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No Warranties or Representations
The data and information presented in this web site are presented in good faith and believed to be accurate. Any and all liability for the content or any omissions including any inaccuracies, errors, or misstatements in such data or information is expressly disclaimed. The web site is compiled for the sole purpose of informing community members of resources and information pertaining to Lyme Borreliosis Disease and its coinfections.
The Canadian Lyme Disease Foundation, Directors and members are not liable for any direct or indirect damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action arising out of or in connection with the use or performance of information available from this website.
Consult a qualified Lyme ( Borreliosis ) Disease literate doctor for medical advice if Lyme Disease is suspect.
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see also a warning from the United States CDC for pregnant women. Here
Congenital Lyme Disease
Syphilis and borreliosis during pregnancy
J. Hercogova & D. Vanousova
Dermatology Department, Charles University Prague, Czech Republic
Address correspondence and reprint requests to: Prof Jana Hercogova, MD, Dermatology Department, Charles University Prague, Bulovka University Hospital, Budinova 2, 180 81 Prague, Czech Republic, or email: Dermatology@fnb.cz.
Copyright © 2008 Blackwell Publishing
ABSTRACT
Syphilis and lyme borreliosis have similar etiologic, clinical, and epidemiologic characteristics. Both are multisystem infectious disorders spread worldwide. Their clinical course can be divided into three stages and as to spirochetal origin, antibiotic therapy is similar too. Taxonomical relationship of Treponema and Borrelia could explain also congenital manifestations well-known in syphilis, and suggested in borreliosis. Therapy of pregnant women with syphilis and lyme borreliosis should follow the same strategy.
Lyme Disease in Pregnancy: Case Report and Review of the Literature.
CME Program
Obstetrical & Gynecological Survey. 62(1):41-50, January 2007.
Walsh, Colin A. MB *; Mayer, Elizabeth W. MD +; Baxi, Laxmi V. MD ++
Abstract:
Lyme disease is the most common vector-borne disease in the United States. A number of other spirochetal diseases, if contracted in pregnancy, have been shown to cause fetal harm and there is concern over a similar effect with gestational borreliosis. Previously published individual case reports have suggested a possible association between gestational borreliosis and adverse pregnancy outcome; however, no specific pattern of teratogenicity has been shown, and a causal relationship has never been proven. In addition, larger epidemiological and serological series have consistently failed to demonstrate an increased risk to pregnant women who develop Lyme disease if they receive appropriate antimicrobial therapy. We describe a favorable outcome in a 42-year-old woman who developed Lyme disease in the third trimester and was treated with a full course of oral amoxicillin. In addition, we offer a review of the relevant literature regarding Lyme disease and pregnancy. The appropriate investigation and management of a woman with gestational borreliosis are discussed.
Target Audience: Obstetricians & Gynecologists, Family Physicians
Learning Objectives: After completion of this article, the reader should be able to recall that Lyme disease is not an uncommon disease during pregnancy and can occur in states outside of the Northeast, explain that the diagnosis is made clinically and may be confirmed by laboratory tests, state that treatment is recommended during pregnancy, and summarize that there is no consistent data of adverse fetal effects even though the placenta is infected.
Here is a reference to the first documented case...
Lyme disease can potentially adversely affect pregnancy. In 1985,
researchers published the first proof of maternal-fetal transmission of
Borrelia burgdorferi (Bb): A baby died shortly after birth and Bb
spirochetes were found in the infant's spleen, kidney, and bone marrow.
(Schlesinger P, Duray P, Burke B, Steere A, Stillman A. Maternal-fetal
transmission of the Lyme disease spirochete Borrelia burgdorferi. Annals of
Internal Med. 1985:(Vol 103) 67-68.)see Maternal-fetal transmission of lyme...a case study
To date, miscarriage, stillbirth, neonatal deaths (rare),
and congenital Lyme disease have all been described in the medical
literature.
Further research is
necessary to investigate possible teratogenic effects that might occur if the spirochete
reaches the fetus during the period of organogenesis.
Autopsy and clinical studies have associated gestational Lyme borreliosis with various
medical problems including fetal death, hydrocephalus, cardiovascular anomalies,
neonatal respiratory distress, hyperbilirubinemia, intrauterine growth retardation, cortical
blindness, sudden infant death syndrome, and maternal toxemia of pregnancy.
Whether any or all of these associations are coincidentally or causally related remains to
be clarified by further investigation. It is my expectation that the spectrum of gestational
Lyme borreliosis will expand into many of the clinical domains of prenatal syphilis.
