Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 2/2016

11.11.2015 | Maternal-Fetal Medicine

Q fever and pregnancy: experience from the Limoges Regional University Hospital

verfasst von: Perrine Coste Mazeau, Sébastien Hantz, Jean-Luc Eyraud, Lorène Donadel, Aymeline Lacorre, Sylvie Rogez, Yves Aubard, Tristan Gauthier

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Q fever is an ubiquitous zoonosis caused by Coxiella burnetii. Its tropism for the uterus is a potential source of obstetric complications.

Materials and methods

We describe the obstetric consequences of Q fever diagnosed during pregnancy from a series of cases. When an antenatal diagnosis was made, antibiotic therapy with roxithromycin (Rulid®) was started until delivery.

Results

Between 2007 and 2012, 30 patients were treated for Q fever diagnosed during pregnancy, i.e. 1.9 cases per 1000 people. The most common reasons for performing serology was intrauterine growth retardation, preterm labor and oligoamnios. Q fever was diagnosed as acute and chronic in 26 and 4 cases, respectively. Progression to chronic disease occurred in 8 % of acute forms of the diseases. The prevalence of obstetric complications was 66 %, including 10 % foetal deaths, 31 % preterm delivery and 27 % low birthweight <10th percentile. The obstetric complication rate amongst the 22 patients treated with ante partum macrolides was 60, 30 % of which involved prematurity and 33 % involved low growth. No cases of foetal death were found on treatment and no congenital malformation and placental or neonatal injury was found. No case of disease reactivation was diagnosed in the eight patients who became pregnant again.

