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Ureaplasma Urealyticum Chorioamnionitis
Author(s) -
Maher Christopher F.,
Haran Mano V.,
Farrell David J.,
Cave Donald G.
Publication year - 1994
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1994.tb01276.x
Subject(s) - ureaplasma urealyticum , chorioamnionitis , cervical cerclage , medicine , obstetrics , ureaplasma , premature rupture of membranes , pregnancy , mycoplasmataceae , gestation , gynecology , mollicutes , mycoplasma , biology , microbiology and biotechnology , genetics
EDITORIAL COMMENT: We accepted this paper for publication to remind readers that Ureaplasma urealyticum, which is a common vaginal commensal, can be associated with and apparently the cause of chorioamnionitis, premature labour, premature rupture of the membranes and intrauterine infection. As the authors note, antepartum cultures for Ureaplasma urealyticum are not useful in predicting pregnancy outcome (14). What then is the takeaway message from these cases? It seems to the editorial subcommittee that, since prematurity and premature rupture of the membranes tend to reoccur, that when the conditions have been associated with chorioamnionitis and culture of U. urealyticum, there is a case for prophylactic, long‐term treatment with an appropriate antibiotic in any future pregnancy. This is more strongly recommended if there is a past history of perinatal mortality associated with chorioamnionitis. The authors of this paper consider (communication to the editor in response to this editorial comment) that further research is required to establish risk factors for the development of Ureaplasma urealyticum chorioamnionitis, although they believe that previous uterine or cervical surgery may be a risk factor. Further trials of antibiotic therapy in women with a past history of premature labour and premature rupture of the membranes associated with or with Ureaplasma infection are required. Since about 40% of all perinatal deaths occur in the 1% of women who deliver between 20–28 weeks' gestation (A), it also seems necessary to reevaluate if women without a past history of the above obstetric complications should receive treatment when antepartum cultures for Ureaplasma urealyticum are positive. In summary, there is not much good news about prevention of the 2 main perinatal killers, prematurity and premature rupture of the membranes, but we should pursue all leads such as chorioamnionitis with Ureaplasma urealyticum or other bacteria (group B beta haemolytic streptococci) as its provocant. Summary: Controversy reigns over the role of Ureaplasma urealyticum in determining pregnancy outcome. U. urealyticum infection of the chorioamnion is strongly associated with chorioamnionitis (1–3), premature birth (2–4), and perinatal morbidity (4–6). We present 4 cases of U urealyticum chorioamnionitis and associated morbidity and mortality.