Systemic Maternal Infections
Severe maternal infection with any type of organism
may result in fetal death. Examples include appendicitis,
pneumonia, pyelonephritis, and viruses such as
influenza. The pathophysiology of fetal loss may
include hypoxia due to respiratory distress, poor
uterine perfusion related to factors such as sepsis and
dehydration, the metabolic effects of high fever, and
the initiation of a cascade of toxic inflammatory
mediators. Systemic infection (as well as intra-amniotic
infection) also may lead to fetal death by initiating
preterm labor, resulting in intrapartum death, especially
at previable gestations.