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maternal sepsis

C V Ananth, J A Lavery, A M Friedman, R J Wapner, J D Wright
OBJECTIVE: We examined rates of serious maternal complications in relation to severe pre-eclampsia based on the delivering hospital's annualised volume. DESIGN: Retrospective cohort study. POPULATION AND SETTING: Singleton deliveries (n = 25 782 235) in 439 hospitals in the USA. METHODS: Annualised hospital volume was categorised as 25-500, 501-1000, 1001-2000 and >2000. MAIN OUTCOME MEASURES: Rates of in-hospital maternal death and serious maternal complications, including puerperal cerebrovascular disorders, pulmonary oedema, disseminated intravascular coagulation, acute renal, heart and liver failure, sepsis, haemorrhage and intubation in relation to severe pre-eclampsia...
October 21, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Richard Kalisa, Stephen Rulisa, Thomas van den Akker, Jos van Roosmalen
BACKGROUND: The WHO Maternal Near Miss (MNM) approach was developed to evaluate and improve quality of obstetric care worldwide. This study aimed to study the incidence of MNM and quality of care at a district hospital in rural Rwanda by applying this approach. METHODS: A facility based, prospective cohort study conducted at a district hospital in rural Rwanda between June 2013 and December 2014. Subjects were followed from time of admission to discharge or death...
October 21, 2016: BMC Pregnancy and Childbirth
Lourdes A Blanco Esquivel, Jorge Macia Urbina, Hugo Mendieta Zerón
BACKGROUND: Severe obstetric morbidity constitutes a serious problem worldwide; however, an effective obstetrical prognosis scale is still missing. OBJECTIVE: To propose a modified Sequential Organ Failure Assessment Score (SOFA) score based on time before reaching specialized medical attention. METHOD: This was an ambispective, descriptive study, including all women treated at the Obstetrical Intensive Care Unit (OICU) of the "Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS), Toluca, Mexico, from June 2009 to June 2013...
September 2016: Ghana Medical Journal
Olivia Oria de Rueda Salguero, José Beceiro Mosquera, Marta Barrionuevo González, María Jesús Ripalda Crespo, Cristina Olivas López de Soria
INTRODUCTION: Early diagnosis of early-onset neonatal sepsis (EONS) is essential to reduce morbidity and mortality. Procalcitonin (PCT) in cord blood could provide a diagnosis of infected patients from birth. OBJECTIVE: To study the usefulness and safety of a procedure for the evaluation of newborns at risk of EONS, based on the determination of PCT in cord blood. PATIENTS AND METHODS: Neonates with infectious risk factors, born in our hospital from October 2013 to January 2015 were included...
October 14, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
David Carr, Elizabeth Helen Barnes, Adrienne Gordon, David Isaacs
BACKGROUND: Antibiotic resistance is a worldwide problem. We describe 25 years of responsible antibiotic use in a tertiary neonatal unit. METHODS: Data on neonatal infections and antibiotic use were collected prospectively from 1990 to 2014 at a single tertiary Sydney neonatal intensive care unit attached to a maternity unit. There are approximately 5500 deliveries and 900 nursery admissions per year. RESULTS: The mean annual rate of late-onset sepsis was 1...
October 13, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Patrick G C Ilboudo, Giulia Greco, Johanne Sundby, Gaute Torsvik
BACKGROUND: Treatment costs of induced abortion complications can consume a substantial amount of hospital resources. This use of hospitals scarce resources to treat induced abortion complications may affect hospitals' capacities to deliver other health care services. In spite of the importance of studying the burden of the treatment of induced abortion complications, few studies have been conducted to document the costs of treating abortion complications in Burkina Faso. Our objective was to estimate the costs of six abortion complications including incomplete abortion, hemorrhage, shock, infection/sepsis, cervix or vagina laceration, and uterus perforation treated in two public referral hospital facilities in Ouagadougou and the cost saving of providing safe abortion care services...
October 7, 2016: BMC Health Services Research
Adam S Dingens, Tessa S Fairfortune, Susan Reed, Caroline Mitchell
BACKGROUND: Bacterial vaginosis (BV) during pregnancy is a well-established risk factor for preterm birth and other preterm pregnancy complications. Little is known about adverse neonatal outcomes associated with BV exposure in full-term births, nor its influence on adverse outcomes independent of its effect on gestational age. The purpose of this study was to examine the relationship between BV during pregnancy and adverse neonatal outcomes among full-term and preterm infants. METHODS: We conducted a retrospective cohort study of Washington State mother/infant pairs from 2003-2013, stratified by full-term (primary outcomes) and preterm births (secondary outcomes)...
