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severe sepsis during pregnancy

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https://www.readbyqxmd.com/read/27926655/maternal-morbidity-after-previable-prelabor-rupture-of-membranes
#1
Sarah K Dotters-Katz, Alexis Panzer, Matthew R Grace, Marcela C Smid, J Adeolu Keku, Catherine J Vladutiu, Kim A Boggess, Tracy A Manuck
OBJECTIVE: To identify risk factors for maternal morbidity after previable prelabor rupture of membranes (PROM). METHODS: We conducted a case-control study of singleton and twin pregnancies complicated by previable PROM (14.0-22.9 weeks of gestation) at a single tertiary care referral institution, 2000-2015. Pregnancies complicated by fetal anomalies, previable PROM within 2 weeks of chorionic villus sampling or amniocentesis, and those with contraindications to expectant management (eg, chorioamnionitis) were excluded...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27899925/increased-risk-of-group-b-streptococcus-invasive-infection-in-hiv-exposed-but-uninfected-infants-a-review-of-the-evidence-and-possible-mechanisms
#2
REVIEW
Nicolas Dauby, Mustapha Chamekh, Pierrette Melin, Amy L Slogrove, Tessa Goetghebuer
Group B Streptococcus (GBS) is a major cause of neonatal sepsis and mortality worldwide. Studies from both developed and developing countries have shown that HIV-exposed but uninfected (HEU) infants are at increased risk of infectious morbidity, as compared to HIV-unexposed uninfected infants (HUU). A higher susceptibility to GBS infections has been reported in HEU infants, particularly late-onset diseases and more severe manifestations of GBS diseases. We review here the possible explanations for increased susceptibility to GBS infection...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27885296/outcome-of-twin-deliveries-at-a-tertiary-care-centre-of-eastern-nepal
#3
S Chaudhary, R R Singh, G S Shah, J Agrawal, S Kafle, L Shah
BACKGROUND: Twins, compared to singletons, have higher perinatal mortality and morbidity. The aim of this study was to describe the twinning rate, epidemiological variables and hospital outcome of twin deliveries and to find out ways of better management of twins in our part. METHODS: A retrospective evaluation of the outcome of 92 twin pregnancies during one year study period (1st January 2014 to 31st December 2014) was conducted at BPKIHS. Twins delivered within the institution were included but cases less than 28 weeks gestation were excluded...
May 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/27721728/spontaneous-bacterial-peritonitis-and-anasarca-in-a-female-patient-with-ovarian-hyperstimulation-syndrome-complicated-by-respiratory-and-kidney-failure
#4
Muhammad Abdul Mabood Khalil, Muhammad Salman Ghazni, Jackson Tan, Nazish Naseer, Muhammad Ashhad Ullah Khalil
Ovarian hyperstimulation syndrome (OHSS) was first described in 1960. It may occur as a complication of gonadotropin hormone therapy during assisted pregnancy or for primary infertility. A 26-year-old female patient with polycystic ovarian syndrome and primary infertility was treated to conceive. She received intravenous gonadotropin-releasing hormone (GnRH) along with follicle-stimulating hormone in an outside private clinic. She presented to the emergency department with abdominal and chest pain, loose stool, vomiting, shortness of breath and decreasing urine output...
May 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27617671/neutrophil-extracellular-traps-promote-hypercoagulability-in-patients-with-sepsis
#5
Shuofei Yang, Haozhe Qi, Kejia Kan, Chenjia Quan, Hui Xie, Xiangjiang Guo, Lan Zhang
BACKGROUND: Patients with sepsis commonly exhibit a hypercoagulability with high risk of venous thromboembolism (VTE). Neutrophil extracellular traps (NETs) are found to trigger inflammation and coagulation. We aim to determine whether NETs promoted the hypercoagulability and early anticoagulation reduced NETs releasing during sepsis. METHODS: In this prospective study, septic patients between September 2013 and June 2015 were included. Patients of age < 18 years, acute organ failure, pregnancy, coagulation disorders, receiving anticoagulation before admission were excluded...
