health and Well-being
dc.subject.ods05 Gender Equality
dc.subject.odspa03 Salud y bienestar
dc.subject.odspa05 Igualdad de género
dc.titleIdiopathic vaginal bleeding during pregnancy as the only clinical manifestation of intrauterine infection
dc.typeartículo
dc.volumen18
sipa.codpersvinculados80926
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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