A sad portrait of congenital syphilis in the State of Rio de Janeiro. Case report with Polymerase Chain Reaction (PCR) of scrapings from skin lesions and placenta fragment positive for Treponema pallidum

Introduction: Congenital syphilis is a serious public health problem that causes high rates of intrauterine morbidity and mortality, revealing flaws and weaknesses in the health system. Objective: to report a case of congenital syphilis in a university hospital in the Center-South Region of the State of Rio de Janeiro, Brazil. Case report: A pregnant woman, aged between 19 and 23 years old, carrying a Pregnant Woman's Handbook with a record of seven prenatal consultations and a note of the serological reaction for positive syphilis, but without any treatment, hospitalized at the University Hospital of Vassouras (RJ), in labor, gave birth to a newborn (NB) with a clinical picture and serological test of congenital syphilis. The NB required care in an intensive care unit and was discharged 28 days after birth. Scraping of skin lesions of the NB and placenta was performed for analysis by molecular biology (PCR in house) and genetic material of Treponema pallidum was detected. Conclusion: Congenital syphilis is a serious outcome of syphilis during pregnancy, consuming high financial resources and significant emotional distress for the mother, father, the whole family, as well as for the health teams. Our case report was the first that we are aware of in Brazil with a diagnosis by PCR for positive Treponema pallidum of skin scraping and placental fragment. It also showed poor quality prenatal care, a common factor in most cases of CS in our reality

Imunodetecção de Toxoplasma gondii em tecido placentário de cabras naturalmente infectadas / Immunodetection of Toxoplasma gondii in placenta tissue of naturally infected goats

A imuno-histoquímica (IHQ) é considerada uma ferramenta rápida e precisa para a identificação de protozoários, como Toxoplasma gondii, em tecidos fetais e placentários. Neste estudo foi avaliada a imunodetecção de Toxoplasma gondii em tecido placentário de cabras naturalmente infectadas. Foram coletadas e analisadas 80 amostras de placentas de cabras procedentes de único rebanho com sorologia positiva para T. gondii na técnica de ELISA. Na histopatologia, 27/80 amostras apresentaram lesões sugestivas de infecção por protozoários. Após a avaliação histopatológica, procedeu-se à realização da técnica de imuno-histoquímica, obtendo-se 85,2% (23/27) de amostras com marcação positiva. A imunodetecção ocorreu no epitélio de revestimento das vilosidades coriônicas e foi classificada de acordo com o grau de intensidade da imunomarcação. Também foi evidenciada imunomarcação no interior dos vasos sanguíneos fetais em 8,69% (2/23) das amostras. Este estudo demonstrou que a técnica de IHQ se comportou como uma ferramenta valiosa no diagnóstico da infeção por T. gondii em tecido placentário de cabras naturalmente infectadas e complementou, de forma decisiva, o diagnóstico, além de agregar maior valor aos resultados obtidos nas análises histopatológica e sorológica.(AU)

Immunohistochemistry (IHC) is considered to be a rapid and accurate tool for the identification of protozoa such as Toxoplasma gondii in fetal and placental tissues. In this study, we evaluated the immunodetection of Toxoplasma gondii in placental tissue from naturally infected goats. A total of 80 samples of goat placentas from a single herd with positive ELISA serology for T. gondii were collected and analyzed. In the histopathology, 27/80 samples presented lesions suggestive of protozoal infection. After the histopathological evaluation, the immunohistochemistry technique was performed, obtaining 85.2% (23/27) of samples with positive marking. Immunodetection occurred in the lining epithelium of the chorionic villi and was classified according to the degree of intensity of the immunostaining. Immunostaining within the fetal blood vessels was also evidenced in 8.69% (2/23) of the samples. This study demonstrated that the IHQ technique behaved as a valuable tool in the diagnosis of T. gondii infection in placental tissue of naturally infected goats completing the diagnosis in a decisive way and adding greater value to the results obtained in the histopathological and serological analysis.(AU)

