Streptococcus mitis Chorioamnionitis after Dental Scaling an
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A 43-year-old female, gravida 4 para 3, presented in active preterm labour at 21 weeks and 5 days’ gestation. Her cervix was 4-5?cm dilated with the amniotic sac bulging into the vagina. Membranes were not ruptured. She was afebrile with no evidence of any infectious symptoms.

She delivered a male infant approximately 9 hours after the onset of contractions. The infant weighed 510 grams and died approximately 1 hour after delivery. A neonatologist assessed the infant postpartum and determined that it was consistent with a gestational age of approximately 22 weeks.

Her prenatal history was unremarkable. She had three normal ultrasounds within the pregnancy: a normal dating ultrasound at 7 weeks’ gestation, a normal nuchal translucency of 1.0?mm at 12 weeks’ gestation, and normal fetal anatomy at 20 weeks’ gestation. Cervical length was normal on sonographic images. In addition, chorionic villus sampling was performed at 12 weeks and 5 days’ gestation, and a normal male karyotype (46XY) was obtained. The patient had had routine dental scaling performed 14 days prior to delivery. She did not have any history of gingival disease or cavities but had been noticing malodorous breath. Her husband had known periodontal disease, and the couple had engaged in oral sex approximately 10 days prior to delivery.

A culture of the amniotic membrane was performed that isolated S. mitis. Placental pathology showed signs of acute chorioamnionitis including acute inflammation of the placental plate chorion and acute funisitis of the three-vessel umbilical cord.