Maternal-Fetal Transmission of the Lyme Disease Spirochete, Borrelia burgdorferi.
PETER A. SCHLESINGER, M.D.; PAUL H. DURAY, M.D.; BARBARA A. BURKE, M.D.; ALLEN C. STEERE. M.D.; and M. THOMAS STILLMAN. M.D.
Hennepin County Medical Center and the University of Minnesota Medical School, Minneapolis, Minnesota; Yale University School of Medicine, New
From the text :
"We report the case of a woman who developed Lyme discase during the first trimester of pregnancy. She did not recive antibiotic therapy. Her infant, born at 35 weeks gestational age, died of congenital heart disease during the first week of life. Histologie examination of autopsy material showed the Lyme disease spirochete in the spleen, kidneys, and bone marrow."
"A 28-year-old mother of two healthy children became pregnant for the third time in September 1983. Soon thereafter, she participated in outdoor
activities in an area of northwestern Wisconsin known to be endemic for Lyme disease (3).
On 7 November 1983, she noted an expanding annular skin lesion in the left poplileal region reaching a size of 20 X 30 cm. She also developed two secondary skin lesions, headache, stiff neck, arthralgias, malaise, and inguinal lymphadenopathy. All symptoms resolved within several
weeks without treatment. Thereafter, the antepartum course was normal except for recurrent arthralgias during the third trimester. No medications were taken during the pregnancy.
On 6 May 1984, the patient delivered a 3000-g male infant whose estimated gestational age was 35 weeks. No skin lesions were seen. The baby had respiratory distress. An echocardiogram and cardiac catheterization showed a dilated. poorly contractile left ventricle; aortic valvular stenosis; patent ductus arteriosus; and coarctation of thc aorta. Despite emergency balloon catheter dilatation of the coarctation and aortic valvotomy, the infant died after 39 hours."
Annals of internal medicine july 1985 volume 103 number 1