Panorama de la infección por Listeria monocytogenes / Overview of Listeria monocytogenes infection

Resumen La listeriosis es una infección infrecuente pero potencialmente grave, causada por Listeria monocytogenes. La principal vía de transmisión es por el consumo de alimentos contaminados, afecta generalmente a personas mayores, mujeres embarazadas y hospederos inmunosuprimidos, aunque también se ven casos en adultos y niños inmunocompetentes. Listeria monocytogenes es un bacilo grampositivo corto, anaerobio facultativo, no formador de esporas, móvil, que provoca una zona angosta de hemólisis en agar sangre. Es un patógeno intracelular facultativo, por lo que presenta una compleja patogenia. Esta bacteria tiene la habilidad de atravesar la barrera intestinal, la placenta y la barrera hemato-encefálica produciendo cuadros de gastroenteritis, infecciones materno-fetales y meningoencefalitis. Se diagnostica, generalmente, a partir de un cultivo positivo de un sitio estéril. El tratamiento de elección incluye el uso de ampicilina intravenosa sola o en combinación con gentamicina.

Listeriosis is an uncommon but potentially serious infection caused by Listeria monocytogenes. The main route of transmission is through the consumption of contaminated food. It generally affects elderly people, pregnant women and immunosuppressed hosts, although cases are also seen in immunocompetent adults and children. Listeria monocytogenes is a short, anaerobic, non-spore-forming gram-positive bacillus that causes a narrow zone of hemolysis in blood agar. It is a facultative intracellular pathogen, and therefore it shows a complex pathogenesis. This bacterium has the ability to cross the intestinal barrier, the placenta and the blood-brain barrier producing gastroenteritis, maternal-fetal infections and meningoencephalitis. It is most commonly diagnosed from a positive culture of a sterile site. The treatment of choice includes the use of intravenous ampicillin alone or in combination with gentamicin.

Transplacental transmission of Neospora caninum in naturally infected small ruminants from northeastern Brazil / Transmissão transplacentária de Neospora caninum em pequenos ruminantes infectados naturalmente do Nordeste do Brasil

Toxoplasma gondii and Neospora caninum are causative agents of abortion in sheep and goats. Thus, the present study aimed to describe the transplacental transmission of these protozoans in small ruminants of northeastern Brazil. Seventeen fetuses (6 goats and 11 sheep) from farms with history of abortion were necropsied and samples were collected from different tissues (brain, liver, lung, kidney and heart). The samples were analyzed by PCR, histopathology (HP) and immunohistochemistry (IHC) to evaluate whether T. gondii and/or N. caninum infection were the cause of abortion. None of the samples was positive for T. gondii according to PCR and IHC results. Some brain, liver, lung, kidney and heart samples of goat fetuses were positive for N. caninum by PCR. In the histopathology, mild mononuclear infiltration and necrosis with calcification were observed in the liver and brain of one goat fetus, respectively, that also was positive for N. caninum by PCR and IHC. The results confirmed vertical transmission of N. caninum in naturally infected goats of northeastern, Brazil.(AU)

Toxoplasma gondii e Neospora caninum são reconhecidos como protozoário causadores de aborto em ovinos e caprinos. Desta forma, objetivou-se descrever a transmissão transplacentária desses agentes em pequenos ruminantes na região Nordeste do Brasil. Foram examinados seis fetos caprinos e onze fetos ovinos, totalizando 78 amostras de diferentes tecidos (cérebro, fígado, pulmão, rim e coração) provenientes de propriedades rurais com histórico de aborto. As amostras foram analisadas por Reação em Cadeia da Polimerase (PCR), Histopatologia (HP) e Imunohistoquímica (IHQ), com a finalidade de associar o abortamento a T. gondii e/ou N. caninum. Nenhuma amostra foi positiva na PCR e IHQ para T. gondii. Algumas amostras de cérebro, fígado, pulmão, rim e coração de fetos de caprinos e ovinos foram positivas na PCR para N. caninum. Na histopatologia foi observado leve infiltrado mononuclear no fígado e necrose com calcificação no SNC de um caprino, associada à imunomarcação positiva para N. caninum na IHQ e PCR positiva. Os resultados confirmam a transmissão vertical de N. caninum em caprinos naturalmente infectados na região nordeste do Brasil.(AU)

