Conservative treatment for placenta accreta can help women avoid hysterectomy and involves a low rate of severe maternal morbidity in centers with adequate equipment and resources.

We report a highly reproducible, quantitative tool to objectively analyze vaginal flora that uses cutoff values for the concentrations of A. vaginae and G. vaginalis to establish the molecular diagnosis of BV.

Assistance Publique-Hôpitaux de Paris and the University of Geneva.

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Background. Q fever is a zoonosis caused by Coxiella burnetii. During pregnancy, it may result in obstetric complications, such as spontaneous abortion, intrauterine growth retardation, intrauterine fetal death, and premature delivery. Pregnant women are exposed to the risk of chronic Q fever.Methods. We included 53 pregnant women who received a diagnosis of Q fever. We compared the incidence of obstetric and maternal Q fever complications for women who received long-term cotrimoxazole treatment ( ) with that for women who did not receive long-term cotrimoxazole treatment ( ); long-term n p 16 n p 37 cotrimoxazole treatment was defined as oral administration of trimethoprim-sulfamethoxazole during at least 5 weeks of pregnancy.Results. Obstetric complications were observed in 81.1% of pregnant women who did not receive long-term cotrimoxazole therapy: 5 (13.5%) women experienced spontaneous abortions, 10 (27%) experienced intrauterine growth retardation, 10 (27%) experienced intrauterine fetal death, and 10 (27%) experienced premature delivery. Oligoamnios was observed in 4 patients (10.8%). Obstetric complications were found to occur significantly more often in patients infected during their first trimester of pregnancy than in those infected later ( ). The P p .032 outcome of the pregnancy was found to depend on placental infection by C. burnetii ( ). Long-term P p .013 cotrimoxazole treatment protected against maternal chronic Q fever ( ), placental infection ( ), P p .001 P p .038 and obstetric complications ( ), especially intrauterine fetal death ( ), which was found to be related P p .009 P p .018 to placental infection ( ). P p .008 Conclusions. Q fever during pregnancy results in severe obstetric complications, including oligoamnios. Because of its ability to protect against placental infection, intrauterine fetal death, and maternal chronic Q fever, longterm cotrimoxazole treatment should be used to treat pregnant women with Q fever.