Intra amniotic candidiasis. Case report and meta-analysis cases

We present a case of mid pregnancy loss with retained intrauterine contrace ptive device associated with fetal Candida infection. Review of English lit erature identified 53 additional cases of fetal candidal infection, with 17 associated with an IUCD in situ. The presence of an IUCD was associated wi th delivery at a statistically significant earlier gestational age when com pared to cases not associated with an IUCD (23.3 +/- 4.9 vs 31.6 +/- 7.0, p < 0.001). Seventy-seven percent of fetal candidal infections associated wi th an IUCD were systemic (heart, brain, liver, gastrointestinal, lung) comp ared to 33 % of cases not associated with an IUCD. In contrast to bacterial intraamniotic infections there was a low incidence of maternal febrile mor bidity. An hypothesis as to the pathogenesis of Candidal infections in the presence and absence of an IUCD is offered as well as a paradigm for the ma nagement of the gravid patient with an IUCD in situ.