September 9, 2016: Shock
https://www.readbyqxmd.com/read/27435163/metformin-in-women-with-type-2-diabetes-in-pregnancy-mity-a-multi-center-randomized-controlled-trial
#6
Denice S Feig, Kellie Murphy, Elizabeth Asztalos, George Tomlinson, Johanna Sanchez, Bernard Zinman, Arne Ohlsson, Edmond A Ryan, I George Fantus, Anthony B Armson, Lorraine L Lipscombe, Jon F R Barrett
BACKGROUND: The incidence of type 2 diabetes in pregnancy is rising and rates of serious adverse maternal and fetal outcomes remain high. Metformin is a biguanide that is used as first-line treatment for non-pregnant patients with type 2 diabetes. We hypothesize that metformin use in pregnancy, as an adjunct to insulin, will decrease adverse outcomes by reducing maternal hyperglycemia, maternal insulin doses, maternal weight gain and gestational hypertension/pre-eclampsia. In addition, since metformin crosses the placenta, metformin treatment of the fetus may have a direct beneficial effect on neonatal outcomes...
July 19, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27400016/outcomes-of-pregnancies-complicated-by-preterm-premature-rupture-of-membranes-between-20-and-24-weeks-of-gestation
#7
Mia Kibel, Elizabeth Asztalos, Jon Barrett, Michael S Dunn, Carly Tward, Alex Pittini, Nir Melamed
OBJECTIVE: To assess the natural history and contemporary outcomes in pregnancies complicated by previable preterm premature rupture of membranes (PROM). METHODS: Retrospective study of all women with a singleton or twin pregnancy admitted to a single tertiary referral center who experienced preterm PROM between 20 and 23 6/7 weeks of gestation during 2004-2014 and underwent expectant management. Women electing termination of pregnancy and pregnancies complicated by major fetal anomalies were excluded...
August 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27357953/community-s-perceptions-of-pre-eclampsia-and-eclampsia-in-sindh-pakistan-a-qualitative-study
#8
Asif Raza Khowaja, Rahat Najam Qureshi, Sana Sheikh, Shujaat Zaidi, Rehana Salam, Diane Sawchuck, Marianne Vidler, Peter von Dadelszen, Zulfiqar Bhutta
BACKGROUND: Maternal mortality is of global public health concern and >99 % of maternal deaths occur in less developed countries. The common causes of direct maternal death are hemorrhage, sepsis and pre-eclampsia/eclampsia. In Pakistan, pre-eclampsia/eclampsia deaths represents one-third of maternal deaths reported at the tertiary care hospital settings. This study explored community perceptions, and traditional management practices about pre-eclampsia/eclampsia. METHODS: A qualitative study was conducted in Sindh Province of Pakistan from February to July 2012...
June 8, 2016: Reproductive Health
https://www.readbyqxmd.com/read/27310552/evaluation-of-perinatal-outcomes-in-pregnant-women-with-preterm-premature-rupture-of-membranes
#9
Alex Sandro Rolland Souza, Adriane Farias Patriota, Gláucia Virgínia de Queiroz Lins Guerra, Brena Carvalho Pinto de Melo
OBJECTIVE: To determine the association between amniotic fluid index (AFI) and perinatal outcomes in preterm premature rupture of membranes (PPROM). METHOD: A retrospective cohort study was conducted between 2008 and 2012. 86 pregnant women were included, with a diagnosis of PPROM and gestational age from 24 to 35 weeks. Women who presented hypertensive disorders, diabetes, fetuses with birth defects and infection at admission were excluded. To determine the association between AFI and perinatal outcomes, chi-square and Fisher's exact test were used if necessary, as well as risk ratio (RR) and 95% confidence intervals (95CI)...
May 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27286326/mortality-associated-with-severe-sepsis-among-age-similar-women-with-and-without-pregnancy-associated-hospitalization-in-texas-a-population-based-study
#10
Lavi Oud
BACKGROUND The reported mortality among women with pregnancy-associated severe sepsis (PASS) has been considerably lower than among severely septic patients in the general population, with the difference being attributed to the younger age and lack of chronic illness among the women with PASS. However, no comparative studies were reported to date between patients with PASS and age-similar women with severe sepsis not associated with pregnancy (NPSS). MATERIAL AND METHODS We used the Texas Inpatient Public Use Data File to compare the crude and adjusted hospital mortality between women with severe sepsis, aged 20-34 years, with and without pregnancy-associated hospitalizations during 2001-2010, following exclusion of those with reported chronic comorbidities, as well as alcohol and drug abuse...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27067934/early-recognition-and-management-of-maternal-sepsis
#11
Lori Olvera, Danette Dutra
Although septic shock is rare in pregnancy, it is an important contributor to maternal mortality. A woman in the perinatal period can appear deceptively well before rapidly deteriorating to septic shock. We evaluated compliance with early goal-directed therapy before, during, and after the implementation of a standardized physician order set and interprofessional education. A retrospective study included 97 women with positive screening results for sepsis from April 2014 to January 2015. When comparing preintervention and postintervention results in women with sepsis, statistical significance was achieved for blood lactate level testing (p = ...
