11 - Maternal and Fetal Infection

Abstract

This chapter presents an overview of maternal and fetal infections. The great majority of infants born at term to apparently healthy women are free of readily identifiable infection. Preterm infants, on the other hand, are at greater risk for their birth is sometimes preceded or accompanied by low-grade genital infection in the mother that rarely affects her well-being and is thus unsuspected. Viral and protozoal infections acquired in the first trimester because of rubella, cytomegalovirus, herpes simplex virus (HSV), and Toxoplasma can be devastatingly crippling for the individual child. Numerically speaking, however, such early damaging infections are in the minority, and, with the possible exceptions of rubella early in the second trimester and HSV at any time, acquisition of viral and protozoal infections later in pregnancy or even during delivery leads to mild or inapparent clinical involvement of the child. Many early and later spontaneous abortions may be accompanied by chorioamnionitis, and ascending bacterial infection may have a causal role. Women with many sexual partners and of poor social background are more likely to be colonized with a number of microorganisms, which may be transmitted to the fetus in labor. Surgical induction and transvaginal monitoring may occasionally increase the risk of ascending infection.