Streptococcus agalactiae [Group B Streptococci] carriage in late pregnancy in Kuwait

This study investigated the vaginal colonization rate of Streptococcus agalactiae [group B streptococci, GBS] in an antenatal population in a maternity hospital. Subjects and Anal, vaginal and combined anal and vaginal specimens were obtained from 110 pregnant women [mean age 30.7 ' 5.5 years] at 35-37 weeks of gestation, using a commercially prepared culturette, and transported in 0.5 ml of Stuart's transport medium. The specimens were then cultured in standard selective Todd-Hewitt broth medium, supplemented with gentamicin and nalidixic acid. After 36 h of incubation, the broth culture was subcultured onto sheep blood agar and incubated in 5% carbon dioxide for 18-24 h. Representative colonies morphologically resembling GBS were tested with latex agglutination kit. Each culture-positive woman was given ampicillin or piperacillin prophylactically and followed up through labour and postpartum. Detailed records of biodata, antecedent antenatal events and pregnancy outcome were reviewed. The combined vaginal and anal specimens were positive for GBS in 18 [16.4%] women. Gestational age at delivery was 39.01 ' 1.79 weeks. The deliveries were uneventful and no neonate developed sepsis. Diabetes mellitus and pregnancy-induced hypertension/hypertension were detected antenatally in 16.6 and 11.5%, respectively. GBS carriage was not associated with adverse outcome of pregnancy. The colonization rate of GBS in pregnant women in Kuwait is high, and on the basis of the documented benefits of antenatal screening in Western countries, we recommend routine screening especially for our at-risk patients

relationship of recurrent spontaneous miscarriage with reproductive failure

To investigate the reproductive performance of non-pregnant women with recurrent spontaneous miscarriage [RSM] and the association between RSM and polycystic ovary syndrome [PCOS] in reproductive failure. Subjects and Fifty non-pregnant women with 3 or more consecutive RSM attending our RSM clinic were evaluated prospectively. Detailed history and physical examination were completed. Extensive laboratory investigations, ultrasonographic, radiological and specialized procedures/tests were performed. Those patients who did not achieve pregnancy within the first 6 months of follow-up had appropriate treatment options implemented. The outcome of any subsequent pregnancies was analyzed. The mean age of the patients was 33.8 +/- 4.6 years [range 22-43 years]. The aetiological factors associated with RSM were chromosome anomaly, uterine abnormality, antiphospholipid syndrome, PCOS and infections; 40% were 'unexplained'. Thirty patients [60%] were able to achieve viable pregnancies which progressed to term, resulting in live births. Fourteen of the other 20 patients had high body mass index [BMI] >30 and evidence of PCOS. Of these 20 patients, 13 eventually achieved pregnancies which ended again in first-second-trimester abortions [cause undetermined]. The remaining 7 patients [4 with high BMI] who had a combination of male factor/protracted PCOS/ovarian failure did not achieve pregnancies. The association of RSM with PCOS resulted in poor reproductive performance, which may progress to reproductive failure