| Comments |
P.2 right column 2nd paragraph: "Determining the relationship between maternal infection and stillbirth is often challenging, and finding organisms in the placenta or on the fetus does not prove causality [ref 77]. However, the evidence that amniotic fluid infection is causal for stillbirth comes from different studies. Placental histology has been compared in stillbirths and various control groups and, in most cases, the frequency of histological chorio-amnionitis in the stillbirth group is several times greater than in the control group(s) [ref 77]. Even more convincing is the finding of microorganisms in internal fetal organs or placentas: cultures from interior sites such as brain, liquor, lung, liver, cardiac fluid and/or placentas, obtained at sterile autopsy, are less likely to be contaminated by vaginal microbes and are more likely to yield the etiological agent of an intrauterine infection [ref 84]. Such findings have been described in several case series and case–control studies, and have confirmed E. coli intrauterine (subclinical) infection as a major contributor to intrauterine fetal mortality ( Table 1) [refs 96, 44, 125, 84, 33, 74, 121, 16]." |