Molecular detection and genotypic characterization of toxoplasma gondii in paraffin-embedded fetoplacental tissues of women with recurrent spontaneous abortion

Background: Congenital toxoplasmosis is an important cause of spontaneous abortion worldwide. However, there is limited information on detection and genotypic characterization of Toxoplasma gondii [T. gondii] in women with recurrent spontaneous abortion [RSA]. The aim of this study is the molecular detection and genotypic characterization of T. gondii in formalin-fixed, paraffin-embedded fetoplacental tissues [FFPTs] of women with RSA that have referred to the Avicenna Research Institute in Tehran, Iran

Materials and Methods: This experimental research was undertaken on 210 FFPTs of women with RSA. The information of the patients was collected from the archives of Avicenna Research Institute in Tehran, Iran. After DNA extraction, the presence of T. gondii was examined by nested polymerase chain reaction targeting the GRA6 gene. Genotyping was performed on positive samples using polymerase chain reaction-restriction fragment length polymorphism [PCR-RFLP] that targeted the GRA6 and SAG3 genes. Sequencing was conducted on two GRA6 positive samples

Results: T. gondii DNA was detected in 3.8% [8/210] of the samples. Genotyping showed that all positive samples belonged to type III of the T. gondii genotype. Sequencing two genomic DNAs of the GRA6 gene revealed 99% similarity with each other and 99-100% similarity with T. gondii sequences deposited in GenBank. There were six patients with histories of more than three abortions; one patient had a healthy girl and another patient had two previous abortions. Abortions occurred in the first trimester of pregnancy in seven patients and in the second trimester of pregnancy in one patient

Conclusion: The results of this study have indicated that genotype III is the predominant type of T. gondii in women with RSA in Tehran, Iran. Also, our findings suggest that toxoplasmosis may play a role in the pathogenesis of RSA. However, further studies are needed to elucidate a clear relationship between T. gondii infection and RSA

Respuesta humoral y consecuencias reproductivas en ovejas desafiadas con Brucella ovis al final de la gestación / Immune response and reproductive consequences in experimentally infected ewes with Brucella ovis during late pregnancy

La brucelosis ovina por Brucella ovis es una enfermedad de prevalencia alta en Argentina. Para evaluar la patogenicidad de B. ovis y la respuesta serológica durante el último mes de gestación, 6 ovejas se distribuyeron en dos grupos: G1, ovejas preñadas, n = 4 y G2, ovejas no preñadas, n = 2. Tres ovejas del G1 (15 días preparto) y una del G2 fueron inoculadas con B. ovis. Se analizaron muestras de suero mediante diferentes pruebas serológicas. Se realizó aislamiento y PCR a partir de mucus cérvico-vaginal (mcv), placenta y leche. En las muestras de placenta se realizó histopatología. Las hembras del G1 parieron corderos vivos; se detectaron anticuerpos en las ovejas desafiadas del G1 a partir de los 5 días posinoculación. El mcv de las ovejas desafiadas resultó negativo al aislamiento en ambos grupos. Las muestras de leche del G1 fueron positivas por cultivo y PCR a B. ovis. La técnica de PCR resultó positiva en las placentas de las ovejas desafiadas del G1. La histopatología reveló una placentitis necrótica supurativa en una de las ovejas desafiadas. El desafío con B. ovis preparto resultó en la invasión de la placenta y de la glándula mamaria, con la consecuente excreción de la bacteria por leche. La infección con B. ovis indujo una respuesta humoral temprana en las ovejas. La colonización de la placenta por B. ovis y la excreción de la bacteria por la leche sugieren un potencial riesgo de infección activa para los corderos y la posibilidad de que estos se comporten como portadores latentes de la infección.