Conclusion

Q fever during pregnancy is responsible for severe obstetric complications. It must be diagnosed early and its clinical forms known in order to start appropriate antibiotic therapy.
Literatur
1.
Zurück zum Zitat Tissot Dupont H, Raoult D, Brouqui P, Janbon F, Peyramond D, Weiller PJ et al (1992) Epidemiologic features and clinical presentation of acute Q fever in hospitalized patients: 323 French cases. Am J Med 93(4):427–434CrossRefPubMed Tissot Dupont H, Raoult D, Brouqui P, Janbon F, Peyramond D, Weiller PJ et al (1992) Epidemiologic features and clinical presentation of acute Q fever in hospitalized patients: 323 French cases. Am J Med 93(4):427–434CrossRefPubMed
2.
Zurück zum Zitat Raoult D, Brouqui P (1998) Les rickettsioses. Elsevier, Paris Raoult D, Brouqui P (1998) Les rickettsioses. Elsevier, Paris
3.
Zurück zum Zitat Bru (1983) Enquête épidémiologique de la Fièvre Q dans une commune rurale. Lyon Med 249:459–61 Bru (1983) Enquête épidémiologique de la Fièvre Q dans une commune rurale. Lyon Med 249:459–61
4.
Zurück zum Zitat Raoult D, Toga B, Chaudet H, Chiche-Portiche C (1987) Rickettsial antibody in southern France: antibodies to Rickettsia conorii and Coxiella burnetii among urban, suburban and semi-rural blood donors. Trans R Soc Trop Med Hyg 81(1):80–81CrossRefPubMed Raoult D, Toga B, Chaudet H, Chiche-Portiche C (1987) Rickettsial antibody in southern France: antibodies to Rickettsia conorii and Coxiella burnetii among urban, suburban and semi-rural blood donors. Trans R Soc Trop Med Hyg 81(1):80–81CrossRefPubMed
5.
Zurück zum Zitat Anderson AD, Kruszon-Moran D, Loftis AD, McQuillan G, Nicholson WL, Priestley RA et al (2009) Seroprevalence of Q fever in the United States, 2003–2004. Am J Trop Med Hyg 81(4):691–694CrossRefPubMed Anderson AD, Kruszon-Moran D, Loftis AD, McQuillan G, Nicholson WL, Priestley RA et al (2009) Seroprevalence of Q fever in the United States, 2003–2004. Am J Trop Med Hyg 81(4):691–694CrossRefPubMed
6.
Zurück zum Zitat Tissot-Dupont H, Amadei M-A, Nezri M, Raoult D (2004) Wind in November, Q fever in December. Emerg Infect Dis Juill 10(7):1264–1269CrossRef Tissot-Dupont H, Amadei M-A, Nezri M, Raoult D (2004) Wind in November, Q fever in December. Emerg Infect Dis Juill 10(7):1264–1269CrossRef
7.
Zurück zum Zitat Raoult D, Marrie T, Mege J (2005) Natural history and pathophysiology of Q fever. Lancet Infect Dis Avr 5(4):219–226CrossRef Raoult D, Marrie T, Mege J (2005) Natural history and pathophysiology of Q fever. Lancet Infect Dis Avr 5(4):219–226CrossRef
9.
Zurück zum Zitat Anderson A, Bijlmer H, Fournier P-E, Graves S, Hartzell J, Kersh GJ et al (2013) Diagnosis and management of Q fever–United States, 2013: recommendations from CDC and the Q Fever Working Group. MMWR Recomm Rep Morb Mortal Wkly Rep Recomm Rep Cent Dis Control 62:1–30 Anderson A, Bijlmer H, Fournier P-E, Graves S, Hartzell J, Kersh GJ et al (2013) Diagnosis and management of Q fever–United States, 2013: recommendations from CDC and the Q Fever Working Group. MMWR Recomm Rep Morb Mortal Wkly Rep Recomm Rep Cent Dis Control 62:1–30
11.
Zurück zum Zitat Million M, Lepidi H, Raoult D (2009) Q fever: current diagnosis and treatment options. Médecine Mal Infect Févr 39(2):82–94CrossRef Million M, Lepidi H, Raoult D (2009) Q fever: current diagnosis and treatment options. Médecine Mal Infect Févr 39(2):82–94CrossRef
13.
Zurück zum Zitat Carcopino X, Raoult D, Bretelle F, Boubli L, Stein A (2007) Managing Q fever during pregnancy: the benefits of long-term cotrimoxazole therapy. Clin Infect Dis Off Publ Infect Dis Soc Am 45(5):548–555CrossRef Carcopino X, Raoult D, Bretelle F, Boubli L, Stein A (2007) Managing Q fever during pregnancy: the benefits of long-term cotrimoxazole therapy. Clin Infect Dis Off Publ Infect Dis Soc Am 45(5):548–555CrossRef
14.
Zurück zum Zitat Gikas A, Kofteridis DP, Manios A, Pediaditis J, Tselentis Y (2001) Newer macrolides as empiric treatment for acute Q fever infection. Antimicrob Agents Chemother 45(12):3644–3646CrossRefPubMedPubMedCentral Gikas A, Kofteridis DP, Manios A, Pediaditis J, Tselentis Y (2001) Newer macrolides as empiric treatment for acute Q fever infection. Antimicrob Agents Chemother 45(12):3644–3646CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Carcopino X, Raoult D, Bretelle F, Boubli L, Stein A (2009) Q Fever during pregnancy: a cause of poor fetal and maternal outcome. Ann N Y Acad Sci 1166:79–89CrossRefPubMed Carcopino X, Raoult D, Bretelle F, Boubli L, Stein A (2009) Q Fever during pregnancy: a cause of poor fetal and maternal outcome. Ann N Y Acad Sci 1166:79–89CrossRefPubMed
17.
Zurück zum Zitat Rey D, Obadia Y, Tissot-Dupont H, Raoult D (2000) Seroprevalence of antibodies to Coxiella burnetti among pregnant women in South Eastern France. Eur J Obstet Gynecol Reprod Biol 93(2):151–156CrossRefPubMed Rey D, Obadia Y, Tissot-Dupont H, Raoult D (2000) Seroprevalence of antibodies to Coxiella burnetti among pregnant women in South Eastern France. Eur J Obstet Gynecol Reprod Biol 93(2):151–156CrossRefPubMed
18.
Zurück zum Zitat Bollani L, Strocchio L, Stronati M (2013) Congenital toxoplasmosis. Early Hum Dev 89(Supplement 4):S70–S72CrossRef Bollani L, Strocchio L, Stronati M (2013) Congenital toxoplasmosis. Early Hum Dev 89(Supplement 4):S70–S72CrossRef
19.
Zurück zum Zitat Karacan M, Batukan M, Cebi Z, Berberoglugil M, Levent S, Kır M et al (2014) Screening cytomegalovirus, rubella and toxoplasma infections in pregnant women with unknown pre-pregnancy serological status. Arch Gynecol Obstet 290(6):1115–1120CrossRefPubMed Karacan M, Batukan M, Cebi Z, Berberoglugil M, Levent S, Kır M et al (2014) Screening cytomegalovirus, rubella and toxoplasma infections in pregnant women with unknown pre-pregnancy serological status. Arch Gynecol Obstet 290(6):1115–1120CrossRefPubMed
20.
Zurück zum Zitat Guillet M (2010) Rubéole congénitale en 2010 et vaccination. Antibiotiques 12(3):171–180CrossRef Guillet M (2010) Rubéole congénitale en 2010 et vaccination. Antibiotiques 12(3):171–180CrossRef
21.
Zurück zum Zitat Tissot-Dupont H, Vaillant V, Rey S, Raoult D (2007) Role of sex, age, previous valve lesion, and pregnancy in the clinical expression and outcome of Q fever after a large outbreak. Clin Infect Dis Off Publ Infect Dis Soc Am 15 44(2):232–7 Tissot-Dupont H, Vaillant V, Rey S, Raoult D (2007) Role of sex, age, previous valve lesion, and pregnancy in the clinical expression and outcome of Q fever after a large outbreak. Clin Infect Dis Off Publ Infect Dis Soc Am 15 44(2):232–7
22.