2016: BMC Pregnancy and Childbirth
Archana D Rathod, Rohidas P Chavan, Vijay Bhagat, Sandhya Pajai, Atul Padmawar, Prachi Thool
OBJECTIVE: (1) To determine the incidence of near-miss, maternal death and mortality index; (2) to compare near-miss cases as per WHO criteria with that of maternal mortality; and (3) to study the causes of near-miss and maternal deaths. STUDY DESIGN: Retrospective cohort study. SETTING: Shri Vasantrao Naik Govt. Medical College, Yavatmal, India. STUDY POPULATION: All cases of near-miss as per newer WHO criteria and maternal deaths...
October 2016: Journal of Obstetrics and Gynaecology of India
V Mishra Vineet, A Goyal Preeti, S Aggarwal Rohina, S Choudhary, Tanvir Tanvir, D Dharaiya Nisarg, A Gaddagi Rashmi
BACKGROUND: Acute kidney injury (AKI) is a clinical syndrome characterized by a sudden decline in glomerular filtration rate leading to decreased excretion of nitrogenous waste products. It continues to be a common problem in developing countries. AIMS: The aim of this study was to understand AKI characteristics in pregnancy and identify the factors related to its unfavorable outcome. STUDY DESIGN: A prospective cross-sectional study. METHODS: This prospective study was conducted between January 2013 and May 2014...
October 2016: Journal of Obstetrics and Gynaecology of India
Maimoona Ahmed, Sunil T Pandya, Tarakeswari Supraneni
PURPOSE: To determine the risk factors and associated comorbidities with a relaparotomy after primary surgery in pregnant mothers and to identify preventable causes. METHODS: A retrospective observational study was done at a tertiary care centre from January 2009 till August 2014. All records of exploratory laparotomy following primary surgery in the obstetric population during this period were retrieved from the hospital database and analysed. RESULTS: The incidence of relaparotomy was 0...
October 2016: Journal of Obstetrics and Gynaecology of India
Ashakiran T Rathod, K V Malini
PURPOSE: To analyze obstetric admissions to intensive care unit and to identify the risk factors responsible for intensive care admission. METHODS: This is a retrospective study of all obstetric cases admitted to the intensive care unit over a period of 3 years. Data were collected from case records. The risk factors responsible for ICU admission were analyzed. RESULTS: There were 765 obstetric admissions to ICU accounting for 1.24 % of all deliveries...
October 2016: Journal of Obstetrics and Gynaecology of India
S Igbaruma, B Olagbuji, A Aderoba, W Kubeyinje, B Ande, C Imarengiaye
BACKGROUND: Data on outcomes of obstetric admissions to intensive care units can serve as useful markers for assessing the quality of maternal care. We evaluated the intensive care unit utilization rate, diagnoses, case-fatality rate, mortality rate and associated factors among obstetric patients. METHODS: A prospective observational study of obstetric patients admitted to the general intensive care unit was performed. Women at 24 or more weeks of gestation, or within six weeks postpartum, who were admitted to the intensive care unit constituted the study population...
August 4, 2016: International Journal of Obstetric Anesthesia
Mohan Venkata Sumedha Maturu, Tom Devasia, Mugula Sudhakar Rao, Hashir Kareem
Infective endocarditis (IE) is a highly morbid condition in pregnancy which poses both maternal and fetal risk. In majority of cases, endocarditis occurs only on single valve and usually occurs on valve with structural disease or prosthetic valve. Multi-valvular involvement is not common and so we report a case of native triple valve endocarditis as a complication of post abortal sepsis which was successfully treated medically.
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Lucky Osaheni Lawani, Chukwuemeka Anthony Iyoke, Peter Onubiwe Nkwo, Robinson Chukwudi Onoh, Paul Olisaemeka Ezeonu, Isa Ayuba Ibrahim
This study determined the incidence, obstetric morbidity and the socio-cultural factors associated with ruptured uterus. A 6-year prospective review of ruptured uterus and an enquiry into socio-cultural barriers to specialised care was conducted. The incidence of ruptured uterus was 12 per 1000 deliveries. Occurrence was common in uneducated (78/116; 67.2%), unbooked (110/116; 94.8%) and rural women (112/116; 96.6%). The major causes were prolonged obstructed labour (104/116; 89.7%) and injudicious use of oxytocics (90/116; 77...