Ovine brucellosis by Brucella ovis is a highly prevalent disease in Argentina. This study aimed to evaluate the pathogenicity of B. ovis and the serological response in ewes during late pregnancy and in their offspring. Six adult ewes were distributed in two groupsGI (pregnant females, n = 4) and G2 (nonpregnant females, n = 2). Three pregnant ewes at 15 days prepartum and one nonpregnant eve were inoculated with B. ovis. Sera of sheep and their offspring were analyzed by different serological tests. Samples of cervicovaginal mucus, placenta and milk were studied by bacteriology. A Brucella genus-specific PCR assay was carried out in placenta and milk samples. Placenta samples were hystopathologically processed. G1 females gave birth to live lambs, but one died hours postpartum. Serological techniques employed detected antibodies in serum of inoculated pregnant animal 5 days postchallenge. Sera of female controls G1 and G2 remained negative throughout the study. Cervicovaginal mucus of infected ewes in G1 and G2 yielded negative results to bacteriology, but B. ovis was isolated from milk. The PCR assay was positive for the placenta and milk from inoculated pregnant ewes. Histopathology revealed necrotic suppurative placentitis in one placenta. However, although results demonstrated that B. ovis can invade the placenta and mammary gland, this bacterium did not cause abortion when it was inoculated intravenously at 15 days prepartum. B. ovis infection induced an early humoral response in pregnant ewes, but their lambs remained seronegative, indicating that there was no transfer of antibodies in infancy. Placenta colonization and milk excretion of B. ovis involves a potential source of infection for lambs, which could play a role as latent carriers of infection.

In vivo cell aggregations of a recent swine biofilm-forming isolate of Leptospira interrogans strain from Argentina / Agregaciones celulares in vivo de Leptospira interrogans producidas por un aislamiento porcino capaz de formar biofilm

Leptospirosis is a zoonosis of ubiquitous distribution caused by spirochetes. Leptospires exist either as saprophytic water-associated organisms or as animal pathogens that can survive in water. Previous works have demonstrated that both saprophytic and pathogenic leptospires are able to produce functional biofilms, which consist of a community of bacteria embedded in an extracellular matrix attached to a surface. This structure is believed to provide protection from environmental aggressiveness. In the present study, we analyzed the capacity of biofilm formation both of a a recent field isolate of Leptospira interrogans serovar Pomona obtained from an aborted swine fetus and of the saprophytic Leptospira biflexa serovar Patoc. We used light microscopy, immunofluorescence, and scanning electron microscopic examinations on glass and polystyrene plate models to evaluate the process in vitro. The ability to form bacterial aggregations in vivo was tested using pregnant guinea pigs infected with both strains. We obtained biofilms both on glass and plastic surfaces. Scanning electron microscopic analysis showed differences in the biofilm structure formed by both strains. L. interrogans serovar Pomona cell aggregations were observed in placental tissues by light microscopy. Biofilms and cell aggregations are consistent with the life of saprophytic strains in water and could help pathogenic strains to colonize the host and lead to abortion in pregnant animals.

