A Case of Intrauterine Fetal Death Associated with Maternal Campylobacter coli Bacteraemia

EDITORIAL COMMENT: We accepted this case report for publication to remind readers that intrauterine infection can cause fetal death even though the membranes are intact; of course in patients with vaginal discharge in the second trimester it is often uncertain whether or not the membranes are ruptured. We support the authors' statement that the placenta should always be sent for histological and microbiological analyses when the infant is stillborn or born in poor condition; it is also suggested that a Kleihauer test be performed on the mother's blood in such cases since fetomaternal haemorrhage is more common than previously believed. Although permission for autopsy may occasionally not be granted, the placenta should always be available for examination. Indeed the editor has never heard of parents refusing to have a placenta examined and it is doubtful if their permission for such examination is required. Indeed in many centres it is recommended that after all deliveries the placenta should be kept refrigerated within a plastic bag for 1 week in case a clinical complication arises in the baby or mother which indicates its further examination. Our legal consultant informs us that placentas, like surgical specimens, are the property of the hospital. Testing for Aids antibodies is a special situation since it is a community expectation that this will not be performed without consent following adequate counselling. The occasional couple may have a birth plan which includes taking the placenta home for special disposal; this wish should be respected but does not preclude examination of the organ. Summary: Campylobacter species are known to cause infectious abortion in domestic animals. In humans, Campylobacter are an important cause of enteritis, an occasional cause of systemic infection and have had a rare association with abortion and perinatal infection. A case history of spontaneous abortion, at 26 weeks' duration, associated with maternal bacteraemia, due to Campylobacter coli is presented. Transmission, pathogenesis, treatment, and the need for further investigation are discussed.