Zurück zum Zitat van der Hoek W, Meekelenkamp JCE, Leenders ACAP, Wijers N, Notermans DW, Hukkelhoven CWPM (2011) Antibodies against Coxiella burnetii and pregnancy outcome during the 2007–2008 Q fever outbreaks in The Netherlands. BMC Infect Dis 11:44CrossRefPubMedPubMedCentral van der Hoek W, Meekelenkamp JCE, Leenders ACAP, Wijers N, Notermans DW, Hukkelhoven CWPM (2011) Antibodies against Coxiella burnetii and pregnancy outcome during the 2007–2008 Q fever outbreaks in The Netherlands. BMC Infect Dis 11:44CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Nielsen SY, Andersen A-MN, Mølbak K, Hjøllund NH, Kantsø B, Krogfelt KA et al (2013) No excess risk of adverse pregnancy outcomes among women with serological markers of previous infection with Coxiella burnetii: evidence from the Danish National Birth Cohort. BMC Infect Dis 13:87CrossRefPubMedPubMedCentral Nielsen SY, Andersen A-MN, Mølbak K, Hjøllund NH, Kantsø B, Krogfelt KA et al (2013) No excess risk of adverse pregnancy outcomes among women with serological markers of previous infection with Coxiella burnetii: evidence from the Danish National Birth Cohort. BMC Infect Dis 13:87CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Munster JM, Leenders AC, Hamilton CJ, Meekelenkamp JC, Schneeberger PM, van der Hoek W et al (2013) Routine screening for Coxiella burnetii infection during pregnancy: a clustered randomised controlled trial during an outbreak, the Netherlands, 2010. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull 18(24) Munster JM, Leenders AC, Hamilton CJ, Meekelenkamp JC, Schneeberger PM, van der Hoek W et al (2013) Routine screening for Coxiella burnetii infection during pregnancy: a clustered randomised controlled trial during an outbreak, the Netherlands, 2010. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull 18(24)
25.
Zurück zum Zitat Boden K, Brueckmann A, Wagner-Wiening C, Hermann B, Henning K, Junghanss T et al (2012) Maternofetal consequences of Coxiella burnetii infection in pregnancy: a case series of two outbreaks. BMC Infect Dis 12:359CrossRefPubMedPubMedCentral Boden K, Brueckmann A, Wagner-Wiening C, Hermann B, Henning K, Junghanss T et al (2012) Maternofetal consequences of Coxiella burnetii infection in pregnancy: a case series of two outbreaks. BMC Infect Dis 12:359CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Nielsen SY, Mølbak K, Henriksen TB, Krogfelt KA, Larsen CS, Villumsen S (2014) Adverse pregnancy outcomes and Coxiella burnetii antibodies in pregnant women. Denmark. Emerg Infect Dis 20(6):925–931CrossRefPubMedPubMedCentral Nielsen SY, Mølbak K, Henriksen TB, Krogfelt KA, Larsen CS, Villumsen S (2014) Adverse pregnancy outcomes and Coxiella burnetii antibodies in pregnant women. Denmark. Emerg Infect Dis 20(6):925–931CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Angelakis E, Million M, D’Amato F, Rouli L, Richet H, Stein A et al (2013) Q fever and pregnancy: disease, prevention, and strain specificity. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol 32(3):361–368CrossRef Angelakis E, Million M, D’Amato F, Rouli L, Richet H, Stein A et al (2013) Q fever and pregnancy: disease, prevention, and strain specificity. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol 32(3):361–368CrossRef
28.
Zurück zum Zitat Forland F, De Carvalho Gomes H, Nokleby H, Escriva A, Coulombier D, Giesecke J et al (2012) Applicability of evidence-based practice in public health: risk assessment on Q fever under an ongoing outbreak. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull 17(3):20060 Forland F, De Carvalho Gomes H, Nokleby H, Escriva A, Coulombier D, Giesecke J et al (2012) Applicability of evidence-based practice in public health: risk assessment on Q fever under an ongoing outbreak. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull 17(3):20060
29.
Zurück zum Zitat Mylonas I (2011) Antibiotic chemotherapy during pregnancy and lactation period: aspects for consideration. Arch Gynecol Obstet 283(1):7–18CrossRefPubMed Mylonas I (2011) Antibiotic chemotherapy during pregnancy and lactation period: aspects for consideration. Arch Gynecol Obstet 283(1):7–18CrossRefPubMed
30.
Zurück zum Zitat Cerar D, Karner P, Avsic-Zupanc T, Strle F (2009) Azithromycin for acute Q fever in pregnancy. Wien Klin Wochenschr 121(13–14):469–472CrossRefPubMed Cerar D, Karner P, Avsic-Zupanc T, Strle F (2009) Azithromycin for acute Q fever in pregnancy. Wien Klin Wochenschr 121(13–14):469–472CrossRefPubMed
31.
Zurück zum Zitat Munster JM, Hamilton CJCM, Leenders ACAP, Lestrade PJ (2011) Chronic Q fever during pregnancy. Ned Tijdschr Geneeskd 155:A2781PubMed Munster JM, Hamilton CJCM, Leenders ACAP, Lestrade PJ (2011) Chronic Q fever during pregnancy. Ned Tijdschr Geneeskd 155:A2781PubMed
32.
Zurück zum Zitat Million M, Roblot F, Carles D, D’Amato F, Protopopescu C, Carrieri MP et al (2014) Reevaluation of the risk of fetal death and malformation after Q Fever. Clin Infect Dis Off Publ Infect Dis Soc Am 59(2):256–260CrossRef Million M, Roblot F, Carles D, D’Amato F, Protopopescu C, Carrieri MP et al (2014) Reevaluation of the risk of fetal death and malformation after Q Fever. Clin Infect Dis Off Publ Infect Dis Soc Am 59(2):256–260CrossRef
33.
Zurück zum Zitat Million M, Raoult D (2015) Recent advances in the study of Q fever epidemiology, diagnosis and management. J Infect 71(Suppl 1):S2–S9CrossRefPubMed Million M, Raoult D (2015) Recent advances in the study of Q fever epidemiology, diagnosis and management. J Infect 71(Suppl 1):S2–S9CrossRefPubMed
34.
Zurück zum Zitat Raoult D, Fenollar F, Stein A (2002) Q fever during pregnancy: diagnosis, treatment, and follow-up. Arch Intern Med 162(6):701–704CrossRefPubMed Raoult D, Fenollar F, Stein A (2002) Q fever during pregnancy: diagnosis, treatment, and follow-up. Arch Intern Med 162(6):701–704CrossRefPubMed
35.
Zurück zum Zitat Stein A, Raoult D (1998) Q fever during pregnancy: a public health problem in southern France. Clin Infect Dis Off Publ Infect Dis Soc Am 27(3):592–596CrossRef Stein A, Raoult D (1998) Q fever during pregnancy: a public health problem in southern France. Clin Infect Dis Off Publ Infect Dis Soc Am 27(3):592–596CrossRef
36.
Zurück zum Zitat Racult D, Stein A (1994) Q fever during pregnancy—a risk for women, fetuses, and obstetricians. N Engl J Med 330(5):371PubMed Racult D, Stein A (1994) Q fever during pregnancy—a risk for women, fetuses, and obstetricians. N Engl J Med 330(5):371PubMed
Metadaten
Titel
Q fever and pregnancy: experience from the Limoges Regional University Hospital
verfasst von
Perrine Coste Mazeau
Sébastien Hantz
Jean-Luc Eyraud
Lorène Donadel
Aymeline Lacorre
Sylvie Rogez
Yves Aubard
Tristan Gauthier
Publikationsdatum
11.11.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2016
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-015-3958-9

