Editors
Gauri
Gandhi
MD Professor Department of Obstetrics and Gynaecology
MAMC and Lok Nayak Hospital,
New Delhi
Sumita
Mehta
DGO, DNB
Senior Research Associate Department of Obstetrics and Gynaecology
MAMC and Lok Nayak Hospital,
New Delhi
Swaraj
Batra
MS, FICOG
Director - Professor and Head Department of Obstetrics and Gynaecology
MAMC and Lok Nayak Hospital,
New Delhi
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
EMCA House, 23/23B Ansari Road, Daryaganj
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Infections in Obstetrics and Gynaecology
© 2006, Gauri Gandhi, Sumita Mehta, Sawraj Batra
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
This book has been published in good faith that the material provided by contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer, editors will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition : 2006
9788180616075
Typeset at JPBMP typesetting unit
Printed atReplika Press Pvt. Ltd., Plot No. 310, EPIP, Kundli, Sonepat, Haryana, India
4Contributors
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Raksha Arora
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Professor
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Sutopa Banerjee
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Senior Resident
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Swaraj Batra
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Director Professor and
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Head of Department
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Chanchal
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Junior Resident
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital
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New Delhi
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S. Chandra
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Chief Medical Officer
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NTPC, New Delhi
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Mona Dahiya
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Senior Resident
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Neha Gami
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Senior Resident
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Gauri Gandhi
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Professor
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Deepti Goswami
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Associate Professor
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital
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New Delhi
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Sangeeta Gupta
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Assistant Professor
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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C Jassal
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Senior Resident
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Ashok Kumar
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Professor
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Associate Professor
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Usha Manaktala
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Director Professor
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Sumita Mehta
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Senior Research Associate
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Sudha Prasad
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Professor
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Asmita M Rathore
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Professor
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Poonam Sachdeva
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Specialist
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Aparna Sharma
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Junior Resident
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Ruchira Singh
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Junior Resident
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Rimpi Singla
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Junior Resident
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital
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New Delhi
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Renu Tanwar
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Senior Resident
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital
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New Delhi
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Anjali Tempe
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Professor
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Reva Tripathi
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Professor
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Shakun Tyagi
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Senior Research Associate
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Department of Obstetrics and Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Leena Wadhwa
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Senior Research Associate
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
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Vijay Zutshi
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Senior Specialist
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Department of Obstetrics and
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Gynaecology
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Maulana Azad Medical College and
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Lok Nayak Hospital, New Delhi
Infections cause significant morbidity and sometimes mortality in obstetrics and gynaecology as they do in other clinical specialities. Therefore, it is important to have a basic knowledge of the more common causative organisms and their effects on the female genital organs, on the pregnant women and on the foetus and the neonate.
This book describes some of the more important viral, bacterial and parasitic infections relevant to obstetrics and gynaecology.
During pregnancy, some infections have a deleterious effect not only on the pregnant woman but also on the foetus and the newborn. Some viral infections during pregnancy can cause foetal demise and congenital malformations in the foetus. The chapters on viral infections describe these effects on mother and child and also the appropriate counselling and treatment to be given.
The problem of HIV/AIDS has assumed alarming proportions in our country. One chapter has been devoted to HIV in obstetrics and gynaecology and antiretroviral therapy.
Bacterial and parasitic infections need appropriate antimicrobial therapy. This has been described in each chapter. In addition, there is one chapter devoted to antimicrobial therapy in pregnancy, describing the safety profile of these drugs during pregnancy.
Immunisation in pregnancy has been described separately.
The important gynaecological infections like genital tuberculosis, sexually transmitted diseases and pelvic inflammatory disease have been described in different chapters.
Antibiotic prophylaxis is a very important step to prevent infections in elective or emergency surgery. The last chapter describes the evidence based guidelines regarding antibiotic prophylaxis in obstetrics and gynaecology.
We hope this book will help the practising clinicians to treat infections and also judiciously use antibiotics to prevent infections.
Gauri Gandhi
Sumita Mehta
Swaraj Batra
7Acknowledgements
The editors would like to express their gratitude to all the contributing authors who have put in a lot of effort to comprehensively present the latest developments in every topic.
We would also like to thank our families who have given us constant support during preparation of this manuscript.
Last, but not the least, we are extremely grateful to Jaypee Brothers Medical Publishers (P) Ltd for their co-operation during the compilation of this book.