Incidence and pattern of infections in pregnant women with bad obstetric history


  • N. Swetha Goud Department of Obstetrics and Gynecology, Ayaan Institute of Medical Sciences, Moinabad, Ranga Reddy, Telangana, India
  • M. Manasa Reddy Department of Obstetrics and Gynecology, Ayaan Institute of Medical Sciences, Moinabad, Ranga Reddy, Telangana, India
  • Savitha Desai Department of Obstetrics and Gynecology, Ayaan Institute of Medical Sciences, Moinabad, Ranga Reddy, Telangana, India



Bad obstetric history, Incidence, Infections, Outcome, Pregnancy


Background: Adverse outcomes have been seen in pregnant women who had prior bad obstetric history along with infection with TORCH [toxoplasma, other infections (syphilis, varicella zoster, hepatitis B), rubella, cytomegalovirus, herpes simplex]complex and bacterial vaginosis. These infections are known to affect the health of the fetus. Objective was to study incidence and pattern of infections in pregnant women with bad obstetric history.

Methods: A total of 190 patients with bad obstetric history fulfilling the methodology criteria were evaluated. Serological and molecular evaluations were carried out for TORCH complex and bacterial vaginosis was detected by both gram stain and gold standard clinical Amsel criteria and outcomes were followed.

Results: Out of 190 pregnant women with bad obstetric history, a total of 36 (18.8%) were detected to have infections causing bad obstetric history. Toxoplasma was positive in 7 (20%) of the cases, 3 (51.92%) of them had abortions. Rubella in 12 (32%) of the cases, 7 (60%) cases had sensorineural deafness. Cytomegalovirus in 1 (2%) of the cases, 1 (100%) of the case had microcephaly. Herpes in 8 (22%) cases, 6 (71.1%) cases had abortions. Bacterial vaginosis in 8 (22%) of the cases, 4 (48.6%) cases had preterm delivery. The presence of infections with TORCH complex and bacterial vaginosis was related to adverse pregnancy outcomes.

Conclusions: Women with bad obstetric history are prone to infections during pregnancy and have been found out to be associated with adverse pregnancy outcomes. Hence pregnant women should be screened so that early diagnosis and treatment of infections can be done to have better pregnancy outcomes.


Stephenson MD. Frequency of factors associated with habitual abortion in 197 couples. Fertil Steril. 1996;66:24-9

Rick JA, Zacur HA. The clinical management of repeated early pregnancy wastage. Fertil Steril. 1983;39:123-40.

Meka A, Reddy BM. Recurrent spontaneous abortions: an overview of genetic and non genetic backgrounds. Int J Hum Genet. 2006;6(2):109-17.

Bloomenthal D, Dadelszen P, Liston R, Magee I, Tsang P. The effect of factor V Leiden carriage on maternal and fetal health. Canadian Med Assoc J. 2002;167(1):48-54.

Higashino M, Takakuwa K, Arakawa M, Tamura M, Yasuda M, Tanaka K. Anti cardiolipin antibody and anti cardiolipin bets 2 glycoprotein I antibody in patients with recurrent fetal miscarriage. J Perinat Med. 1998;26(5):384-9.

Sutandar M, Garcia-Bournissen F, Koren G. Hypothyroidism in pregnancy. Obstet Gynecol Can. 2007;29(4):354-6.

Devi R, Sreenivas N, Rajangam S. Bad obstetric history and infections causes. Int J Hum Genet. 2002;2(4):269-71.

Stirrat GM. Recurrent miscarriage II: Clinical associations, causes and management. Acta Europea Fertilitis. 1990;21(3):141-3.

Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med. 2002;346:752-63.

Cunnigham F, Lenovo K, Bloom S, Hauth J, Rouse D, Spong C, eds. Williams Obstetrics, 23rd edn. Berkshire, UK: McGraw-Hill; 2010:1404.

Surpam RB, Kamlakar UP, Khadse RK, Qazi MS, Jalgaonkar SV. Serological study for TORCH infections in women with bad obstetric history. J Obstet Gynecol. 2006;56(1):41-3.

Zargar AH, Masoodi SR, Laway BA, Sofi BA, Wani AI. Seroprevalence of toxoplasmosis in women with repeated abortions in Kashmir. J Epidemiol Community Health. 1998;52:135-6.

Jones JL, Kruszon-Moran D, Sanders-Lewis K, Wilson M. Toxoplasma gondii infection in the United States, 1999-2004, decline from the prior decade. Am J Trop Med Hyg. 2007;77:405-10.

Burg JL, Grover CM, Pouletty P, Boothroyd JC. Direct and sensitive detection of a pathogenic protozoan, Toxoplasma gondii, by polymerase chain reaction. J Clin Microbiol. 1989;27:1787-92.

Peyron F, Wallon M, Bernadoux C. Long-term follow-up of patients with congenital ocular toxoplasmosis. N Eng J Med. 1996;334:993-4.

Amsel R, Toten P, Spiegel CA, Chen KC, Eschenbach D, Holmes KK. Non-specific vaginitis: diagnostic techniques and microbial and epidemiologic associations. Am J Med. 1983;74:14-22.

Kekki M, Kurki T, Pelkonen J, Kurkinen-Raty M, Cacciatore B, Paavonen J. Vaginal clindamycin in preventing preterm birth and preipartal infections in asymptomatic women with bacterial vaginosis: a randomized, controlled trial. Obstet Gynecol. 2001;97(5 Pt 1):643-8.

Adler B, Scrivano L, Ruzcics Z, Rupp B, Sinzger C, Koszinowski U. Role of human cytomegalovirus UL131A in a cell type specific virus entry and release. J Gen Virol. 2006;87(Pt 9):2451-60.

Monbro M, Perathoner C, Leone A. Congenital toxoplasmosis: assessment of risk to newborns in confirmed and uncertain maternal infections. Eur J Pediatr. 2003;162:703-6.

Montoya JG, Liesenfeld O. Toxoplasmomsis. Lancet. 2004;363:1965-76.

Stagno S, Pass RF, Cloud G, Britt WJ, Henderson RE, Walton PD, et al. Primary cytomegalovirus infection in pregnancy. Incidence, transmission to fetus and clinical outcome. J Am Med Assoc. 1986;256:1904-8.

Brown LA, Selke SA, She J. Acquisition of herpes simplex virus during pregnancy. N Engl J Med. 1997;337:509-15.






Original Research Articles