Fetal Candida infection associated with an intrauterine contraceptive device.

ABSTRACT

PIP: Although fetal intra-amniotic infection with Candida albicans is a rare event, a retained IUD during pregnancy is a major risk factor. Reported in this paper is the case of a 25-year-old woman admitted at 15 weeks' gestation with uterine contractions and vaginal discharge. She reported a history of genital condylomata. Examination revealed premature rupture of the membranes and evidence of an abruptio placentae. An IUD was visible in the uterine cavity. Histologic examination of the placenta revealed growth of Candida pseudohyphae on the surface of the amniotic membranes and at the fetal side of the chorion. A heavy polymorphonuclear infiltrate with areas of necrosis and hemorrhage was noted. Vaginal cultures revealed Candida albicans infection. Most other cases of IUD-associated intra-amniotic candidiasis reported in the literature failed to note whether Candida was present in the vagina or cervix as well. Diagnostic amniocentesis is recommended in all pregnant women with preterm labor and a retained IUD; also indicated is prompt topical antifungal treatment to prevent the spread of Candida to the amniotic cavity.