Corioamnionitis

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Autores

Oscar Eduardo Mendoza R.
Francisco Briceño Palomino
Nataly Ramos Franco
Diego Rodríguez Guerra
Nicolás Rodríguez Niño

Resumen

La corioamnionitis es una patología de difícil diagnóstico certero, por lo que constituye un problema para los médicos que se ven abocados a su manejo. No solo produce alteraciones en el transcurso usual de los embarazos sino que causa alta morbimortalidad en los recién nacidos. El presente escrito muestra en forma general la fisiopatología, los hallazgos clínicos y paraclínicos de la enfermedad y su manejo, con la finalidad de realizar una actualización breve del estado del arte que impacte en los especialistas que se enfrentan a las maternas con probables infecciones intraamnióticas. Abreviaturas: SIRF, síndrome de respuesta inflamatoria fetal; RPM, ruptura prematura de membranas; RN, recién nacido (s).

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Referencias

1. Cobo T, Plaza A., Palacio M. Corioamnionitis clinica. En: Protocolos de medicina fetal y perinatal. Barcelona: Hospital Universitari;2008. p. 1 - 3.

2. Tita AT, Andrews W. Diagnosis and management of clinical chorioamnionitis. Clin Perinatol. 2010 Jun; 37(2):339-54.

3. Espitia de la Hoz FJ. Diagnóstico y tratamiento de la corioamnionitis clinica. Rev Colomb Obstet Ginecol. 2008. 59(3): 231-7.

4. Rivera R., C.F., Smirnow M., Aguilera J., Larraín A. Fisiopatología de la rotura prematura de las membranas ovulares en embarazos de pretérmino. Rev Chil Obstet Ginecol. 2004. 69 (3):249-55.

5. Czikk MJ, McCarthy FP, Murphy KE. Chorioamnionitis: from pathogenesis to treatment. Clin Microbiol Infect. 2011 Sep; 17(9):1304-11.

6. Redline RW. Inflammatory response in acute chorioamnionitis. Semin Fetal Neonatal Med. 2012 Feb; 17(1):20-5.

7. Menon R, Taylor RN, Fortunato SJ. Chorioamnionitis--a complex pathophysiologic syndrome. Placenta, 2010. 31(2):113-20.

8. Rincón Ricote MI, Magdaleno Dans F, Sancha Naranjo M, Omeñaca Teres F, González González A. Corioamnionitis histológica y morbimortalidad neonatal: aproximación al síndrome de respuesta inflamatoria fetal. . Rev Chil Obstet Ginecol. 2010; 75(3): 172-8.

9. Anderson BL, Simhan HN, Simons KM, Wiesenfeld HC. Untreated asymptomatic group B streptococcal bacteriuria early in pregnancy and chorioamnionitis at delivery. Am J Obstet Gynecol. 2007 Jun; 196(6): 524.e1-5.

10. Newton ER. Preterm labor, preterm premature rupture of membranes, and chorioamnionitis. Clin Perinatol. 2005 Sep; 32(3):571-600.

11. Romero R, Espinoza J, Gonçalves LF, Kusanovic JP, Friel L, Hassan S. The role of inflammation and infection in preterm birth. Semin Reprod Med. 2007 Jan; 25(1):21-39.

12. Goldman AS, Schmalstieg FC. The pathogenesis of chorioamnionitis. J Pediatr. 2008 Jul; 153(1):3-4.

13. Ovalle A, Gómez R, Martínez R, Rubio R, Valderrama O, Lira P, Romero R. Antibiotic therapy in patients with preterm premature rupture of membranes: a prospective randomized, placebo-controlled study with microbiological assessment of the amniotic cavity and lower genital tract. J Perinat Neonat Med 1997; 2: 123-6.

14. Baschat AA, Towbin J, Bowles NE, Harman CR, Weiner CP. Prevalence of viral DNA in amniotic fluid of low-risk pregnancies in the second trimester. Maternalfetal & neonatal medicine J Matern Fetal Neonatal Med. 2003 Jun; 13(6):381-4.

15. Tsekoura EA, Konstantinidou A, Papadopoulou S, Athanasiou S, Spanakis N, Kafetzis D, et al. Adenovirus genome in the placenta: association with histological chorioamnionitis and preterm birth. J Med Virol. 2010 Aug; 82(8):1379-83.

