Does amniotomy influence the prognosis of babies in cases with severe chorioamnionitis - Report of a twin pregnancy with varying outcome

We report our experience in a woman with a twin pregnancy, The patient suff ered severe Escherichia coli chorioamnionitis and the outcomes were differe nt between the two babies after birth. The first baby had only a mild infec tion, but the second suffered sepsis and subsequent perinatal death. These differences in outcome appeared to be due to amniotomy performed for the fi rst baby after late labor stage I to augment uterus contractions. Removal o f infectious amniotic fluid from the amniotic cavity might thus have preven ted the spread of the chorioamnionitis, E, coli sometimes causes severe inf ection during pregnancy and the perinatal period. In this case, a large num ber of enteropathogenic E. coli (serotype O-6) was cultured from blood, sto ol, pharyngeal swab, gastric juice and puncture fluid from the thoracic cav ity of the second baby. O-6 is classified an enterotoxigenic strain mainly causing diarrhea because of endotoxin released from bacteria. O-6 has not h itherto been reported as a cause of severe infection in chorioamnionitis an d perinatal sepsis. Copyright (C) 2000 S. Karger AG, Basel.