Streptococcus milleri and second trimester abortion

Abstract

Review of 214 fetal necropsies performed in the department of pathology, University of Aberdeen, showed 40 cases of chorioamnionitis or intrauterine pneumonia, five of which were associated with Streptococcus milleri. In two cases there was good evidence to implicate S milleri as the cause of infected abortion while in the other cases its pathogenic role was less clear.

PIP: A review of 214 fetal necropsies submitted to the University of Aberdeen's Department of Pathology in 1983-86 revealed 40 cases of chorioamnionitis or intrauterine pneumonia, 5 of which were associated with Streptococcus milleri. Abortion had occurred between 18-23 weeks' gestation. There was no systemic evidence of infection in any of the 5 mothers. 3 of the women had prolonged (longer than 24 hours) rupture of membranes and 1 had an IUD in place. 1 woman had a cervical suture inserted in this pregnancy after a cone biopsy in 1975; another had had a previous septic abortion and 2 terminations. There was good evidence to implicate S milleri as a cause of septic abortion in 2 cases. In both these women, a profuse growth of S milleri was obtained from a maternal high vaginal swab collected before abortion and from a swab taken from the fetal airways at necropsy. the pathogenic role of S milleri was less clear in the remaining 3 cases. It is also unknown whether intrauterine infection follows spontaneous rupture of membranes or whether heavy vaginal colonization with a particular organism predisposes to rupture and preterm labor.