1. Marisiensis 2014 INFECTIONS IN PRETERM BIRTH COORDINATOR: Asist. Univ. Dr. OVIDIU GRAMA First author: Farcas Marcela Leontina Authors: Clapon Anca, Roman Nicoleta

2. GENERAL INFORMATIONS -The definition of preterm birth, accepted all around the world is pregnancy ending before 37 weeks or 259 days of gestation. -Intrauterine infection is a major cause of ignite premature labor, beeing present in more than 25 % cases of premature birth.

3. GENERAL INFORMATIONS Preterm labor genesis Microorganisms from the vagina and the cervix ascend chorio-decidual space, then crosses the amnio-choriale membranes, infecting the fetus; The release of postaglandine that takes place, will stimulate uterine contraction determine preterm labor.

4. GENERAL INFORMATIONS Ethiology The incriminated infections in preterm birth ethiology are: inferior genital tract infections, or colonisations from this level; Urinary infections; Some indirect infections (ex. Periodontitis, Chickenpox, Measles)

5. GENERAL INFORMATIONS Incidence of intrauterine infections The prevalence of positive cultures in women with preterm labor 13% - with intact membranes; 32,4% - in case of membranes ruptured; 11,9% - gemelare pregnancy. Lower gestational age at birth increases the frequency of microbial invasion.

6. PURPOSE AND OBJECTIVES The purpose of this study is to determine the frequency of preterm births associated with infections in urban versus rural environment and the age at which is the most frequently seen premature birth.

7. MATERIAL AND METHOD Observational retrospective study ; During 1 january – 30 august 2013; The group included 102 patients Representing pregnant women hospitalized for preterm birth, in Clinic of Obstetrics and Gynecology 2 of Tg. Mures.

8. MATERIAL AND METHOD I watched lower genital tract infections, cervical infections and urinary infections Using: Microscopic examination of vaginal content; Seedings on culture environments from the cervical canal; Urocultures.

9. RESULTS Examination of vaginal content It was conducted in 66 patients; I followed the infections with: Candida albicans; Trichomonas vaginalis; Gardnerella vaginalis.

10. RESULTS

11. Insaminations from cervical canal pre- /postpartum Was performed in 59 of the cases; The most common germs Candida albicans; E. coli; Gardnerella; Streptococus bete-hemolitic; Trichomonas vaginalis; Klebsiella pneumoniae.

12. RESULTS Premature births Prepartum Postpartum numberPercent %numberPercent % Candida albicans414,28310,71 E. coli27,1413,57 Gardnerella27,14310,71 Streptococus bete-hemolitic 510,713 Trichomonas vaginalis 27,142 Klebsiella pneumoniae 13,570-

13. RESULTS Uroculture I have identified performed urocultures at 35 among patients Most did not show any patogent agent

14. RESULTS Uroculture Premature births Pozitive Urocultures Negative Urocultures numberPercent %numberPercent % 1131,422468,58 Acinetobacter Baumanii 19.09- E.Coli218,18- Enterococcus436,36- Candida albicans218,18- Streptococcus bete hemolitic 218,18-

15. INFECTIONS IN PRETERM BIRTH Results The environment from which patients come

16. INFECTIONS IN PRETERM BIRTH Results

19. INFECTIONS IN PRETERM BIRTH Conclusions Most infections are found before birth in case of cervical canal germs. The germ most frequently encountered after vaginal examination content was Candida albicans. Infections in preterm birth are most frequently in rural areas, perhaps because of socio- economic conditions, as well as the lack of health education. Most preterm births are found in the age range 26-30 years old.

20. Thank you, for your atention!