September 13, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Meryem Kurek Eken, Abdülhamit Tüten, Enis Özkaya, Güner Karatekin, Ateş Karateke
OBJECTIVE: To assess the predictors of outcome in terms of length of stay in the neonatal intensive care unit (NICU) and survival of neonates from women with preterm premature rupture of membranes (PPROM). METHODS: A population-based retrospective study including three hundred thirty-one singleton pregnant women with PPROM at 24-34 gestational weeks between January 2013 and December 2015 was conducted. Gestational age at delivery, birth weight, route of delivery, newborn gender, maternal age,oligohydramnios, premature retinopathy (ROP), necrotising enterocolitis (NEC), sepsis, fetal growth retardation (FGR), intracranial hemorrhagia (ICH), bronchopulmonary dysplasia (BPD), respiratory distress syndrome (RDS), primary pulmonary hypertension (PPH), congenital cardiac disease (CCD), patent ductus arteriosus (PDA), use of cortisol (betamethasone) and maternal complications including gestational diabetes, preeclampsia, and chorioamnionitis were used to predict neonatal outcomes in terms of length of stay in the NICU and survival...
September 14, 2016: Journal of Maternal-fetal & Neonatal Medicine
Jack W Samways, Sarah Vause, Evangelos Kontopantelis, Jane Eddleston, Sarah Ingleby, Anna Roberts, Bernard Clarke
OBJECTIVES: 1) Describe the distribution of heart rate in the first 48h postpartum in women with no evidence of sepsis, anaemia or haemorrhage. 2) Investigate the relationship between postpartum heart rate and other maternal factors. STUDY DESIGN: A retrospective cross-sectional study of postpartum women who delivered between July 2012 and June 2015 in a tertiary hospital. Data was analysed from the local maternity system and electronic vital signs database. The main outcome measures: Heart rate at 6, 12, 24 and 48h postpartum...
August 31, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Christina Herrera, Ryan Meehan, Varsha Podduturi, Alexander L Eastman, David B Nelson
BACKGROUND: Soft-tissue infections in women with subcutaneous injection drug use are often polymicrobial. CASE: A 21-year-old nulliparous woman presented at 14-15 weeks of gestation with several gluteal abscesses related to subcutaneous injection of heroin. She was well appearing, afebrile, and without findings of systemic illness. After empiric broad-spectrum intravenous antibiotics, same-day incision and drainage was performed. Immediately after the procedure, she developed refractory hypotension, severe tachycardia, pulmonary edema, and leukemoid reaction (white blood cell count 80×10/L)...
October 2016: Obstetrics and Gynecology
Kelley L Baumgartel, Maureen W Groer, Susan M Cohen, Dianxu Ren, Diane L Spatz, Yvette P Conley
BACKGROUND: Maternal interleukin (IL) single nucleotide polymorphisms (SNPs) are associated with obstetrical outcomes. Conversely, infant SNPs are associated with subsequent neonatal intensive care unit (NICU) outcomes. Little is known about relationships between maternal SNPs and neonatal outcomes. PURPOSE: To examine the relationships between maternal IL genotypes and neonatal outcomes. METHODS: An ancillary study was conducted among mothers (N = 63) who delivered very low-birth-weight infants (N = 74)...
September 6, 2016: Biological Research for Nursing
Zbynek Stranak, Jaroslav Feyereisl, Peter Korcek, Simona Feyereislova, Ladislav Krofta
AIMS: To analyze the relationship between maternal, cord blood and neonatal procalcitonin (PCT) levels in preterm deliveries with and without histologically proven chorioamnionitis (HCA). METHODS: 91 mother-infant pairs from 24+0 to 33+0 gestational weeks were analyzed. Procalcitonin was measured in all mothers within 24 hours before and subsequently in cord blood and in neonates within the first two hours after delivery. PCT levels were analysed in relationship to HCA and clinical outcome...
September 5, 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
William W Hay, Kendra C Hendrickson
Whereas human milk is the recommended diet for all infants, preterm formulas are indicated for enteral feeding of preterm very low birth weight infants when sufficient maternal breast milk and donor human milk are not available. Feeding with preterm formulas helps to ensure consistent delivery of nutrients. The balance of risks and benefits of feeding preterm formulas versus supplemented maternal and donor breast milk for preterm infants, however, is uncertain. Numerous studies and extensive practice have shown improved growth with preterm formulas, but there is concern for increased risks of necrotizing enterocolitis, possibly from cow milk antigen in the formulas or from different gut microbiomes, increased duration of total parenteral nutrition, and increased rates of sepsis in infants receiving preterm formulas...
August 30, 2016: Seminars in Fetal & Neonatal Medicine
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