From the Research
A positive placental culture indicates the presence of infectious microorganisms in the placenta, suggesting an infection that may have affected the placental tissue during pregnancy, and requires prompt identification and treatment to prevent adverse outcomes such as preterm birth, chorioamnionitis, postpartum endometritis, and neonatal sepsis. This finding is supported by a study published in 2023 1, which highlights the importance of appropriate management of women with intrapartum fever, with or without other signs of infection, to prevent maternal and neonatal complications. Common organisms found in positive placental cultures include Group B Streptococcus, E. coli, Listeria monocytogenes, and various anaerobic bacteria. When a placental culture is positive, it typically requires follow-up care for both the mother and newborn. For the mother, antibiotic treatment may be necessary based on the specific organism identified and her clinical symptoms. The choice of antibiotic depends on culture sensitivity results, with common options including ampicillin, gentamicin, or clindamycin for 7-10 days in cases of postpartum infection. The newborn should be monitored closely for signs of infection and may require prophylactic antibiotics or treatment depending on clinical presentation.
Some key points to consider in the management of a positive placental culture include:
- The use of broad-spectrum antibiotics, such as ampicillin and gentamicin, may be necessary to cover a range of potential pathogens 1
- The importance of monitoring the newborn for signs of infection, such as respiratory distress, fever, or lethargy, and providing prompt treatment if necessary 1
- The potential for placental infections to lead to complications such as preterm birth, chorioamnionitis, postpartum endometritis, and neonatal sepsis, highlighting the need for prompt identification and treatment 2, 3, 4, 5
- The value of placental microbial evaluation in diagnosing intra-amniotic infection, although the accuracy of placental cultures in predicting amniotic fluid infection may be limited 5