La leptospirosis es una zoonosis de amplia distribución causada por el género Leptospira. Las leptospiras existen de manera saprófita asociadas a ambientes acuáticos o como patógenos animales que también pueden sobrevivir en el agua. Trabajos previos demostraron que tanto las leptospiras saprófitas como las patógenas tienen la capacidad de formar biofilms, que consisten en una comunidad de bacterias embebidas en una matriz extracelular adherida a una superficie. Esta estructura tendría la función de proveer protección contra el medioambiente. En este estudio, analizamos la capacidad de formar biofilm en un aislamiento obtenido recientemente de un feto porcino abortado, caracterizado como Leptospira interrogans serovar Pomona, y en la bacteria saprófita Leptospira biflexa serovar Patoc. Se estudió la formación de biofilm en distintas superficies (vidrio y poliestireno), las que se evaluaron por microscopía óptica, inmunofluorescencia y microscopía electrónica de barrido. La capacidad de formar agregaciones bacterianas in vivo se evaluó utilizando un modelo de cobayas preñadas infectadas con ambas cepas. Se obtuvieron biofilms tanto en las superficies plásticas como de vidrio. La microscopía de barrido mostró diferencias en la estructura del biofilm formado entre ambas cepas. Se observaron agregaciones celulares en vasos placentarios de los animales infectados con L. interrogans serovar Pomona. Los biofilms y las agregaciones celulares son compatibles con la vida saprofítica en el agua y podrían favorecer a los microorganismos patógenos en la colonización del hospedador, lo que podría llevar al aborto en los animales preñados.

Relación entre enfermedad periodontal, infección bacteriana ascendente y patología placentaria con parto prematuro / Relationship between periodontal diseases and ascending bacterial infection with preterm delivery

Background: There is an association between periodontal diseases and preterm delivery. Aim: To assess the relationship between periodontal diseases, ascending bacterial infection and placental pathology with preterm delivery. Patients and methods: A periodontal examination and collection of amniotic fluid and subgingival plaque samples were performed in women with preterm labor with intact membranes, without an evident clinical cause or preterm premature rupture of membranes, without clinical chorioamnionitis or labor and a gestational age between 24 and 34 weeks. Microbial invasion of the amniotic cavity was defined as the presence of a positive amniotic fluid culture. Cervicovaginal infection was defined as a bacterial vaginosis or positive culture of cervix or vagina with a high neutrophil count. Ascending bacterial infection was diagnosed as the microbial invasion of the amniotic cavity by ascending bacteria or cervicovaginal infection. Corioamnionitis, funisitis or vellositis were diagnosed. Results: Fifty-nine women were included: fortytwowith preterm labor with intact membranes and seventeen with preterm premature rupture of membranes. The prevalence of periodontal diseases was 93.2%. Microbial invasion of the amniotic fluid was detected in 27.1% of patients. Periodontal pathogenic bacteria were isolated in 18.6% of amniotic fluid samples and 71.2% of subgingival plaque samples. The prevalence of ascending bacterial infection was 83.1% and in 72.9% of women it was associated with periodontal disease. Preterm delivery (<37 weeks) occurred in 64.4% of patients and was significantly associated with generalized periodontal disease and with the association of ascending bacterial infection and periodontal diseases. Patients with preterm delivery and generalized periodontal disease had a higher frequency of chorioamnionitis and funisitis...

La superficie intervellosa de la placa basal de la placenta humana: estudio con el microscopio electrónico de barrido / Intervellous surface of the human palcenta basal plaque: study with electronic microscopic sacnning

Aplicar la técnica de microscopía electrónica de barrido, a la superficie intervellosa de la placa basal de la placenta de 38 semanas, obtenida por cesárea, en paciente de 24 años, aparentemente normal. Especímenes de placa basal fueron obtenidos inmediatamente después del parto, lavados en buffer fosfato a pH 7,3 y fijados por inmersión en glutaraldehido al 2 por ciento, en el mismo buffer, para ser procesados con las técnicas convencionales de microscopía electrónica de barrido. Laboratorio de microscopía electrónica de barrido, CIADANA, Facultad de Ciencias de la Salud, Maracay, Estado Aragua. Se observó una superficie relativamente lisa en algunas regiones y con numerosos pliegues del sincitio en otras, sobre la cual se destacan eritrocitos, células de la placa basal y el aspecto morfológico de la interacción de la vellosidad de anclaje. Esta nueva visión tridimensional exhibe la superficie intervellosa trofoblástica y su interacción con la vellosidad de anclaje, de interés para el entendimiento del desprendimiento placentario

