Spontaneous abortions and their relationship with listeria monocytogenes and cytomegalovirus: case report
Our aim is to make a case report about Listeriosis, the cytomegalovirus infection, and their relationship with spontaneous early abortions, considering its relevance during pregnancy. First-pregnant patient, 19 years old, gestational age (GA) 20 weeks due to amenorrhea, attended to obstetr...
Guardado en:
| Autores principales: | , , , , , , , |
|---|---|
| Formato: | Artículo revista |
| Publicado: |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2023
|
| Materias: | |
| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/42776 |
| Aporte de: |
| Sumario: | Our aim is to make a case report about Listeriosis, the cytomegalovirus infection, and their relationship with spontaneous early abortions, considering its relevance during pregnancy.
First-pregnant patient, 19 years old, gestational age (GA) 20 weeks due to amenorrhea, attended to obstetric control, where no fetal heartbeat (FH) was observed. Presents an only tocogynecological ultrasound (TU): single fetus, positive FH. Unremarkable (UN) segmental examination. GA consistent with amenorrhea. TU was performed: negative FH. Fetal edema is observed, ultrasound GA 17.2 weeks, rest UN. Hospitalization is decided for control and treatment. Patient clinically and hemodynamically stable, afebrile. Admission laboratory within normal parameters. HIV, Hepatitis B, Syphilis, Chagas and Toxoplasmosis tests came negative. Vaginal delivery occurs, fetus is born without vital signs. Edema was observed in the thorax and abdomen with a purplish color, without other macroscopic malformations. Immediate puerperium UN. Serological studies cannot be expanded (Rubella, CMV and Parvovirus B 19). Deferred pathological anatomy reports: Macroscopy: female fetus. Globular abdomen with edema and low set of ears. Fetal placenta with congested vessels. Maternal face appears complete, with whitish areas. Microscopy: chorionic villi, characteristic of the 2nd trimester, lined by syncytotrophoblast, some edematous. Others with dystrophic calcification. Presence of Hofbaüer cells (placental macrophages), neutrophilic polomorphonuclear inflammatory infiltrate with necrosis (microabscess formation linked to Listeria) and eosinophilic inclusions with a perinuclear halo (suggestive of cytomegalovirus, positive with immunohistochemistry.)
The anatomopathological findings allow us to reflect on infections with high maternal-fetal morbidity and mortality, despite their subclinical condition, thus reinforcing the symptoms to suspect them in time and the measures to take into account during pregnancy to prevent them. Listeriosis is a rare but eventually severe infection, more frequently in pregnancy due to the associated physiological immunosuppression, and also in direct relationship with early abortions during the first and second trimester, and with preterm births and neonatal infection during the third trimester. Regarding cytomegalovirus infection, no relationship was established with spontaneous abortions, other gestational complications being more frequent (intrauterine growth restriction and post-birth sequelae). |
|---|