Death 8-Day Old Californian Baby Boy
Culture positive seronegative transplacental Lyme borreliosis infant mortality.
Lavoie PE;Lattner BP;Duray PH; Barbour AG; Johnson HC.
Arthritis Rheum 1987; Volume 30, Number 4, 3(Suppl):S50.
"Transplacental infection by Borrelia burgdorferi (Bb), the agent of Lyme Borreliosis
(LB), has recently been documented (L.E. Markowitz, et al; P.A. Schlesinger, et al). Fetal
infection confirmed by culture has been reported by A.B. MacDonald (in press) from a
highly endemic region (Long Island, NY).
We report a culture positive neonatal death occurring in California, a low endemic
region. The boy was born by C-section because of fetal distress. He initially appeared
normal. He was readmitted at age 8 days with profound lethargy leading to
unresponsiveness. Marked peripheral cyanosis, systemic hypertension, metabolic
acidosis, myocardial dysfunction, & abdominal aortic thrombosis were found. Death
ensued. Bb was grown from a frontal cerebral cortex inoculation. The spirochete
appeared similar to the original Long Island tick isolate. Silver stain of brain & heart was
confirmatory of tissue infection.
The infant was the second born to a California native. The 20 m/o sibling was well. The
mother had been having migratory arthralgias and malaise since experiencing horse fly &
mosquito bites while camping on the Maine coast in 1971. The family was seronegative
for LB by ELISA at Yale. Cardiolipin antibodies were also not found."
JAMA. 1986 Jun 27;255(24):3394-6.
Lyme disease during pregnancy.
Markowitz LE, Steere AC, Benach JL, Slade JD, Broome CV.
Lyme disease is an increasingly recognized tick-borne illness caused by a spirochete,
Borrelia burgdorferi. Because the etiologic agent of Lyme disease is a spirochete, there
has been concern about the effect of maternal Lyme disease on pregnancy outcome.
We reviewed cases of Lyme disease in pregnant women who were identified before
knowledge of the pregnancy outcomes. Nineteen cases were identified with onset
between 1976 and 1984. Eight of the women were affected during the first trimester,
seven during the second trimester, and two during the third trimester; in two, the
trimester of onset was unknown.
Thirteen received appropriate antibiotic therapy for Lyme disease.
Of the 19 pregnancies, five had adverse outcomes, including syndactyly, cortical
blindness, intrauterine fetal death, prematurity, and rash in the newborn.
Adverse outcomes occurred in cases with infection during each of the trimesters.
Although B burgdorferi could not be implicated directly in any of the adverse outcomes,
the frequency of such outcomes warrants further surveillance and studies of pregnant
women with Lyme disease.
PMID: 2423719 [PubMed - indexed for MEDLINE]
Gestational Lyme borreliosis. Implications for the fetus.
Rheum Dis Clin North Am 1989 Nov;15(4):657-77
MacDonald AB Southampton Hospital, New York
Great diversity of clinical expression of signs and symptoms of gestational Lyme
borreliosis parallels the diversity of prenatal syphilis. It is documented that transplacental
transmission of the spirochete from mother to fetus is possible. Further research is
necessary to investigate possible teratogenic effects that might occur if the spirochete
reaches the fetus during the period of organogenesis.
Autopsy and clinical studies have associated gestational Lyme borreliosis with various
medical problems including fetal death, hydrocephalus, cardiovascular anomalies,
neonatal respiratory distress, hyperbilirubinemia, intrauterine growth retardation, cortical
blindness, sudden infant death syndrome, and maternal toxemia of pregnancy. Whether
any or all of these associations are coincidentally or causally related remains to be
clarified by further investigation. It is my expectation that the spectrum of gestational
Lyme borreliosis will expand into many of the clinical domains of prenatal syphilis.
2685924 NLM CIT. ID: 90069113
Acta Eur Fertil 1988 Sep-Oct;19(5):279-81
Lyme Borrelia positive serology associated with spontaneous abortion in an endemic
Italian area.
Carlomagno G; Luksa V; Candussi G; Rizzi GM; Trevisan G
Dept. of Obstetrics and Gynecology, University of Trieste School of Medicine.
Lyme borreliosis acquired during pregnancy may be associated with stillbirth and fetal
malformations. This paper reports preliminary results of a study intended to evaluate the
frequency of Borrelia burgdorferi infection associated with spontaneous abortion in an
endemic Italian area.
Also see Karen Forschner's story
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