Antibiotics in the treatment of preterm labor

Kirschbaum, Thomas H.

doi:10.1016/0002-9378(93)90375-s

Cited by 32 publications

(12 citation statements)

References 28 publications

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“…Close correlations between the C trachomatis infection rate and PROM have been described in the literature. 10 The data from our study did not support this. Perinatal mortality as one of the most important features of perinatal care was significantly higher among C trachomatis positive patients.…”

Section: Discussioncontrasting

confidence: 64%

Epidemiological study of Chlamydia trachomatis infection in pregnant women in Hungary

Nyári

Deák

Nagy

et al. 1998

Sexually Transmitted Infections

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A multicentre survey was carried out in order to determine the prevalence and risk factors of Chlamydia trachomatis infection in the pregnant population in Hungary. The nucleic acid hybridisation method (PACE 2 Gen-Probe) was applied for the examination of C trachomatis. The overall average prevalence of C trachomatis cases during an 18 month survey on 6161 pregnant women was 5.87%. There were significant diVerences in the proportions of chlamydial infection in the diVerent survey centres, and also in the diVerent age groups and the diVerent family status groups. The perinatal mortality rate exhibited a significantly higher prevalence (8.52%) among C trachomatis positive than among negative patients (2.03%). In the anamnestic histories of C trachomatis infected patients, the frequency of premature uterine activity was 8.13%, in contrast with 5.18% in the non-infected group (p<0.05). We suggest that all pregnant women be tested for C trachomatis infection. (Sex Transm Inf 1998;74:213-215)

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Section: Discussioncontrasting

confidence: 64%

Epidemiological study of Chlamydia trachomatis infection in pregnant women in Hungary

Nyári

Deák

Nagy

et al. 1998

Sexually Transmitted Infections

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“…Antibiotic therapy is now standard of care for management of pPROM94. However, usual regimens failed to eradicate organisms including Ureaplasma or diminish inflammation in the amniotic cavity in pregnancies complicated by pPROM95.…”

Section: Therapeutic Considerationsmentioning

confidence: 99%

Ureaplasma Species: Role in Diseases of Prematurity

Viscardi

2010

Clinics in Perinatology

120

105

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SYNOPSISThere is accumulating epidemiologic and experimental evidence that intrauterine and/or postnatal infection with Ureaplasma species is a significant risk factor for adverse pregnancy outcomes and complications of extreme preterm birth such as BPD and intraventricular hemorrhage. In a cohort of very low birth weight infants, Ureaplasma spp. were detected by culture or PCR in respiratory secretions, blood, and/or CSF of almost half of the subjects, suggesting that this organism is the most common pathogen affecting this population. This review will summarize the evidence supporting the hypothesis that Ureaplasma-mediated inflammation in different compartments (intrauterine, lung, blood, and/or brain) during a common developmental window of vulnerability contributes to preterm labor and lung and brain injury. Appropriate methods for detecting these fastidious organisms and potential strategies to prevent or ameliorate the effects of Ureaplasma infection are discussed. KeywordsUreaplasma urealyticum; Ureaplasma parvum; intrauterine infection; prematurity; bronchopulmonary dysplasia; intraventricular hemorrhage Ureaplasma parvum (serotypes 1, 3, 6, and 14) and U. urealyticum (serotypes 2, 4, 5, 7-13) are closely related species of the Mollicutes class that are among the smallest free-living, selfreplicating cells [1][2][3] . All serovars lack cell walls, exhibit limited biosynthetic abilities, hydrolyze urea to generate ATP, and adhere to human mucosal surfaces 3 . U. parvum is the most common species isolated from clinical specimens 3,4 . Although Ureaplasma spp. are not typically considered pathogens in early onset neonatal sepsis, they have been implicated in complications of human pregnancy and neonatal outcomes. As observed by Volgmann et al. 5 in the title, of a recent review, Ureaplasma is either a "harmless commensal or underestimated enemy of human reproduction". This review will address this controversy and review evidence that the timing, duration, and intensity of the inflammatory response to Ureaplasma infection are major determinants of pregnancy and neonatal outcomes. EpidemiologyUreaplasma spp. are the most common bacteria implicated in human urogenital infections, including non-gonococcal urethritis in men and complications of pregnancy in women 5 . Ureaplasma spp. can be detected in vaginal flora in 40% of sexually inactive and 67% of © 2009 Elsevier Inc. All rights reserved.Mailing address: 29 S. Greene St., Rm GS110, Baltimore, MD 21201, Phone: 410-706-1913, Fax: 410-706-0404, rviscard@umaryland.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain....

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“…No large clinical or epidemiologic study has implicated viral diseases in the etiology of preterm delivery; however, both cytomegalovirus and herpes simplex virus infections may cause preterm delivery (40). Both urinary tract infection and group B streptococcal infections of the cervix may induce labor (41,42). Bacteria that migrate through the cervical mucous stimulate an inflammatory reaction in the placenta, membranes and decidua (24).…”

Section: Epidemiology and Etiology Of Premature Deliverymentioning

confidence: 99%

“…Antibiotic prophylaxis is given, especially to mothers who have group B streptococcal infections (42). Antibiotic treatment prolongs pregnancy and reduces the frequency of chorioamnionitis (40).…”

Section: Infections and Antibiotic Treatmentmentioning

confidence: 99%

Preterm delivery: an overview

Haram¹,

Mortensen²,

Wollen³

2003

Acta Obstet Gynecol Scand

116

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Preterm delivery is the leading factor causing neonatal mortality and morbidity. We have conducted a PubMed literature search to obtain an update on the etiology, diagnostic problems and therapeutic considerations of preterm delivery. Approximately 5-10% of all births are premature. Preterm labor is associated with preterm rupture of membranes, cervical incompetence, polyhydramnion, fetal and uterine anomalies, infections, social factors, stress, smoking, heavy work and other risk factors. The diagnosis is made on the patients presenting symptoms, clinical findings and of progressive effacement and dilatation of the cervix. Biochemical markers of preterm delivery are of minor importance in daily clinical work. Measurement of the cervix, however, is a practical and valuable tool to predict preterm delivery. Cervical cerclage can be useful in selected cases. Antibiotics may help to prevent preterm labor in cases of known etiologic agents (e.g. preterm rupture of membranes and urinary infection). The use of tocolytic agents such as beta-sympathetic receptor stimulators can be advocated for a few days. There is evidence that their long-term use is not beneficial and could even be harmful to the fetus. Calcium channel blockers (nifedipine) and a new selective oxytocin receptor antagonist, atosiban, appear to be as effective as beta-sympathomimetic drugs on uterine contractions with fewer side-effects. Prostaglandin synthetase inhibitors such as indomethacin may prevent uterine contractions and can be used prior to the 32nd week of pregnancy. A single course of corticosteroid treatment in two doses of 12 mg betamethasone or 6 mg of dexamethasone is important for the prevention of respiratory distress between the 24th and 34th weeks of pregnancy. Multiple doses may be harmful and should be avoided. In these cases management should depend on gestation age (fetal maturity). Uterine contractions after 34 weeks' gestation are not an indication for tocolytic treatment.

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Antibiotics in the treatment of preterm labor

Cited by 32 publications

References 28 publications

Epidemiological study of Chlamydia trachomatis infection in pregnant women in Hungary

Epidemiological study of Chlamydia trachomatis infection in pregnant women in Hungary

Ureaplasma Species: Role in Diseases of Prematurity

Preterm delivery: an overview

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