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Am J Perinatol.1986 Jul;3(3):213-8.

Candida chorioamnionitis diagnosed by amniocentesis with subsequentfetal infection.

Bruner JP,Elliott JP,Kilbride HW,Garite TJ,Knox GE.AbstractIsolation of Candida albicans from the vaginal secretions of pregnant women occurs with an incidence of 5-23%.Intrauterine infection caused by Candida during pregnancy is relatively rare; only 81 cases, all diagnosed afterdelivery, have been reported. We report six cases of candidal chorioamnionitis diagnosed by amniocentesis andconfirmed by histologic studies, associated with preterm labor and delivery of five viable infants. Three of the sixmaternal patients had intrauterine contraceptive devices in situ. Three infants had a diagnosis of congenitalcutaneous candidiasis and two had congenital systemic candidiasis, one with monilial pneumonia, and one withmeningitis and septicemia. All viable neonates were treated successfully. The sixth, a very immature infant, diedsoon after delivery. Torulopsis (Candida) glabrata was isolated from this amniotic fluid. C. Albicans is a pathogenthat potentially may cause chorioamnionitis and has been associated with high mortality (94%) in infantsweighing less than 1500 gm. Use of amniocentesis in patients with preterm labor may allow early detection ofsubclinical candidal chorioamnionitis, thus guiding appropriate perinatal management.

PMID:

Journal of Reproductive Medicine2000 Vol. 45 No. 4 pp. 354-356

ISSN

0024-7758

Record Number

20013038838

AbstractAlthough cervicovaginal Candidainfections occur in 20-25% of pregnancies, the incidence of ascending infection

in these cases is only 0.8%, and such infection rarely causes chorioamnionitis. Sudden intrauterine fetal demise

(IUFD) of twin A occurred in a diabetic primigravida presenting with a twin pregnancy and preterm labour at 33

weeks of gestation. Placental pathology and autopsy of the stillborn twin revealed extensive chorioamnionitis and

fetal sepsis in the presence of Candida albicans. Twin B was unaffected. In this case, Calbicans chorioamnionitis

seemed to be associated with sudden IUFD. (J Reprod Med 2000;45:354-356) Chorioamnionitis is likely to be

caused by ascending vaginal infection with microorganisms such asTrichomonas vaginalis,

Bacteroidesspp, Ureaplasma urealyticumand others.1Occurring preterm, it often is associated with labour and

subsequent preterm birth, the latter known to be major cause of neonatal morbidity and mortality. Although

isolated cases of Candidachorioamnionitis have been reported, serious systemicCandidainfections are

uncommon. We report a case of a woman presenting with a twin pregnancy, preterm labour and sudden

intrauterine fetal demise (IUFD) of twin A. Autopsy revealed extensive Candida albicanschorioamnionitis and

fetal sepsis of the stillborn.

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