N. Mendoza et al., RELATIONSHIP BETWEEN INFECTION OF THE FEMALE GENITAL-TRACT AND TOCOLYTIC RESPONSE IN PRETERM LABOR, Journal of maternal-fetal investigation, 7(1), 1997, pp. 21-24
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.