April 2016: Nursing for Women's Health
https://www.readbyqxmd.com/read/26932657/oligohydramnios-and-growth-restriction-do-not-portend-worse-prognosis-in-gastroschisis-pregnancies
#12
Robert Johnston, Sina Haeri
OBJECTIVES: Gastroschisis is a common abdominal wall defect. While most neonates have an excellent prognosis, complications do occur. Several risk factors for adverse neonatal outcomes have been identified, however, the impact of intrauterine growth restriction (IUGR) and oligohydramnios on neonatal morbidity and mortality has not been fully elucidated. METHODS: In this retrospective cohort study of pregnancies complicated by gastroschisis at two tertiary-care centers during an eight-year period, maternal, fetal and neonatal data were analyzed to estimate the impact of IUGR and oligohydramnios upon neonatal outcomes...
December 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26908745/benefit-of-early-initiation-of-influenza-antiviral-treatment-to-pregnant-women-hospitalized-with-laboratory-confirmed-influenza
#13
Ikwo K Oboho, Carrie Reed, Paul Gargiullo, Michelle Leon, Deborah Aragon, James Meek, Evan J Anderson, Patricia Ryan, Ruth Lynfield, Craig Morin, Marisa Bargsten, Shelley M Zansky, Brian Fowler, Ann Thomas, Mary Lou Lindegren, William Schaffner, Ilene Risk, Lyn Finelli, Sandra S Chaves
BACKGROUND: We describe the impact of early initiation of influenza antiviral treatment among pregnant women hospitalized with laboratory-confirmed influenza during the 2010-2014 influenza seasons. METHODS: Severe influenza was defined as illness with ≥1 of the following: intensive care unit admission, need for mechanical ventilation, respiratory failure, pulmonary embolism, sepsis, or death. Within severity stratum, we used parametric survival analysis to compare length of stay by timing of antiviral treatment, adjusting for underlying conditions, influenza vaccination, and pregnancy trimester...
August 15, 2016: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/26843736/risk-factors-for-retinopathy-of-prematurity-in-premature-born-children
#14
Jasmina Alajbegovic-Halimic, Denisa Zvizdic, Emina Alimanovic-Halilovic, Irena Dodik, Sanela Duvnjak
INTRODUCTION: Retinopathy of Prematurity (ROP) represent disease of the eye in premature born children which affects immature blood vessels of the retina during their development. The emergence of retinopathy of prematurity depends on the interaction of multiple factors, such as: gestational age, low birth weight, hypoxia, duration of oxygen supplementation, respiratory distress syndrome, twin pregnancy, anemia, blood transfusions, sepsis, intraventricular hemorrhage, hypotension, hypothermia, etc...
December 2015: Medical Archives
https://www.readbyqxmd.com/read/26842679/antenatal-betamethasone-for-women-at-risk-for-late-preterm-delivery
#15
RANDOMIZED CONTROLLED TRIAL
Cynthia Gyamfi-Bannerman, Elizabeth A Thom, Sean C Blackwell, Alan T N Tita, Uma M Reddy, George R Saade, Dwight J Rouse, David S McKenna, Erin A S Clark, John M Thorp, Edward K Chien, Alan M Peaceman, Ronald S Gibbs, Geeta K Swamy, Mary E Norton, Brian M Casey, Steve N Caritis, Jorge E Tolosa, Yoram Sorokin, J Peter VanDorsten, Lucky Jain
BACKGROUND: Infants who are born at 34 to 36 weeks of gestation (late preterm) are at greater risk for adverse respiratory and other outcomes than those born at 37 weeks of gestation or later. It is not known whether betamethasone administered to women at risk for late preterm delivery decreases the risks of neonatal morbidities. METHODS: We conducted a multicenter, randomized trial involving women with a singleton pregnancy at 34 weeks 0 days to 36 weeks 5 days of gestation who were at high risk for delivery during the late preterm period (up to 36 weeks 6 days)...
