Marisiensis 2014

INFECTIONS IN PRETERM BIRTH

COORDINATOR:

Asist. Univ. Dr. OVIDIU GRAMA

First author: Farcas Marcela Leontina

Authors: Clapon Anca, Roman Nicoleta

GENERAL INFORMATIONS

- The definition of preterm birth, accepted all around the world is pregnancy ending before 37 weeks or 259 days of gestation.

- Intrauterine infection is a major cause of ignite premature labor, beeing present in more than 25 % cases of premature birth.

GENERAL INFORMATIONSPreterm labor genesis

• Microorganisms from the vagina and the cervix ascend chorio-decidual space, then crosses the amnio-choriale membranes , infecting the fetus;

• The release of postaglandine that takes place, will stimulate uterine contraction determine preterm labor.

GENERAL INFORMATIONSEthiology

• The incriminated infections in preterm birth ethiology are:

• inferior genital tract infections, or colonisations from this level;• Urinary infections;• Some indirect infections (ex.

Periodontitis, Chickenpox, Measles)

GENERAL INFORMATIONSIncidence of intrauterine infections

• The prevalence of positive cultures in women with preterm labor• 13% - with intact membranes;• 32,4% - in case of membranes ruptured;• 11,9% - gemelare pregnancy.

• Lower gestational age at birth increases the frequency of microbial invasion.

PURPOSE AND OBJECTIVES

• The purpose of this study is to determine the frequency of preterm births associated with infections in urban versus rural environment and the age at which is the most frequently seen premature birth.

MATERIAL AND METHOD

• Observational retrospective study ;• During 1 january – 30 august 2013;• The group included 102 patients• Representing pregnant women hospitalized

for preterm birth, in Clinic of Obstetrics and Gynecology 2 of Tg. Mures.

MATERIAL AND METHOD

• I watched lower genital tract infections, cervical infections and urinary infections • Using:• Microscopic examination of vaginal content;• Seedings on culture environments from the

cervical canal;• Urocultures.

RESULTS

• Examination of vaginal content • It was conducted in 66 patients;• I followed the infections with:• Candida albicans;• Trichomonas vaginalis;• Gardnerella vaginalis.

RESULTS

Candida albicans Trichomonas vaginalis

Gardnerella

0%

200%

400%

600%

800%

1000%

1200%

1400%

1600%

1800%

2000%

16,66%

6.06% 6.06%

RESULTS

• Insaminations from cervical canal pre-/postpartum• Was performed in 59 of the cases;• The most common germs

• Candida albicans;• E. coli;• Gardnerella;• Streptococus bete-hemolitic;• Trichomonas vaginalis;• Klebsiella pneumoniae.

RESULTS

Premature births

Prepartum Postpartum

number Percent % number Percent %

Candida albicans

4 14,28 3 10,71

E. coli 2 7,14 1 3,57

Gardnerella 2 7,14 3 10,71

Streptococus bete-hemolitic

5 10,71 3 10,71

Trichomonas vaginalis

2 7,14 2 7,14

Klebsiella pneumoniae

1 3,57 0 -

RESULTS

•Uroculture

• I have identified performed urocultures at 35 among patients

• Most did not show any patogent agent

RESULTSUroculture

Premature births

Pozitive Urocultures

Negative Urocultures

number Percent % number Percent %

11 31,42 24 68,58

Acinetobacter Baumanii

1 9.09 -

E.Coli 2 18,18 -

Enterococcus 4 36,36 -

Candida albicans 2 18,18 -

Streptococcus bete hemolitic

2 18,18 -

INFECTIONS IN PRETERM BIRTH Results• The environment from which patients

come

INFECTIONS IN PRETERM BIRTHResults

not p

erfo

rmed

pozitiv

e re

sults

nega

tive

resu

lts100.00%

1000.00%

10000.00%2100%

5100%3000%

microbiological tests

INFECTIONS IN PRETERM BIRTHResults

74,19%

25,81%

1 January 2014-31 August 2014

rural areas aso-ciated with infec-tionsurban areas asociated with infections

INFECTIONS IN PRETERM BIRTHResults

15-20 years 21-25

years 26-30 years 31-35

years >35 years

05

10152025

21 21 2420

16

women delivered age

INFECTIONS IN PRETERM BIRTHConclusions

• Most infections are found before birth in case of cervical canal germs.• The germ most frequently encountered

after vaginal examination content was Candida albicans.• Infections in preterm birth are most

frequently in rural areas, perhaps because of socio-economic conditions, as well as the lack of health education.• Most preterm births are found in the age

range 26-30 years old.

Thank you, for your atention!