16. Asemota OA, Nyirjesy P, Fox R, Sobel JD. Candida glabrata complicating in vitro pregnancy: successful management of subsequent pregnancy. Fertil Steril. 2011 Feb; 95(2):803.e1-2.

17. Meizoso T, Rivera T, Fernández-Aceñero MJ, Mestre MJ, Garrido M, Garaulet C. Intrauterine candidiasis: report of four cases. Arch Gynecol Obstet. 2008 Aug; 278(2):173-6.

18. Fowler P. Methicillin-resistant Staphylococcus aureus chorioamnionitis: a rare cause of fetal death in our community. Aust N Z J Obstet Gynaecol. 2002 Feb; 42(1):97-8.

19. Geisler JP, Horlander KM, Hiett AK. Methicillin resistant Sthaphylococcus aureus as a cause of chorioamnionitis. Clin Exp Obstet Gynecol. 1998; 25(4):119-20.

20. Bjartling C, Osser S, Persson K. The association between mycoplasma genitalium and pelvic inflammatory disease after termination of pregnancy. BJOG. 2010 Feb; 117(3):361-4.

21. Waites KB, Schelonka RL, Xiao L, Grigsby PL, Novy MJ. Congenital and opportunistic infections: Ureaplasma species and Mycoplasma hominis. Semin Fetal Neonatal Med. 2009 Aug; 14(4):190-9.

22. Robertson JA, Stemke GW, Davis JW Jr, Harasawa R, Thirkell D, Kong F Proposal of Ureaplasma parvum sp. nov. and emended description of Ureaplasma urealyticum (Shepard et al. 1974) Robertson et al. 2001. Int J Syst Evol Microbiol. 2002 Mar; 52(Pt 2):587-97.

23. Smith DG, Rusell WC, Ingledew WJ, Thirkell D. Hydrolysis of urea by Ureaplasma urealyticum generates a transmembrane potential with resultant ATP synthesis. J Bacteriol. 1993 June; 175(11): 3253-58.

24. Glass JI, Lefkowitz EJ, Glass JS, Heiner CR, Chen EY, Cassell GH. The complete sequence of the mucosal pathogen Ureaplasma urealyticum. Nature. 2000 Oct 12; 407(6805):757-62.

25. Zheng X, Watson HL, Waites KB, Cassell GH. Serotype diversity and antigen variation among invasive isolates of Ureaplasma urealyticum from neonates. Infect Immun. 1992 August; 60(8): 3472-74.

26. Monecke S, Helbig JH, Jacobs E. Phase variation of the multiple banded protein in Ureaplasma urealyticum and Ureaplasma parvum. Int J Med Microbiol. 2003 Jun; 293(2-3):203-11.

27. Zimmerman CU, Stiedl T, Rosengarten R, Spergser J. Alternate phase variation in expression of two major surface membrane proteins (MBA and UU376) of Ureaplasma parvum serovar 3. FEMS Microbiol Lett. 2009 Mar; 292(2):187-93.

28. Knox CL, Dando SJ, Nitsos I, Kallapur SG, Jobe AH, Payton D, et al. The severity of chorioamnionitis in pregnant sheep is associated with in vivo variation of the surface-exposed multiple-banded antigen/gene of Ureaplasma parvum. Biol Reprod. 2010 Sep; 83(3):415-26.

29. Kong F, Gilbert GL. Postgenomic taxonomy of human ureaplasmas – a case study based on multiple gene sequences. Int J Syst Evol Microbiol. 2004 Sep; 54(Pt 5):1815-21.

30. McIver CJ, Rismanto N, Smith C, Naing ZW, Rayner B, Lusk MJ, et al. White P., Rawlinson W., Multiplex PCR Testing Detection of Higher-than-Expected Rates of Cervical Mycoplasma, Ureaplasma, and Trichomonas and Viral Agent Infections in Sexually Active Australian Women. J Clin Microbiol. 2009 May; 47(5):1358-63.