April 7, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26821906/thrombocytopenia-during-pregnancy-in-women-with-hiv-infection-receiving-no-treatment
#16
H M Sebitloane
UNLABELLED:  Background. Thrombocytopenia (TCP) complicates 5 - 8% of pregnancies. Most cases of TCP are gestational, and the condition is usually mild and occurs in the latter part of pregnancy. Apart from pregnancy-associated medical complications such as pre-eclampsia, HIV infection is a recognised cause of TCP, and a relatively high prevalence of TCP during pregnancy would be expected in a setting with a high antenatal seroprevalence of HIV. METHODS: This was a sub-analysis of the data from a prospective trial in which the incidence of postpartum sepsis in HIV-infected women was compared with that in HIV-uninfected women...
February 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/26595143/does-time-of-delivery-influence-the-risk-of-neonatal-morbidity
#17
Kathleen F Brookfield, Katharine O'Malley, Yasser Y El-Sayed, Yair J Blumenfeld, Alexander J Butwick
OBJECTIVE: To examine whether time of delivery influences the risk of neonatal morbidity among women with singleton pregnancies. STUDY DESIGN: Secondary analysis of data from the Maternal Fetal Medicine Units Network Factor V Leiden Mutation study. We categorized time of delivery as day (07:00-16:59), evening (17:00-23:59), and overnight (midnight-06:59). Severe neonatal morbidity was defined by at least one of the following: respiratory distress syndrome, transient tachypnea of the newborn, sepsis, seizures, neonatal intensive care admission, or a 5-minute APGAR ≤3...
April 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/26578103/the-role-of-infection-and-sepsis-in-the-brazilian-network-for-surveillance-of-severe-maternal-morbidity
#18
MULTICENTER STUDY
L C Pfitscher, J G Cecatti, S M Haddad, M A Parpinelli, J P Souza, S M Quintana, F G Surita, M L Costa
OBJECTIVE: To identify the burden of severe infection within the Brazilian Network for Surveillance of Severe Maternal Morbidity and factors associated with worse maternal outcomes. METHODS: This was a multicentre cross-sectional study involving 27 referral maternity hospitals in Brazil. WHO's standardised criteria for potentially life-threatening conditions and maternal near miss were used to identify cases through prospective surveillance and the main cause of morbidity was identified as infection or other causes (hypertension, haemorrhage or clinical/surgical)...
February 2016: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/26536344/very-high-intrapartum-fever-in-term-pregnancies-and-adverse-obstetric-and-neonatal-outcomes
#19
Uri P Dior, Liron Kogan, Smadar Eventov-Friedman, Moran Gil, Raz Bahar, Zivanit Ergaz, Shay Porat, Ronit Calderon-Margalit
BACKGROUND: Intrapartum fever is a well-known risk factor for adverse perinatal outcomes. Maternal intrapartum fever ≥39.0°C at term is a rare event during labor, and there is scarce evidence regarding its implications. OBJECTIVES: To investigate the association between very high intrapartum maternal fever and perinatal outcomes in term pregnancies. METHODS: A retrospective cohort analysis including 43,560 term, singleton live births in two medical centers between the years 2003 and 2011 was performed...
2016: Neonatology
https://www.readbyqxmd.com/read/26499401/prospective-observational-study-of-near-miss-obstetric-events-at-two-tertiary-hospitals-in-mumbai-maharashtra-india
#20
MULTICENTER STUDY
Ragini Kulkarni, Sanjay Chauhan, Rekha Daver, Yogeshwar Nandanwar, Anushree Patil, Archana Bhosale
OBJECTIVE: To review the incidence and patterns of near-miss obstetric events (defined as "A woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy"), as well as studying the classification criteria for near-miss events. METHODS: A prospective observational study was conducted in two tertiary hospitals in Mumbai. Women with near-miss obstetric events were interviewed during the period September 2012-August 2013...
February 2016: International Journal of Gynaecology and Obstetrics
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