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Infection-mediated preterm birth: Bacterial origins and avenues for intervention.
- Source :
-
The Australian & New Zealand journal of obstetrics & gynaecology [Aust N Z J Obstet Gynaecol] 2019 Dec; Vol. 59 (6), pp. 781-790. Date of Electronic Publication: 2019 Oct 16. - Publication Year :
- 2019
-
Abstract
- Preterm birth (PTB) is globally the leading cause of death and disability in children under five years of age. Intra-amniotic infection is well recognised as a major cause of PTB. Importantly, it is the most common cause of extreme PTB (birth prior to 28 weeks gestation), which is frequently associated with a wide range of serious neonatal morbidities. Recent developments in next generation sequencing technologies, combined with many years of culture-based microbiological data have allowed us to gain a deeper understanding of the pathogenesis of infection-mediated PTB. In particular, studies have revealed numerous potential routes to intra-amniotic infection beyond the classically described ascending vaginal route. Currently, antibiotic therapy is standard treatment for suspected or confirmed intra-amniotic infection, although its use in this context has had mixed success due to problems ranging from inappropriate antibiotic selection in relation to the target organism/s, to poor transplacental drug passage. In this review, we will draw together evidence from animal models and human studies to characterise pathways to intra-amniotic infection. We will then thoroughly outline current therapeutic protocols for cases of intra-amniotic infection and suggest potential new avenues for treatment.<br /> (© 2019 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)
- Subjects :
- Anti-Bacterial Agents therapeutic use
Anti-Inflammatory Agents therapeutic use
Female
Humans
Pregnancy
Pregnancy Complications, Infectious diagnosis
Pregnancy Complications, Infectious microbiology
Pregnancy Complications, Infectious prevention & control
Premature Birth microbiology
Premature Birth prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1479-828X
- Volume :
- 59
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Australian & New Zealand journal of obstetrics & gynaecology
- Publication Type :
- Academic Journal
- Accession number :
- 31617207
- Full Text :
- https://doi.org/10.1111/ajo.13078