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Intraamniotic infection with Candida albicans associated with a retained intrauterine contraceptive device: a case report.

Abstract：

:Intrauterine infection with Candida albicans is a rare occurrence in pregnancy. We report the association of an intrauterine contraceptive device with such an infection in an asymptomatic patient. This infection, discovered incidentally at the time of genetic amniocentesis for advanced maternal age, resulted in a spontaneous abortion at 18 weeks' gestation. :Although intra-amniotic infection with Candida albicans rarely occurs during pregnancy, a recent review of 18 cases of antenatal Candida infection suggests an association with IUD use. The authors present a case of an asymptomatic 39-year-old woman (gravida 12, para 7, abortus 4) diagnosed incidentally at midtrimester amniocentesis with intra-amniotic infection. The woman reported a history of a Lippes Loop in situ for an unknown length of time. When amniocentesis was performed at 16 weeks gestation, due to advanced maternal age, the cell cultures were overgrown with Candida species and a repeat procedure was performed 3 days later to establish a viable cell culture for karyotype. 2 days after the 2nd procedure, the patient presented to the emergency room with spontaneous preterm rupture of the membranes. Amniorrhexis was confirmed, and the patient underwent pregnancy termination induced by prostaglandin E2. There was histologic evidence of chorioamnionitis, and budding spores with pseudohypha consistent with Candida were observed in the placental fragments. It is postulated that bacterial contamination of the endometrial cavity at the time of IUD insertion was causal. The present case is unusual, however, in that the patient was asymptomatic and the diagnosis was made incidentally when the amniocyte culture was overgrown with yeast. This case suggests a need for careful counseling of women with an unretrievable IUD and coexistent pregnancy who do not manifest evidence of infection.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Smith CV,Horenstein J,Platt LD

doi

10.1016/0002-9378(88)90505-4

subject

Has Abstract

pub_date

1988-07-01 00:00:00

pages

123-4

issue

eissn

0002-9378

issn

1097-6868

pii

0002-9378(88)90505-4

journal_volume

159

pub_type

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Intraamniotic infection with Candida albicans associated with a retained intrauterine contraceptive device: a case report.