Clinical and histopathological correlations of immunoreactivity to Chlamydia trachomatis and to epitopes of the C. trachomatis 60 kDa heat shock protein (hsp60) among women with ectopic pregnancy were evaluated in a case-control study. Serological responses to 13 synthetic peptides corresponding to major epitopes of the chlamydial hsp60 were determined in 67 women treated for ectopic pregnancy and 45 women with uncomplicated pregnancy in utero. Plasma cell salpingitis was detected in 29 (43.3%) of the ectopic patients. Its presence correlated with antibodies to two hsp60 epitopes, encompassing amino acids 260-271 and 411-422 (P = 0.02). Antibodies to these two epitopes, along with five other epitopes, also correlated with peritubal adhesion formation in ectopic pregnant patients (P < 0.01). Antibodies to epitopes 260-271 and 188-199 also correlated with a history of pelvic inflammatory disease (PID; P = 0.05). Patients with ectopic pregnancy were also more likely than their intrauterine pregnant controls to have present anti-chlamydial immunoglobulin G (P < 0.005). Women positive for both C. trachomatis and hsp60 epitope antibodies had an increased prevalence over controls of salpingitis, pelvic adhesions or history of PID (P < 0.05). In contrast, patients who were positive for only C. trachomatis antibodies or only hsp60 epitope antibodies did not differ from antibody-negative patients in each of these categories.
Objective: The relationship between pregnancy outcome and expression of the heat shock proteins (hsps) or hsp-antibody complexes of 60'kD (hsp60), 70kD (hsp70), and 90kD (hsp90) Results: In each placental specimen examined, hsp60, hsp70, and hsp90 were identified. However, hsp70-antibody complexes were detected in only four of the preterm labor cases. Similarly, hsp60-antibody complexes were detected in only five preterm labor patients and in one patient with IUGR. None of the placentae contained hsp90-antibody complexes. In the preterm birth group, all patients with hsp60-antibody complexes were also positive for circulating antibodies to hsp60. The presence of hsp70-antibody complexes also correlated with hsp70 antibody in sera.Conclusions: Formation of hsp60-and hsp70-antibody complexes in the placenta may contribute to the induction of preterm birth. Women sensitized to these antibodies may be at increased risk for adverse pregnancy outcome. Infect. Dis. Obstet. Gynecol. 7:180-185, 1999. (C)
Although Candida species are frequent saprophytes of the female genital tract, chorioamnionitis or intrauterine fetal infections are rarely caused by these fungi. The present report describes a 34-year-old woman G2, P2, presenting with vaginal bleeding in the 11.6 weeks of gestation. Clinical and sonographic examination revealed a missed abortion and rested IUD. Histopathologically, a fungal chorioamnionitis due to Candida spp. was found at the curetting material, confirmed by detection of C. albicans infection on mycological culture. Foreign intrauterine bodies, like IUD's and cerclage sutures predispose to fungal chorioamnitis or fetal infections. This conditions urge repetetive search for Candida spp. to establish early anti-fungal therapy which may be therapeutic for this hithero rare intrauterine infection.
Objective: Trichomonas vaginalis vaginal infections are often both asymptomatic and difficult to
detect by current methods. We evaluated the ability of a newly developed polymerase chain reaction (PCR) assay to
identify T. vaginalis in vaginal samples from pregnant and non-pregnant women.
Methods: In the 1st study, we compared the prevalence of T. vaginalis detection by PCR and culture
using Diamond's medium in 52 women with symptoms of vaginal infection. In the 2nd study, T. vaginalis was detected
using PCR and wet mount microscopy in 131 asymptomatic pregnant women.
Results: Among the women with symptoms of vaginitis, 7 (13.5%) were PCR-positive for T. vaginalis.
Six of the PCR-positive women, but none of the PCR-negative women, were culture-positive for this organism. All but 1 of the
women with candidal vaginitis or bacterial vaginosis were PCR-negative for T. vaginalis. Among the asymptomatic pregnant
women, all of whom were negative for T. vaginalis by wet mount, l0 (7.6%) were PCR-positive for T. vaginalis.
Conclusions: PCR offers a rapid and sensitive alternative to culture and microscopy for the detection
of T. vaginalis vaginal infections in both symptomatic and asymptomatic women.
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