A female presents with leaking and meconium- stained liquior at 32 weeks. She is infected with:
Correct Answer: Listeria
Description: Ans. is b, i.e. ListeriaRef: Williams Obs. 23/e, p 1224"Discolored brownish or meconium-stained amniotic fluid is common with fetal infection, even with preterm gestation."Hence, the correct answer is Listeria, rest of the infections do not lead to preterm labour with meconium-stained liquor.ListeriosisCausative organism--listeria monocytogenes (facultative intracellular gram positive bacillus)Mode of infection--Food-borne infection caused by eating food like raw vegetables, coleslaw, apple cider, melons, milk, fresh Mexican style cheese, smoked fish, processed foods.Clinical features-Can be asymptomatic-Can cause febrile illness.Maternal complications which can occur due to listeria infection are:-Preterm labor,-Chorioamnionitis,-Meconium-stained liquor,-Abortions,-Placental macroabscessesMaternal infection can lead to fetal infection characterized by:-Disseminated granulomatous lesions with microabscess in skin-Stillbirth-Overall perinatal mortality--50%.Management-Drug of choice is combination of Ampicillin + gentamicin or in case of pencillin allergy - Trimethoprim sulfamethoxazole-Maternal treatment may be effective for fetal infection-There is no vaccine for listeriosis.
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Gynaecology & Obstetrics
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