31. Kasper DC, Meschtler TP, Reischer GH, Witt A, Langgartner M, Pollak A, et al. The bacterial load of Ureaplasma parvum in amniotic fluid is correlated with an increased intrauterine inflammatory response. Diagn Microbiol Infect Dis. 2010 Jun; 67(2):117-21.

32. Larsen B, Hwang J. Mycoplasma, Ureaplasma, and Adverse Pregnancy Outcomes: A Fresh Look. Infect Dis Obstet Gynecol. 2010; 2010. pii: 521921.

33. Kacerovský M, Pavlovský M, Tosner J. Preterm premature rupture of the membranes and genital mycoplasmas. Acta medica (Hradec Králové). 2009. 52(3):117-20.

34. Namba F, Hasegawa T, Nakayama M, Hamanaka T, Yamashita T, Nakahira K. Placental features of chorioamnionitis colonized with Ureaplasma species in preterm delivery. Pediatr Res. 2010 Feb;67 (2):166-72.

35. Donders GG, Van Calsteren K, Bellen G, Reybrouck R, Van den Bosch T, Riphagen I, Van Lierde S. Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy. BJOG. 2009 Sep; 116(10):1315-24.

36. Ekiel AM, Pietrzak B, Kamiński P, Dolezych H, Jóźwiak J, Martirosian G. Prevalence of urogenital mycoplasmas and ureaplasmas in women after kidney transplantation. Transplantation, 2009. 87(6): 848-51.

37. Gaydos C, Maldeis NE, Hardick A, Hardick J, Quinn TC. Mycoplasma genitalium as a Contributor to the Multiple Etiologies of Cervicitis in Women Attending Sexually Transmitted Disease Clinics. Sex Transm Dis. 2009 Oct; 36(10):598-606.

38. Romero R, Gonzalez R, Sepulveda W, Brandt F, Ramirez M, Sorokin Y, et al. Infection and labor. VIII. Microbial invasion of the amniotic cavity in patients with suspected cervical incompetence: prevalence and clinical significance. Am J Obstet Gynecol. 1992 Oct; 167(4 Pt 1):1086-91.

39. Lee SE, Romero R, Park CW, Jun JK, Yoon BH. The frequency and significance of intraamniotic inflammation in patients with cervical insufficiency. Am J Obstet Gynecol. 2008 Jun; 198(6): 633e1-8.

40. Yoon BH, Romero R, Kim M, Kim EC, Kim T, Park JS, Jun JK. Clinical implications of detection of Ureaplasma urealyticum in the amniotic cavity with the polymerase chain reaction. Am J Obstet Gynecol. 2000 Nov; 183(5):1130-7.

41. Yoon BH, Romero R, Lim JH, Shim SS, Hong JS, Shim JY, Jun JK. The clinical significance of detecting Ureaplasma urealyticum by the polymerase chain reaction in the amniotic fluid of patients with preterm labor. Am J Obstet Gynecol. 2003 Oct; 189(4):919-24.

42. Teng K, Li M, Yu W, Li H, Shen D, Liu D.Comparison of PCR with culture for detection of Ureaplasma urealyticum in clinical samples from patients with urogenital infections. J Clin Microbiol. 1994 Sep; 32(9):2232-4.

43. Blanchard A, Hentschel J, Duffy L, Baldus K, Cassell GH. Detection of Ureaplasma urealyticum by polymerase chain reaction in the urogenital tract of adults, in amniotic fluid, and in the respiratory tract of newborns. Clin Infect Dis. 1993 Aug; 17 Suppl 1:S148-53.

44. Egawa T, Morioka I, Morisawa T, Yokoyama N, Nakao H, Ohashi M, Matsuo M. Ureaplasma urealyticum and Mycoplasma hominis presence in umbilical cord is associated with pathogenesis of funisitis. Kobe J Med Sci. 2007; 53(5):241-9.

45. Goldenberg RL, Andrews WW, Goepfert AR, Faye-Petersen O, Cliver SP, Carlo WA, Hauth JC. The Alabama Preterm Birth Study: umbilical cord blood Ureaplasma urealyticum and Mycoplasma hominis cultures in very preterm newborn infants. Am J Obstet Gynecol. 2008 Jan;198(1):43.e1-5.

