Fm. Shaw et al., RECURRENT CHORIOAMNIONITIS AND 2ND-TRIMESTER ABORTION BECAUSE OF AN ENTEROUTERINE FISTULA, Obstetrics and gynecology, 86(4), 1995, pp. 639-641
Background: Chorioamnionitis, a common cause of second-trimester abort
ion, is usually secondary to an ascending infection. Recurrent chorioa
mnionitis with second-trimester abortion secondary to an occult entero
uterine fistula has not been reported previously. Case: A 26-year-old
Indian woman, para 0-0-2-0, presented with two spontaneous second-trim
ester losses. Her third pregnancy carried to 24 weeks, but she deliver
ed after the development of pneumonia, bacteremia, preterm labor, and
chorioamnionitis. The patient passed melena containing blood clots aft
er the delivery, After the last pregnancy, laparoscopy and laparotomy
revealed an ileal-uterine fistula and a foreign body (necrotic cartila
ge). The blind loop of bowel was resected and the fistulous tract exci
sed. Conclusion: Our patient's recurrent pregnancy wastage was caused
by chorioamnionitis secondary to an enterouterine fistula resulting fr
om foreign body ingestion. A complete reversal of this problem is anti
cipated.