The Infrequent Occurrence of Mycoplasmas in Amniotic Fluid from Women with Intact Fetal Membranes

Abstract

As human genital mycoplasmas have been associated with various forms of reproductive failure, the present study was undertaken to investigate whether M. hominis and U. urealyticum organisms (ureaplasmas) are capable of crossing intact fetal membranes. Nearly 300 women in Denmark and England were investigated. Most of them were seen at about the fourth month of gestation and the remainder towards or at the time of birth, all with unruptured membranes. A swab was taken from the uterine cervix or vagina and M. hominis was isolated from 9% of the women and ureaplasmas from half of them. The presence of these mycoplasmas was not associated with an abnormal outcome of pregnancy. In contrast to the frequent presence of mycoplasmas in the lower genital tract, amniotic fluids obtained by transabdominal amniocentesis or at cesarean section did not contain M. hominis and ureaplasmas were isolated from only one of them. This was associated with the same ureaplasmas serotype being recovered from the cervix and also from the blood of both infant and mother, whose case differed from the others as labor had already started when the amniotic fluid was obtained. Thus, in our populations, we have no evidence that mycoplasmal invasion of the amniotic fluid occurs before the onset of labor. During labor, despite intact membranes, it seems that genital mycoplasmas may occasionally invade the fetal--placental unit, probably by the hematogenous route after strong uterine contractions, or otherwise directly after membrane rupture. Since both these events are followed usually by immediate delivery, there would seem to be insufficient time for the genital mycoplasmas to cause fetal damage.

Genital Mycoplasmas and Biomarkers of Inflammation and Their Association With Spontaneous Preterm Birth and Preterm Prelabor Rupture of Membranes: A Systematic Review and Meta-Analysis

“…With PPROM, over 10% prevalence of M. hominis was reported in vaginal samples from France ( Grattard et al, 1995 ) and Israel ( Horowitz et al, 1995 ), in AF samples from United States ( Perni et al, 2004 ) and Czech Republic ( Kacerovsky et al, 2014 ), and cord blood samples from Czech Republic ( Kacerovsky et al, 2014 ). In contrast, the prevalence of U. urealyticum in SPTL and/or PTB was more than 30% in AF samples from United States ( Gravett et al, 1986 ; Athayde et al, 2000 ; Romero et al, 2019 ) and Israel ( Horowitz et al, 1995 ; Bashiri et al, 1999 ), in vaginal samples from United States ( Gravett et al, 1986 ; Harger et al, 1991 ), Israel ( Holst et al, 1994 ), France ( Grattard et al, 1995 ; Goffinet et al, 2003 ), Germany ( Abele-Horn et al, 1997 ), Korea ( Choi et al, 2012 ), Japan ( Usui et al, 2002 ), Denmark/England ( Thomsen et al, 1984 ), and Czech Republic ( Koucký et al, 2016 ), while more than 30% of U. urealyticum in PPROM was reported in AF samples from United States ( Romero et al, 1992a ; Font et al, 1995 ; Athayde et al, 2000 ; Pacora et al, 2000 ; Perni et al, 2004 ), Israel ( Horowitz et al, 1995 ), and Austria ( Witt et al, 2005 ), in vaginal samples in France ( Grattard et al, 1995 ), and placenta in Austria ( Witt et al, 2005 ). These data demonstrate that the most prevalent microorganisms have been reported in diverse populations.…”

“…Polymicrobial presence demonstrated in PTB ( Thomsen et al, 1984 ; Elliott et al, 1990 ; McGregor et al, 1990 ; Hillier et al, 1991 ; McDonald et al, 1992 , 1994 ; Holst et al, 1994 ; Grattard et al, 1995 ; Kundsin et al, 1996 ; Usui et al, 2002 ; Goffinet et al, 2003 ; Goldenberg et al, 2008 ; Onderdonk et al, 2008 ; Montenegro et al, 2019 ), SPTL ( Minkoff et al, 1984 ; Gravett et al, 1986 ; Lamont et al, 1987 ; Hillier et al, 1988 ; Romero et al, 1989 , 1992c ; McGregor et al, 1990 ; Harger et al, 1991 ; Toth et al, 1992 ; Watts et al, 1992 ; Holst et al, 1994 , 2005 ; Font et al, 1995 ; Horowitz et al, 1995 ; Marconi et al, 2011 ; Choi et al, 2012 ; Kim et al, 2012 ; Lee et al, 2013 ), and PPROM ( Minkoff et al, 1984 ; Romero et al, 1992b , c ; Averbuch et al, 1995 ; Font et al, 1995 ; Grattard et al, 1995 ; Horowitz et al, 1995 ; Kundsin et al, 1996 ; Perni et al, 2004 ; Shim et al, 2005 ; Nasution et al, 2007 ), was mostly based on a combination of U. urealyticum and M. hominis ( Ma et al, 2021 ). Co-infections were also associated with decreased gestational age at birth and birth weight, and a significant increase in the incidence of histologic chorioamnionitis ( Kwak et al, 2014 ).…”

The Effect of Filtration of Amniotic Fluid on the Growth ofChlamydia TrachomatisandEscherichia Coli

“…There was no significant difference between the effect of nonfiltered and filtered amniotic fluid specimens on the growth of E. coli. On the other hand, Gump et al 14 and Thomsen et al 15 showed that amniotic fluid has no antimycoplasmal activity. W0lner-Hanssen et al 6 reported that amniotic fluid inhibits the formation of Chlamydia inclusions in McCoy cell cultures.…”