46. Cunliffe NA, Fergusson S, Davidson F, Lyon A, Ross PW. Comparison of culture with the polymerase chain reaction for detection of Ureaplasma urealyticum in endotracheal aspirates of preterm infants. J Med Microbiol. 1996 Jul; 45(1):27-30.

47. Viscardi RM, Manimtim WM, Sun CC, Duffy L, Cassell GH. Lung pathology in premature infants with Ureaplasma urealyticum infection. Pediatr Dev Pathol. 2002 Mar-Apr; 5(2):141-50.

48. Viscardi RM, Hashmi N, Gross GW, Sun CC, Rodriguez A, Fairchild KD. Incidence of invasive ureaplasma in VLBW infants: relationship to severe intraventricular hemorrhage. J Perinatol. 2008 Nov; 28(11):759-65.

49. Desarrollo de tejidos y organos del cuerpo. En: Moore KL. Embriologia clínica. Barcelona: Elsevier; 2009. p. 74 - 97.

50. Las Heras J, Dabancens A, Cerón-Ferré M. Placenta y anexos embrionarios. En: Pérez Sánchez A. Obstetricia. 3a. ed. Santiago: Editorial Mediterráneo; 1999. p. 118-36.

51. La placenta y las membranas fetales. En: Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom KD. Williams Obstetricia. Buenos Aires: Médica Panamericana; 2001. p. 72 - 91.

52. Malak TM, Bell SC Structural characteristics of term human fetal membranes: a novel zone of extreme morphological alteration within the rupture site. Br J Obstet Gynaecol. 1994 May; 101(5):375-86.

53. Gervasi MT, Chaiworapongsa T, Naccasha N, Pacora P, Berman S, Maymon E, et al. Maternal intravascular inflammation in preterm premature rupture of membranes. J Matern Fetal Neonatal Med. 2002 Mar; 11(3):171-5.

54. Athayde N, Romero R, Maymon E, Gomez R, Pacora P, Yoon BH, Edwin SS. Interleukin 16 in pregnancy, parturition, rupture of fetal membranes, and microbial invasion of the amniotic carity. Am J Obstet Gynecol. 2000 Jan; 182(1 Pt 1):135-41.

55. Keelan JA, Yang J, Romero RJ, Chaiworapongsa T, Marvin KW, Sato TA, Mitchell MD. Epithelial cell-derived neutrophil-activating peptide-78 is present in fetal membranes and amniotic fluid at increased concentrations with intra-amniotic infection and preterm delivery. Biol Reprod. 2004 Jan;70(1):253-9.

56. Buhimschi IA, Kramer WB, Buhimschi CS, Thompson LP, Weiner CP. Reduction-oxidation (redox) state regulation of matrix metalloproteinase activity in human fetal membranes. Am J Obstet Gynecol. 2000 Feb; 182(2):458-64.

57. Maymon E, Romero R, Pacora P, Gomez R, Athayde N, Edwin S, Yoon BH. Human neutrophil collagenase (matrix metalloproteinase 8) in parturition, premature rupture of the membranes and intrauterine infection. Am J Obstet Gynecol. 2000 Jul; 183(1):94-9.

58. Maymon E, Romero R, Pacora P, Gervasi MT, Edwin SS, Gomez R, Seubert DE. Matrilysin (matrix metalloproteinase 7) in parturition, premature rupture of membranes, and intrauterine infection. Am J Obstet Gynecol. 2000 Jun; 182(6):1545-53.

59. Bryant-Greenwood GD, Millar LK. Human fetal membranes: their preterm premature rupture. Biology of Reproduction. Biol Reprod. 2000 Dec; 63(6):1575-9.

60. Ognjanovic S, Tashima LS, Bryant-Greenwood GD. The effects of pre-b-cell colony enhancing factor on the human fetal membranes by microaway analisis. Am J Obstet Gynecol. 2003 Oct; 189(4):1187-95.

61. Kim CJ, Yoon BH, Romero R, Moon JB, Kim M, Park SS, Chi JG. Umbilical arteritis and phlebitis mark different stages of the fetal inflammatory response. Am J Obstet Gynecol. 2001 Aug; 185(2):496-500.

