Accessible Requires Authentication Published by De Gruyter January 18, 2017

Mycoplasma/Ureaplasma infection in pregnancy: to screen or not to screen

Gilbert G.G. Donders, Kateryna Ruban, Gert Bellen and Ljubomir Petricevic

Abstract

Mycoplasmata have been linked to pregnancy complications and neonatal risk. While formerly a limited number of species could be discovered by cultures, molecular biology nowadays discovers both lower quantities and more diverse species, making us realize that mycoplasmata are ubiquitous in the vaginal milieu and do not always pose a danger for pregnant women. As the meaning of mycoplasmata in pregnancy is not clear to many clinicians, we summarized the current knowledge about the meaning of different kinds of mycoplasmata in pregnancy and discuss the potential benefits and disadvantages of treatment. Currently, there is no general rule to screen and treat for mycoplasmata in pregnancy. New techniques seem to indicate that Ureaplasma parvum (Up), which now can be distinguished from U. urealyticum (Uu), may pose an increased risk for preterm birth and bronchopulmonary disease in the preterm neonate. Mycoplasma hominis (Mh) is related to early miscarriages and midtrimester abortions, especially in the presence of abnormal vaginal flora. Mycoplasma genitalium (Mg) is now recognized as a sexually transmitted infection (STI) that is involved in the causation of cervicitis, pelvic inflammatory disease (PID) in non-pregnant, and preterm birth and miscarriages in pregnant women, irrespective of the presence of concurrent other STIs, like Chlamydia or gonorrhoea. Proper studies to test for efficacy and improved pregnancy outcome are scarce and inconclusive. Azythromycin is the standard treatment now, although, for Mg, this may not be sufficient. The role of clarithromycin in clinical practice still has to be established. There is a stringent need for new studies based on molecular diagnostic techniques and randomized treatment protocols with promising and safe antimicrobials.


Corresponding author: Prof Dr. Gilbert G.G. Donders, Femicare vzw, Clinical Research for Women, Gasthuismolenstraat 31, B- 3300 Tienen, Belgium, Tel.: +32 16 808102, Fax: +32 16 808109

Acknowledgments

We thank Dr Jørgen Skov Jenssen for his advice and valuable comments.

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  1. The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2016-3-27
Accepted: 2016-8-1
Published Online: 2017-1-18
Published in Print: 2017-7-26

©2017 Walter de Gruyter GmbH, Berlin/Boston