Prevention of recurrent fetal death in utero due to group B streptococcal chorioamnionitis

Prevention of recurrent fetal death in utero due to group B streptococcal chorioamnionitis Introduction Maternal colonisation with group B Streptococcus (GBS) is a well recognised cause of neonatal sepsis. Colonisation of the infant at delivery results in invasive disease in 1–2% of neonates with a 5% mortality. Routine antenatal screening is recommended and prophylaxis offered to colonised women. We report a case of recurrent mid‐trimester fetal death in utero , caused by GBS chorioamnionitis, and a subsequent successful pregnancy achieved with intermittent amoxicillin therapy from 12 weeks’ gestation. Case report A 33‐year‐old previously well woman presented with recurrent mid‐term fetal death in utero as a result of chorioamnionitis caused by GBS ( Streptococcus agalactiae ). The first pregnancy spontaneously miscarried at 19 weeks’ gestation. There was no history of premature rupture of membranes. No antenatal screening had been undertaken and vaginal colonisation with GBS had not been established. At the time of delivery there was evidence of maternal sepsis with an elevated white cell count of 33.8 × 10 9 /L (4.0–10.0 × 10 9 /L) with left shift and toxic changes. The fetus was macerated but anatomically normal and consistent with gestational age of approximately 20 weeks. The placenta was grossly normal but microscopically showed considerable bacterial infection of the http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australian and New Zealand Journal of Obstetrics and Gynaecology Wiley

Prevention of recurrent fetal death in utero due to group B streptococcal chorioamnionitis

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Publisher
Wiley
Copyright
Copyright © 2004 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0004-8666
eISSN
1479-828X
D.O.I.
10.1111/j.1479-828X.2004.00237.x
Publisher site
See Article on Publisher Site

Abstract

Introduction Maternal colonisation with group B Streptococcus (GBS) is a well recognised cause of neonatal sepsis. Colonisation of the infant at delivery results in invasive disease in 1–2% of neonates with a 5% mortality. Routine antenatal screening is recommended and prophylaxis offered to colonised women. We report a case of recurrent mid‐trimester fetal death in utero , caused by GBS chorioamnionitis, and a subsequent successful pregnancy achieved with intermittent amoxicillin therapy from 12 weeks’ gestation. Case report A 33‐year‐old previously well woman presented with recurrent mid‐term fetal death in utero as a result of chorioamnionitis caused by GBS ( Streptococcus agalactiae ). The first pregnancy spontaneously miscarried at 19 weeks’ gestation. There was no history of premature rupture of membranes. No antenatal screening had been undertaken and vaginal colonisation with GBS had not been established. At the time of delivery there was evidence of maternal sepsis with an elevated white cell count of 33.8 × 10 9 /L (4.0–10.0 × 10 9 /L) with left shift and toxic changes. The fetus was macerated but anatomically normal and consistent with gestational age of approximately 20 weeks. The placenta was grossly normal but microscopically showed considerable bacterial infection of the

Journal

Australian and New Zealand Journal of Obstetrics and GynaecologyWiley

Published: Aug 1, 2004

References

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