Invasión microbiana de la cavidad amniótica en la rotura de membranas de pretérmino: Resultados maternoneonatales y patología placentaria según microorganismo aislado / Outcome of microbial invasion of amniotic cavity in the preterm premature rupture of membranes

Background: Microbial invasion of amniotic cavity occurs in 30 to 50percent of patients with premature membrane rupture. Aim: To determine the outcomes associated with microbial invasion of the amniotic cavity (MIAC) in patients with preterm premature rupture of membrane (pPROM). Patients and methods: One hundred thirty four patients with preterm pPROM between 24 and 34 weeks of pregnancy, without clinical infection or labor, were studied. Cultures were obtained by transabdominal amniocentesis from the amniotic fluid and the lower genital tract. Four groups of MIAC were observed: MIAC1: due to S. agalactiae, F. nucleatum or H. influenzae as only etiologic agents, MIAC2: due to other bacteria, alone or mixed, MIAC3: due to U. urealyticum as only etiologic agent, MIAC0: No MIAC and no infection of the lower genital tract. Study patients received antibiotics and were managed expectantly until 35 weeks unless clinical chorioamnionitis developed or an amniotic fluid culture returned positive for S. agalactiae, F. nucleatum or H. influenzae. Results: Ninety six patients were enrolled: MIAC1 (n=11), MIAC2 (n=30), MIAC3 (n=19) and MIAC0 (n=36). Clinical chorioamnionitis was more common in patients with MIAC1 than those with MIAC3 (p<0.01) and those without infection (p<0.001). The admission to delivery interval was shorter in patients with MIAC1 (2.8 days) than those with MIAC3 (10.1 days, p<0.05) and those without infection (18 days, p<0.001). Delivery within 48 h and within 7 days of admission were also more frequent in patients with MIAC1 than in patients with MIAC3 (p<0.05) or those without infection (p<0.001). Newborns to mothers with MIAC1 had a higher frequency of infection (36percent), asphyxia (36percent), admission to neonatal ICU (100percent) and death (46prcent) than those of mothers with MIAC3 and those without infection. Birth weight was also significantly lower. Histological chorioamnionitis was more common in patients with MIAC1 than in patients with MIAC3 and those without infection. The rate of funisitis was higher in patients with MIAC1 than those without infection. Conclusions: In patients with preterm PROM, microbial invasion of the amniotic cavity by S. agalactiae, F. nucleatum or H. influenzae is associated with high frecuency of adverse maternal and neonatal outcomes and neonatal death.

Typing of Listeria monocytogenes isolates by random amplification of polymorphic DNA.

BACKGROUND & OBJECTIVES: Listeria monocytogenes is an important food-borne pathogen causing meningitis and septicaemia in newborns and immunocompromised persons, abortion and preterm labour in pregnant women. Though various methods are available for typing L. monocytogenes, RAPD analysis has been used for epidemiological purposes in developed countries due to its greater discriminating ability. However, as there are no published reports from India on the typing of L. monocytogenes by RAPD technique the present study was undertaken to type isolates of L. monocytogenes from clinical, food and veterinary samples. METHODS: Isolates of L. monocytogenes were subjected to RAPD using four decamer random primers R1, R2, R3 and R4. Amplified products were analysed by agarose gel electrophoresis. RESULTS: Eight strains of L. monocytogenes on RAPD analysis generated 4 distinct profiles each with R1 and R4 primers and 3 different profiles with R2 and R3 primers. The isolates from fish, clinical and veterinary samples showed different profiles with respect to each other. Isolate from flat fish (serovar 4) showed a different profile from that of clams (serovar 1). Two isolates from placenta (serovar 1) showed similar profiles and all the isolates from veterinary samples generated similar profiles. INTERPRETATION & CONCLUSION: RAPD analysis in the present study allowed discrimination of isolates among the same serotype but from different sources. Since RAPD is a rapid technique and offers greater discrimination of strains, this method may be used for typing L. monocytogenes in India.