62. Cornette L. Fetal and neonatal inflammatory response and adverse outcome. Semin Fetal Neonatal Med. 2004 Dec; 9(6):459-70.

63. Rogers BB, Alexander JM, Head J, McIntire D, Leveno KJ. Umbilical vein interleukin-6 levels correlate with the severity of placental inflammation and gestational age. Hum Pathol. 2002 Mar; 33(3):335-40.

64. Kim CJ, Yoon BH, Kim M, Park JO, Cho SY, Chi JG. Histo-topographic distribution of acute inflammation of the human umbilical cord. Pathol Int. 2001 Nov; 51(11):861-5.

65. Craven CM, Ward K. Fetal endothelial cells express vascular cell adhesion molecule in the setting of chorioamnionitis. Am J Reprod Immunol. 2000 May; 43(5):259-63.

66. D’Alquen D, Kramer BW, Seidenspinner S, Marx A, Berg D, Groneck P, Speer CP. Activation of umbilical cord endothelial cells and fetal inflammatory response in preterm infants with chorioamnionitis and funisitis. Pediatr Res. 2005 Feb;57(2):263-9.

67. Newton ER, Prihoda TJ, Gibbs RS. Logistic regression analysis of risk factors for intra-amniotic infectio. Obstet Gynecol. 1989 Apr; 73(4):571-5.

68. Gibbs RS, Duff P. Progress in pathogenesis and management of clinical intraamniotic infection. Am J Obstet Gynecol. 1991 May; 164(5 Pt 1):1317-26.

69. Fahey JO. Clinical management of intra-amniotic infection and chorioamnionitis: a review of the literature. J Midwifery Womens Health. 2008 May-Jun; 53(3):227-35.

70. ACOG Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol. 2007 Apr; 109(4):1007-19.

71. Hoskins IA, Johnson TR, Winkel CA. Leukocyte esterase activity in human amniotic fluid for the rapid detection of choriamnionitis. Am J Obstet Gynecol. 1987 Sep; 157(3):730-2.

72. van de Laar R, van der Ham DP, Oei SG, Willekes C, Weiner CP, Mol BW. Accuracy of C-reactive protein determination in predicting chorioamnionitis and neonatal infection in pregnant women with premature rupture of membranes: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2009 Dec;147(2):124-9.

73. Tita AT, Andrews WW. Diagnosis and management of clinical chorioamnionitis. Clin Perinatol. 2010 Jun; 37(2):339-54.

74. Newton ER. Preterm labor, preterm premature rupture of menbranes and choriamnionitis. Clin Perinatol. 2005 Sep; 32(3):571-600.

75. Rojas JL, Sayago CA, Rodríguez Daza H. Ruptura prematura de membranas. En: Rojas Mora AE, Parra Duarte SA. Revision de temas y pautas de tratamiento en ginecologia y obstetricia. 2a ed. Bogotá : Fundación Universitaria de Ciencias de la Salud; 2008. p. 327-37.

76. Mercer BM. Preterm premature rupture of the membranes: current approaches to evaluation and management. Obstet Gynecol Clin North Am. 2005 Sep; 32(3):411-28.

77. Kenyon SL, Taylor DJ, Tarnow-Mordi W; ORACLE Collaborative Group. Broad-spectrum antibiotics for preterm, prelabour rupture of fetal membranes: the ORACLE I randomised trial. ORACLE Collaborative Group. Lancet. 2001 Mar 31; 357(9261):979-88.

78. Hopkins L, Smaill F. Antibiotic regimens for management of intraamniotic infection. Cochrane Database Syst Rev. 2002;(3):CD003254.

79. Coto Cotallo GD, Ibañez Fernández A. Protocolo diagnóstico-terapéutico de la sepsis neonatal. Bol Pediatr. 2006. 46(1): 125-34.

80. Gibbs RS, Dinsmoor MJ, Newton ER, Ramamurthy RS. A randomized trial of intrapartum versus immediate postpartum treatment of women with intra-amniotic infection. Obstet Gynecol. 1988 Dec; 72(6):823-8.

81. Klein LL, Gibbs RS. Infection and Preterm Birth. Obstet Gynecol Clin North Am. 2005 Sep; 32(3):397-410.

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