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Fecal Microbiota Transplant for Clostridium difficile Infection in a Pregnant Patient

Saeedi, Bejan J.; Morison, Doree Gardner; Kraft, Colleen S.; Dhere, Tanvi MD

doi: 10.1097/AOG.0000000000001911
Contents: Case Report
Cochrane Reviews
Pearls of Exxcellence

BACKGROUND: Clostridium difficile infection has been associated with negative outcomes in the general population and in pregnant patients. Fecal microbiota transplant has become the standard for treatment of recurrent as well as refractory C difficile infection.

CASE: We present a case of a 28-year-old pregnant woman who presented with recurrent C difficile infection despite treatment with vancomycin and fidaxomicin and underwent a successful fecal microbiota transplant through colonoscopy at 18 weeks of gestation. She no longer required antibiotics for the remainder of her pregnancy to treat C difficile and had a term vaginal delivery at 39 weeks of gestation.

CONCLUSION: Our pregnant patient tolerated and responded to a fecal microbiota transplant for treatment of recurrent C difficile infection. Future large-scale studies are needed to determine the efficacy, safety, and long-term effects of manipulating the microbiome in pregnant patients and the neonates.

Fecal transplant for the treatment of recurrent Clostridium difficile prevents the need for continued antibiotic exposure during pregnancy and repeated recurrences of C difficile infection.

School of Medicine, the Departments of Medicine and Pathology and Laboratory Medicine, and the Division of Digestive Diseases, Emory University, Atlanta, Georgia.

Corresponding author: Tanvi Dhere, MD, Division of Digestive Diseases, Emory University, 1365 Clifton Road, Atlanta, GA 30322; email: tdhere@emory.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has indicated that he or she has met the journal’s requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.