Journal of International Obstetrics and Gynecology ›› 2020, Vol. 47 ›› Issue (5): 584-588.

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A Clinical Analysis of 7 Patients with Maternal Listeriosis

CAO Shi-jiao, YE Liu-qing, LI Hui-qin   

  1. Department of Obstetrics and Gynecology, Shenzhen Baoan Women′s and Children′s Hospital, Shenzhen 518000, Guangdong Province, China
  • Received:2020-05-09 Revised:2020-07-07 Published:2020-10-15 Online:2020-10-27
  • Contact: LI Hui-qin,E-mail: lihuiqin813@163.com E-mail:CSJdoctor@163.com

Abstract: Objective: To analyze the clinical characteristics and perinatal outcomes of listeriosis infection during pregnancy. Methods: The symptoms and signs, examination results and perinatal outcomes of pregnant women diagnosed with Listeria infection admitted from May 2017 to December 2019 were analyzed retrospectively, and their clinical characteristics were summarized. Results: The onset age was 26-32 (mean 27.00±2.03) years old, and the onset gestational age was 21-39(32.0±6.7) weeks, among which two cases were in the second trimester and 5 cases was in the third trimester. 7 cases had a history of eating unclean food and their clinical manifestations were fever (7/7), upper respiratory tract infection (4/7), urinary tract infection (1/7), and abnormal fetal movement (4/7). Laboratory examination showed increased white blood cell count and neutrophil ratio (7/7) and increased CRP and PCT (7/7). The placental pathology showed acute chorioamnitis (7/7). Listeriosis is isolated from blood (5/7), placenta (5/7), amniotic fluid (3/7), and uterus swab (1/7). There were 2 cases of induced labor of intrauterine death in the second trimeter. Two cases were in labor at the time of admission, and were delivered naturally after active treatment,2 neonates of which were not transferred to pediatrics. Three pregnant women underwent cesarean section due to fetal distress and the neonates had positive blood and cerebrospinal fluid listeria culture, while they had a good prognosis after active treatment. The initial treatment was cephalosporin antibiotics, with unsatisfactory curative effect. The therapeutic effect was significantly improved after drug sensitivity adjustment, and all pregnant women were cured. Conclusions: The onset of listeria infection in pregnancy is urgent, while misdiagnosis and missed diagnosis are easy, and the initial empirical treatment has limited efficacy. As a result, the bacterial culture and sensitivity test should be done as soon as possible to guide the clinical treatment and the clinicians should improve the ability to identify the disease so as to improve maternal and infant outcomes.

Key words: Listeriosis;, Pregnant women;, Pregnancy complications;, Chorioamnionitis;, Therapy