Maternal sepsis and intrauterine fetal death resulting from Candida tropicalis chorioamnionitis in a woman with a retained intrauterine contraceptive device
Barth, T.; Broscheit, J.; Bussen, S.; Dietl, J.
Acta Obstetricia et Gynecologica Scandinavica 81(10): 981-982
2002
ISSN/ISBN: 0001-6349 PMID: 12366491 DOI: 10.1034/j.1600-0412.2002.811014.xDocument Number: 233883
A 35-year-old Vietnamese woman living in Germany conceived while using an intrauterine contraceptive device (IUD). She presented at the hospital with a three-week history of malaise and lower abdominal pain at 19 weeks of gestation. Ultrasonography revealed a fetus. Labour was induced with a gemeprost placed intravaginally. Chorioamnionitis was suspected and treatment with ampicillin was started; gentamicin and clindamycin were added later. A stillborn fetus was delivered less than 10 h after presentation and the IUD was extracted. Maternal septicaemia was suspected and blood cultures revealed Candida tropicalis. The antibiotic regimen was changed to a combination of amphotericin, vancomycin and imipenem. After a slight improvement, the patient's condition deteriorated rapidly and she was transferred to the intensive care unit. Antibiotic treatment and supportive intensive care procedures contributed to full recovery. To the author's knowledge, this is the first report of an intraamniotic candidosis complicated by severe maternal septicaemia.