1. CHLAMYDIA, RUBELLA AND CMV (ELISA)

2. Abortion Defined as delivery occurring before the 28 th completed week of gestation Fetus weighing less than 500g Early abortion and late abortion 15% of clinically evident pregnancies 80% of abortions prior to 12 weeks’ gestation

3. Etiology Infection Exposure to high levels of radiation or toxic agents Hormonal problems, Thyroid disease. Uterine abnormalities, Incompetent cervix. Disorders of the immune system, including lupus Some Diseases: Severe kidney disease, Congenital heart disease, Diabetes that is not controlled Certain medications, such as the acne drug Accutane Severe malnutrition

4. Infections Maternal infection with a large number of different organisms has been associated with an increased risk of miscarriage. Fetal or placental infection by the offending organism then leads to pregnancy loss. Examples of infections that have been associated with miscarriage include infections by Listeria monocytogenes, TORCH (Toxoplasma gondii, rubella, herpes simplex, cytomegalovirus) parvovirus B19,, and lymphocytic choriomeningitis virus.

5. CHLAMYDIA

6. Classification Confusion occurred by the discovery of Chlamydia as it was classified as both bacteria and virus: It is classified as virus for its: Basophilic staining in the host cell to form the elementary bodies, which are small, dense and about 0.3µ in diameter. Intracellular micro-organism, they can’t synthesized ATP, but use the host cell for this purpose.

7. It differs from viruses by: They have both DNA and RNA. Have their self-metabolic system. They are able to grow and multiply. They are surrounded by a cell membrane. Response to antibiotic thereby.

8. Species of chlamydia: C. psittaci, cause psittacosis. C. lymphogranulomatis, cause lymphgranuloma venerum. C. trachomatis, cause conjunctival and cornea disease. ( Trachoma ) C. occulogenitalis, cause conjunctivitis.

9. Psittacosis: Is a respiratory disease of man acquired from contact with infected birds, which excretes the organism in the stool. It causes infection in the upper respiratory system and also pneumonia.

10. Laboratory diagnosis: Sputum and blood test ( smear to show elementary bodies ). Virus isolation: as the virus can be isolated by inoculation of the yolk sac, by the intracerebral intranasal or intraperitoneal injection into mice. Serological tests: Complement fixation. Agglutination test. Neutralization test. ELISA

11. Lymphgranuloma venerum: Is a venereal disease characterized by: Enlargement of the regional lymph nodes, tend to form sinuses. Infect the urethral parts and cause urethritis and is accompanied by systemic symptom of an infection.

12. Laboratory diagnosis: Smears ( biopsy from the infected lymph node ), pus cells can be seen from infected lymph nodes and stain ( elementary bodies ). Culture: is not useful as it will give neg. results and resist all antibiotics.

13. Trachoma: Grows in the conjunctival and cornea cells to cause kerato-conjuctivitis. Laboratory diagnosis: Smear. ELISA.

14. RUBELLA

15. Rubella is a rather mild disease spread by the way of respiratory secretion. Cause German measles, there symptom is: Firstly catarrhal symptoms and mild fever. Irregular rash. There incubation period is 3 – 4 weeks. The tragic aspect of Rubella may become evident of infection occurs during pregnancy. The virus can cross the placental wall and infect the virus, this may lead to fetal death or congenital defect which may be: Hearing loss. Mental retardation.

16. Laboratory diagnosis: Complement fixation. Neutralization test. Heme immune agglutination (HIA). Heme agglutination inhibition (HAI). ELISA, IgM and IgG.

17. CYTOMEGALO VIRUS

18. CMV is called salivary gland virus which may infects salivary glands or parotid glands. An increase number of infections with this virus have reported in adults with neoplastic disease, leukemia, or tissue transplantation. We can isolate this virus from all body fluids

19. Laboratory diagnosis: Histopatholgical studies, this virus leads to the formation of certain inclusion in the infected cells. Virus isolation. ELISA.

20. Notice: when we measure IgG, it rarely negative and often positive, so we determine the titer, suppose it is 300 IU/ml, after 2-3 weeks we make follow up and do the CMV again, if: The titer in the same level it is negative. The titer is high, it is positive.

21. HERPES SIMPLEX VIRUS

22. (HSV-1 and HSV-2), also known as human herpesvirus 1 and 2 (HHV-1 and HHV-2), HSV-1 and -2 are transmitted by contact with an infected area of the skin, sexual transmissions. neurotropic and neuroinvasive viruses, HSV-1 and -2 persist in the body by becoming latent and hiding from the immune system in the cell bodies of neurons. Treatment acyclovir

23. Laboratory diagnosis: Virus isolation. ELISA.