Weitere Artikel der Ausgabe 2/2016

Archives of Gynecology and Obstetrics 2/2016 Zur Ausgabe

Gynecologic Endocrinology and Reproductive Medicine

Hysteroscopic adhesiolysis: efficacy and safety

Ambulantisierung: Erste Erfahrungen mit dem Hybrid-DRG

02.05.2024 DCK 2024 Kongressbericht

Die Hybrid-DRG-Verordnung soll dazu führen, dass mehr chirurgische Eingriffe ambulant durchgeführt werden, wie es in anderen Ländern schon länger üblich ist. Die gleiche Vergütung im ambulanten und stationären Sektor hatten Niedergelassene schon lange gefordert. Aber die Umsetzung bereitet ihnen doch Kopfzerbrechen.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Harninkontinenz: Netz-Op. erfordert über lange Zeit intensive Nachsorge

30.04.2024 Harninkontinenz Nachrichten

Frauen mit Belastungsinkontinenz oder Organprolaps sind nach einer Netz-Operation keineswegs beschwerdefrei. Vielmehr scheint die Krankheitslast weiterhin hoch zu sein, sogar höher als von harninkontinenten Frauen, die sich nicht haben operieren lassen.

Welche Übungen helfen gegen Diastase recti abdominis?

30.04.2024 Schwangerenvorsorge Nachrichten

Die Autorinnen und Autoren einer aktuellen Studie aus Griechenland sind sich einig, dass Bewegungstherapie, einschließlich Übungen zur Stärkung der Bauchmuskulatur und zur Stabilisierung des Rumpfes, eine Diastase recti abdominis postpartum wirksam reduzieren kann. Doch vieles ist noch nicht eindeutig belegt.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.