Randomized placental and cord blood sampling culture in women with preterm and term labour to detect infection

Placental tissue and cord blood from women with preterm and term labour were examined for microorganisms and compared in this randomized prospective study. Of 100 women who delivered during a 12-month period, 50 had preterm labour and 50 had term labour. Samples were taken under sterile conditions for routine culture of anaerobic and aerobic bacteria immediately after delivery of the placenta. Fetal blood cultures were positive for 30% of the preterm group and 18% of the term group, which was statistically significant. Placental tissue cultures were positive for 58% of the preterm group and 28% of the term group. These data support previous reports that infection plays a significant role in preterm labour

Echovirus type 19 and herpes simplex type 2 infection in human placenta tissue explants

1. Light and electron microscopy have been used to characterize echovirus 19 and herpes simplex type 2 infection of human placenta tissue in vitro. Immunofluorescence, autoradiography and virus adsorption were used to determine virus replication in this system. 2. Placental tissue was permissive to echovirus 19. Trophoblast cells were lysed with liberation of mature virions. However, during the 48-h period of observation, few cells were damaged and the trophoblastic structure was maintained. 3. HSV-2 infection in placental tissue was aborted although trophoblastic cells allowed virus adsorption, penetration and uncoating. A characteristic cytopathic effect was observed in infected trophoblastic cells in spite of the abortive infection

Demostracion de la infeccion placentaria por T. Cruzi a traves de la tecnica de inmunoperoxidasa / Demostration of transplacental infections for by T. cruzi inmunoperoxidease technique

Los autores en el presente trabajo, muestran la utilidad y especificidad de la tecnica de la inmuno-peroxidasa aplicada para la identificacion del T. Cruzi y sus formas degeneradas (exoantigenos). Tecnicas realizadas en cortes de tejido de placenta, cordon y membrana incluidos en parafina y procedentes de madres con infeccion chagasica cronica

Estudio bacteriologico del liquido amniotico durante el embarazo y parto / Amniotic fluid bacteriological study during pregnancy and delivery

Se estudiaron 220 muestras del liquido amniotico, obtenidas en condiciones esteriles y sembradas en medios de cultivos aerobico y unos pocos casos en anaerobico: al mismo tiempo se hacia extendido en coloracion de Gram. El primer grupo de 110 muestras fueron tomadas durante la operacion cesarea: 68 casos sin trabajo de parto de los cuales 64 con membrana integras, y 4 con membranas rotas de mas de 6 horas; la contaminacion bacteriana del liquido amniotico fue detectada en el 12.5% en los casos de membranas integras y en 50% en los casos de membranas rotas. Los 42 casos restantes eran de mas de 12 horas de trabajo de parto y con membranas rotas; la contaminacion del liquido amniotico fue detectada en el 26.5%. Se examinaron 85 placentas y se encontro placentitis leve en un 2.35%, placentitis severa en 1.1% y placentitis moderada en 4.7%. El segundo grupo de 110 muestras fueron tomadas al final de la primera etapa del parto encontrandose una contaminacion bacteriana en un 20%. Los microorganismos aislados del liquido amniotico fueron los siguientes: Estafilococo epidermidis, E. coli y Estreptococo viridans. Es bueno anotar que del primer grupo solo se registro contaminacion del liquido amniotico en un 12.5% en cesarea electiva con membranas integras; y en el segundo grupo en trabajo de parto y membranas integras la contaminacion del liquido amniotico fue de un 20%. La incidencia total de contaminacion del liquido amniotico en el primer grupo fue de un 20.9% y en el segundo grupo de un 20%. El indice de contaminacion en en liquido amniotico en el total de ..