Loading...
Lethal Neonatal Respiratory Failure by Perinatal Transmission of Ureaplasma Parvum after Maternal PPROM.
Zöllkau, Janine Pieper, Dietmar H Pastuschek, Jana Makarewicz, Oliwia Mentzel, Hans-Joachim Dawczynski, Kristin Schleußner, Ekkehard
Zöllkau, Janine
Pieper, Dietmar H
Pastuschek, Jana
Makarewicz, Oliwia
Mentzel, Hans-Joachim
Dawczynski, Kristin
Schleußner, Ekkehard
Citations
Altmetric:
Advisors
Editors
Other Contributors
Issue Date
2020-12-18
Submitted date
Files
Loading...
Accepted manuscript
Adobe PDF, 328.45 KB
Loading...
figure 1
JPEG, 69.48 KB
Other Titles
Abstract
A primiparous pregnant woman was admitted due to preterm premature rupture of membranes (PPROM) at 27+0 week of gestational age (WGA). Conventional vaginal microbiological analysis had no pathological finding. Management decisions based on national guidelines included antenatal corticoids, tocolytics and antibiotics. Unstoppable efforts of preterm labor in 28+0 WGA and supposed amniotic infection syndrome necessitated emergency cesarean section. The preterm infant underwent NICU therapy, developed an early-onset neonatal sepsis and therapy-refractory pulmonary insufficiency with consecutive right heart failure, resulting in death on the 36th day of life. Microbiota analyses by 16Sr DNA sequencing was performed from maternal vaginal swabs and from neonatal pharyngeal swabs. Maternal antibiotic treatment resulted in depletion of physiological vaginal colonization with Lactobacillus crispatus. Ureaplasma parvum became the dominant vaginal microorganism at delivery and was detected in high relative abundance in the neonatal specimen. Progressive radiological air-space changes and interstitial pathologies associated with Ureaplasma infection (bronchopulmonary dysplasia type III) were seen early at the 3rd and distinctly from 14th day of life. This clearly demonstrates the need of vaginal colonization diagnostics in PPROM patients and awareness of the consecutive risks in the preterm. Vaginal microbiome analysis may allow individualized and targeted maternal and fetal diagnostic, prophylactic and therapeutic strategies to identify, protect and treat the high-risk neonates after PPROM.
Citation
Z Geburtshilfe Neonatol. 2020 Dec 18. English. doi: 10.1055/a-1326-2719. Epub ahead of print.
Publisher
PubMed ID
PubMed Central ID
Additional Links
Embedded video
Type
Article
Language
en
Description
Series/Report no.
ISSN
EISSN
1439-1651
ISBN
ISMN
Gov't Doc #
Sponsors
License
Attribution-NonCommercial-ShareAlike 4.0 International