Electrical pacemaker as a safe and feasible method for decreasing the uterine contractions of human preterm labor.

AIM: The aim of the study was to test the safety and feasibility of a system designed to decrease the uterine contractions of human preterm labor using a weak electrical current. METHODS: Patients in preterm labor had an electrode catheter placed in the posterior vaginal fornix and attached to an electrical pacemaker. Contraction intervals were determined during the 60-min study, in which minutes 0-20 was the preintervention control period (C1); 21-40 was the electrical intervention (EI), with a 10-s burst of current administered just before each expected contraction; and 41-60 was the postintervention control (C2). Mean intervals were calculated and compared mixed-model ANOVA. RESULTS: Five patients were studied. No maternal or fetal vital sign irregularities were seen. All the babies had a normal neonatal intensive care unit stay for gestational age. The respective mean contraction intervals for C1, EI, and C2 and their within- and between-subject standard deviations were 4.64 (±0.81, ±2.45), 5.71 (±3.03, ±1.62), and 3.83 (±0.83, ±1.31) min. There was a significant difference between EI and C2 (P=0.0078) and no difference between C1 and C2 or between EI and C1 (P=0.1373). CONCLUSIONS: EI appears to be a safe and feasible method for decreasing preterm contractions. To confirm and test effectiveness, longer interventions and additional cases are needed.

Transmission of an uncultivated Bergeyella strain from the oral cavity to amniotic fluid in a case of preterm birth.

Intrauterine infection is a recognized cause of preterm birth. The infectious organisms are believed to originate primarily from the vaginal tract and secondarily from other parts of the body. It is plausible that microbes in the oral cavity can be transmitted to the pregnant uterus. However, direct evidence supporting such a transmission is lacking. In this study, amniotic fluids of 34 pregnant women were examined by PCR using 16S and 23S rRNA universally conserved primers. Bacterial DNA was amplified from the only patient with clinical intrauterine infection and histologic necrotizing acute and chronic chorioamnionitis. One strain, Bergeyella sp. clone AF14, was detected and was 99.7% identical to a previously reported uncultivated oral Bergeyella strain, clone AK152, at the 16S rRNA level. The same strain was detected in the subgingival plaque of the patient but not in her vaginal tract. The 16S-23S rRNA sequence of clone AF14 matched exactly with the sequences amplified from the patient's subgingival plaque. These observations suggest that the Bergeyella strain identified in the patient's intrauterine infection originated from the oral cavity. This is the first direct evidence of oral-utero microbial transmission. The patient's periodontal health during pregnancy was unclear. She did not have detectable periodontal disease during postpartum examination. Bergeyella spp. had not been previously associated with preterm birth and were detected in subgingival plaque of women without clinical levels of intrauterine infection. Uncultivated species may be overlooked opportunistic pathogens in preterm birth. This study sheds new light on the implication of oral bacteria in preterm birth.