Professional Documents
Culture Documents
Lower tract – colonized with a mixture of commensal and pathogenic flora, which are similar to
skin and fecal flora
o Lactobacilli species predominate produce and thrive in acid environment (pH 3.8-4.2)
o some are more severe (reason unknown): polio, influenza, varicella, amebioasis, listeria,
malaria, coccidiomycosis
o risk of upper respiratory tract infections(URI) and urinary tract infections(UTI), tendency
toward earlier systemic invasion, and risk for sepsis and life-threatening pulmonary fluid
shift and adult respiratory distress syndrome (ARDS)
o risk of enteric infections: possibly due to altered gastric acidity and motility
o acquired from undercooked meat and aerosolized cat feces "Kitty Litter Disease"
o Diagnosis – history and serologic investigations, Ig assays and PCR of amniotic fluid and
fetal blood
Syphilis – STD caused by Treponema pallidum (9/100,000 women); can cause miscarriage
o Treatment–penicillin according to stage and HIV status (the only effective treatment–
may have to desensitise if allergic)
Rubella – virus, fetal exposure is dangerous through week 20; 50% affected if exposed during
1st month, 10% after third
Cytomegalovirus – DNA herpesvirus; most prevalent cause for neonatal infections 0.2 – 2 %
of all live births; 10% result in clinical disease, 60% seroprevelance; spread by secretions,
transfusion or vertically
Chlamydia – late onset endometritis in mother and conjunctivitis and pneumonia in the newborn
Human Papilloma Virus (HPV)– lesion growth may be enhanced by estrogen, may obstruct
canal and bleeding may be sufficient to require cesarean section; pediatric laryngeal
papillomatosis may occur
HIV – 4th leading cause of death in women of childbearing age; maternal course is unaffected by
pregnancy
o usually caused by a single organism (gram negative enteric bacilli: E. coli, Klebsiella
species, Group B Strep etc.)
o Diagnosis – WBC, CRP, amniocentesis and post facto placental culture and pathology
Group B strep – gram positive bacterium with 10-20% colonization, frequent status change in
women
o Symptoms – fever, uterine tenderness, foul lochia (discharge of tissue, blood and mucus
following child birth)
often self limiting; severe infections have sepsis, abscess, septic pelvic
thrombophlebitis (SPT) and death