Roqué H, Abdelhak Y, Young B K
Dept. of Obstetrics and Gynecology, New York University School of Medicine, USA.
J Perinat Med. 1999;27(4):253-62. doi: 10.1515/JPM.1999.036.
We present a case of mid pregnancy loss with retained intrauterine contraceptive device associated with fetal Candida infection. Review of English literature identified 53 additional cases of fetal candidal infection, with 17 associated with an IUCD in situ. The presence of an IUCD was associated with delivery at a statistically significant earlier gestational age when compared to cases not associated with an IUCD (23.3 +/- 4.9 vs 31.6 +/- 7.0, p < 0.001). Seventy-seven percent of fetal candidal infections associated with an IUCD were systemic (heart, brain, liver, gastrointestinal, lung) compared to 33% of cases not associated with an IUCD. In contrast to bacterial intraamniotic infections there was a low incidence of maternal febrile morbidity. An hypothesis as to the pathogenesis of Candidal infections in the presence and absence of an IUCD is offered as well as a paradigm for the management of the gravid patient with an IUCD in situ.
我们报告一例中期妊娠丢失合并宫内节育器残留且伴有胎儿念珠菌感染的病例。回顾英文文献发现另外53例胎儿念珠菌感染病例，其中17例与宫内节育器在位有关。与未合并宫内节育器的病例相比，宫内节育器的存在与在统计学上显著更早的孕周分娩相关（23.3±4.9周对31.6±7.0周，p<0.001）。与宫内节育器相关的胎儿念珠菌感染77%为全身性感染（心脏、脑、肝、胃肠道、肺），而未合并宫内节育器的病例为33%。与细菌性羊膜腔内感染不同，孕产妇发热发病率较低。本文提出了在有或无宫内节育器情况下念珠菌感染发病机制的假说，以及对在位宫内节育器妊娠患者的管理模式。
