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An examination of 163 females suffering from habitual miscarriage revealed chlamydia in 41.7%. The miscarriage rate was 59.1% inChlamydia infection. All the females recovered from Chlamydia infection delivered in term. Antichlamydial agents should be supplemented as part of combined therapy of habitual abortion in patients with Chlamydia infection.
The risks of perinatal HIV transmission do not currently constitute grounds for morally criticizing the reproductive choices of particular infected women. A contextualized assessment of morally relevant factors might in some cases, however, justify judgments of reproductive irresponsibility. Although no women should be subject to any form of coercive pressure when making the decision to initiate or continue pregnancy, a "moral-education" model of nondirective counseling may be appropriate for women carrying HIV. Not even highly desirable, concerted public efforts to foster social justice will eliminate the ethical questions of whether these women should have children and how to counsel them.
Maternal Chlamydia trachomatis infections have been associated with premature rupture of the membranes, preterm labor, premature birth, and fetal wastage. Women with acute infection may be at particular risk. We report the case of an unexplained second trimester spontaneous abortion with serologic evidence of recent infection with C. trachomatis. Serum IgG antibody titer ultimately exceeded 1:10,240. This patient also had an incidental finding of appendiceal carcinoid tumor. While treatment of asymptomatic chlamydial infections in early pregnancy is controversial, we suggest that delaying treatment may result in fetal loss.
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The Type 2 herpes simplex virus is mainly localized in the genital region and is transmitted by sexual intercourse. A distinction must be made between primary and recurrent infection. During pregnancy, infection of the generative tract with HSV-2 can be expected in 0.1% of cases, depending on the patient's social status. It was possible to culture HSV-2 from the cervical secretion in 0.65% of an investigated group of pregnant women. Fifty percent of all infections in pregnancy are asymptomatic. Miscarriages are common before the 20th week of pregnancy (33%), while later there is a slight increase in premature confinement. Where HSV-2 infection exists at the time of birth, cesarean section is the method of choice for delivery. If rupture of the amnion has occurred over 4 hours previously surgical delivery to prevent infection is no longer justified. A start has been made on therapy for herpes genitalis and neonatal herpes, although sufficient experience for therapeutic recommendations has not yet been gathered.
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A prospective study on brucellosis in 125 black patients presenting with inevitable or incomplete spontaneous abortion not obviously due to another cause is presented. They were all consecutive cases presenting during weekdays to Edendale Hospital, Pietermaritzburg. Brucellosis was investigated by means of the history and serological and culture studies of intra-uterine swabs. No case of acute Brucella infection was demonstrated; however, there were 5 cases in which the serological finding was consistent with chronic brucellosis (4%). In all these cases no positive evidence of close animal contact could be found; furthermore of the 12,1% of women who actually handled domestic animals, only 1 had a history of previous abortion.
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