RELATIONSHIP BETWEEN INFECTION OF THE FEMALE GENITAL-TRACT AND TOCOLYTIC RESPONSE IN PRETERM LABOR

Objective: Strong evidence of an association between female genital in fections and preterm labor has been reported. This association seems m ore obvious in recurrences of preterm labor or when tocolytic treatmen t fails. Methods: We evaluated the presence of microorganisms in the g enital tract, urine, amniotic fluid, and placental tissues in 105 pati ents with preterm labor. Bacteriological comparisons were done between the 85 patients who responded to tocolytic treatment and the 20 in wh om treatment was unsuccessful. Failure of tocolysis was diagnosed when delivery occurred within 7 days of the onset of treatment. Results: O rganisms in the female genital tract, other than Lactobacillus sp., we re isolated more frequently in patients who did not respond to tocolyt ic treatment (85 versus 61.18%, P < 0.05). When the presence of each s pecies of microorganism was analyzed separately, there were no signifi cant differences between the groups in rates of colonization. Microorg anisms were isolated from chorioamniotic tissues more frequently when tocolytic treatment failed (80 versus 19.34%), P < 0.005). In the fail ure group, the percentage of histologic lesions of the placenta and th e severity of these were higher. Conclusions: A number of microorganis ms not commonly isolated in genital infections were found to be highly pathogenic. However, conclusive evidence of the role of genital colon ization by habitual microorganism (e.g., Mycoplasma sp.) in preterm la bor remains elusive.