Accessible Unlicensed Requires Authentication Published by De Gruyter June 1, 2005

Prolonged fetal bradycardia as the presenting clinical sign in Streptococcus agalactiae chorioamnionitis

Giuseppe Presta, Enrico Rosati, Raffaella Giannuzzi, Antonio Del Vecchio, Antonia Lozupone, Mario Criscuolo, Alberto Verrotti, Giuseppe Latini and Claudio De Felice
From the journal


Group B Streptococcus remains a leading infectious cause of neonatal morbidity and mortality. We report a case of a 37 weeks’ gestation infant with severe birth asphyxia, status epilepticus and GBS chorioamnionitis, in which a prolonged fetal bradycardia was the only prenatal clinical sign.


Corresponding author: G. Latini, MD, Division of Neonatology, Ospedale A. Perrino S.S., 7 per Mesagne, 72100 Brindisi/Italy. Tel.: +39-0831-537471, Fax: +39-0831-537861, E-mail:


1 Beinder E, T Grancay, T Menendez, H Singer, M Hofbeck: Fetal sinus bradycardia and the long QT syndrome. Am J Obstet Gynecol185 (2001) 743 Search in Google Scholar

2 Bland ML, ST Vermillion, DE Soper, M Austin: Antibiotic resistance patterns of group B streptococci in late third-trimester rectovaginal cultures. Am J Obstet Gynecol184 (2001) 1125 Search in Google Scholar

3 Buhimschi C, CP Weiner: Endotoxemia causing fetal bradycardia during urosepsis. Obstet Gynecol97 (2001) 818 Search in Google Scholar

4 Covert RF, MD Schreiber: Three different strains of heat-killed group B beta-hemolytic streptococcus cause different pulmonary and systemic responses in conscious neonatal lambs. Pediatr Res33 (1993) 373 Search in Google Scholar

5 Dammann O, KC Kuban, A Leviton: Perinatal infection, fetal inflammatory response, white matter damage, and cognitive limitations in children born preterm. Ment Retard Dev Disabil Res Rev8 (2002) 46 Search in Google Scholar

6 De Felice C, P Toti, RN Laurini, M Stumpo, E Picciolini, T Todros, P Tanganelli, G Buonocore, R Bracci: Early brain injury in histologic chorioamnionitis. J Pediatr138 (2001) 101 Search in Google Scholar

7 Garland SM, F Ni Chuileannain, C Satzke, R Robins-Browne: Mechanisms, organisms and markers of infection in pregnancy. J Reprod Immunol57 (2002) 169 Search in Google Scholar

8 Gomez R, R Romero, F Ghezzi, BH Yoon, M Mazor, SM Berry: The fetal inflammatory response syndrome. Am J Obstet Gynecol179 (1998) 194 Search in Google Scholar

9 Gull I, AJ Jaffa, M Oren, D Grisaru, MR Peyser, JB Lessing: Acid accumulation during end-stage bradycardia in term fetus: how long is too long? Br J Obstet Gynaecol103 (1996) 1096 Search in Google Scholar

10 Hankins GDV, T Leicht, JW Van Hook: Prolonged fetal bradycardia secondary to maternal hypothermia in response to urosepsis. Am J Perinatol14 (1997) 217 Search in Google Scholar

11 Hsueh PR, LJ Teng, LN Lee, SW Ho, PC Yang, KT Luh: High incidence of erythromycin resistance among clinical isolates of Streptococcus agalactiae in Taiwan. Antimicrob Agents Chemother45 (2001) 3205 Search in Google Scholar

12 Loghis C, E Salamalekis, N Panayotopoulos, N Vitoratos, PA Zourlas: The effect of early second stage bradycardia on newborn status. Eur J Obstet Gynecol72 (1997) 149 Search in Google Scholar

13 Morikawa Y, M Kitazato, C Katsukawa, A Tamaru: Prevalence of cefotaxime resistance in group B streptococcus isolates from Osaka, Japan. J Infect Chemother9 (2003) 131 Search in Google Scholar

14 Newton ER: Chorioamnionitis and intraamniotic infection. Clin Obstet Gynecol36 (1993) 795 Search in Google Scholar

15 Peevy KJ, SA Chartrand, HJ Wiseman, RC Boerth, RD Olson: Myocardial dysfunction in group B streptococcal shock. Pediatr Res19 (1985) 511 Search in Google Scholar

16 Rounioja S, J Rasanen, V Glumoff, M Ojaniemi, K Makikallio, M Hallman: Intra-amniotic lipopolysaccharide leads to fetal cardiac dysfunction. A mouse model for fetal inflammatory response. Cardiovasc Res60 (2003) 156 Search in Google Scholar

17 Schrag S, R Gorwitz, K Fultz-Butts, A Schuchat: Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC. MMWR Recomm Rep51 (2002) 1 Search in Google Scholar

18 Shalak LF, JM Perlman: Infection markers and early signs of neonatal encephalopathy in the term infant. Ment Retard Dev Disabil Res Rev8 (2002) 14 Search in Google Scholar

19 Yanowitz TD, JA Jordan, CH Gilmour, R Towbin, A Bowen, JM Roberts, BS Brozanski: Hemodynamic disturbances in premature infants born after chorioamnionitis: association with cord blood cytokine concentrations. Pediatr Res51 (2002) 310 Search in Google Scholar

Published Online: 2005-06-01
Published in Print: 2004-11-04

© Walter de Gruyter