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RCOG Green-Top guideline 2010
What are the infections associated with late IUFD?
What are the infections associated with late IUFD?
Transplacental infections associated with IUFD include
Transplacental infections associated with IUFD include
cytomegalovirus
syphilis
parvovirus B19
listeria
rubella
toxoplasmosis
herpes simplex
coxsackievirus,
leptospira,
Q fever,
Lyme disease
Malaria parasitaemia
Ascending infection, with or without membrane rupture
Ascending infection, with or without membrane rupture
Escherichia coli, Klebsiella,
Group B Streptococcus, Enterococcus,
Mycoplasma/Ureaplasma, Chlamydia
Haemophilus influenzae.
Tests recommended for women with a late IUFD
Tests recommended for women with a late IUFD
Blood culture, midstream urine, vaginal and cervical swab
Blood culture, midstream urine, vaginal and cervical swab
Test for Listeria and Chlamydia spp.
Test when present with fever, flu-like symptom, abnormal (purulent/offensive) liquor & prolonged rupture of membrane before late IUFD
Serology
Serology
Check saved serum for baseline serology
Parvovirus B19, Rubella (if non-immune at booking)
CMV, Herpes, Toxoplasma (routinely)
Syphilis
Other - if risk factors present.
Foetal blood/swab/Placental swab
Foetal blood/swab/Placental swab
More informative than maternal blood
Cord or cardiac blood (if possible/may need consent) in lithium heparin
Stillbirth related to infection varies from 5-22%
Bacterial causes are Escherichia coli - commonest, Group B streptococcus , Enterococcus , Listeria monocytogenes (rare), Chlamydia
Virus - Cytomegalovirus (commonest), Parvovirus, syphilis, herpes simplex virus, Rubella
Other - Toxoplasma
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