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severe sepsis pregnancy

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https://www.readbyqxmd.com/read/27908330/sepsis-in-special-populations
#1
REVIEW
Matthew P Borloz, Khalief E Hamden
Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present. Baseline changes in vital signs and chronic medications often mask clues to the severity of illness. The physiologic, hematologic, and biochemical adjustments that accompany pregnancy and the puerperium introduce similar challenges...
February 2017: Emergency Medicine Clinics of North America
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/27780154/maternal-and-neonatal-outcomes-following-expectant-management-of-preterm-prelabour-rupture-of-membranes-before-viability
#4
Winnie Huiyan Sim, Edward Araujo Júnior, Fabricio Da Silva Costa, Penelope Marie Sheehan
AIM: To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks' gestation and to identify prognostic indicators of this morbid presentation. METHODS: We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM...
October 25, 2016: Journal of Perinatal Medicine
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
#5
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/27651571/study-of-obstetric-admissions-to-the-intensive-care-unit-of-a-tertiary-care-hospital
#6
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
https://www.readbyqxmd.com/read/27617671/neutrophil-extracellular-traps-promote-hypercoagulability-in-patients-with-sepsis
#7
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/27586209/critically-ill-obstetric-patients-requiring-mechanical-ventilation-in-rural-western-india-a-retrospective-analysis
#8
Smruti B Vaishnav, Bhalendu Vaishnav, Kailas N Desai, Nitin S Raithatha, Neeta S Bose
BACKGROUND: There is a dearth of studies on the clinical profile and therapeutic aspects of critically ill obstetric patients from rural areas, especially those requiring tertiary care support and ventilator therapy. METHODS: We retrospectively analysed the aetiological, clinical, interventional and outcome-related factors of obstetric patients requiring mechanical ventilation in western India. We analysed factors that influence seeking of antenatal care, pregnancy and its complications, severity assessment score, indications and initiation of mechanical ventilation, multiorgan failure and their correlation with maternal mortality...
March 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/27512298/changing-picture-of-acute-kidney-injury-in-pregnancy-study-of-259-cases-over-a-period-of-33-years
#9
J Prakash, P Pant, S Prakash, M Sivasankar, R Vohra, P K Doley, L K Pandey, U Singh
The incidence of acute kidney injury (AKI) in pregnancy is declining in developing countries but still remains a major cause of maternal and fetal morbidity and mortality. The aim of the study was to analyze the changing trends in pregnancy related AKI (PR-AKI) over a period of thirty-three years. Clinical characteristics of PR-AKI with respect to incidence, etiology and fetal and maternal outcomes were compared in three study periods, namely 1982-1991,1992-2002 and 2003-2014. The incidence of PR-AKI decreased to 10...
July 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27435163/metformin-in-women-with-type-2-diabetes-in-pregnancy-mity-a-multi-center-randomized-controlled-trial
#10
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...
2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27434146/pulmonary-hemorrhage-due-to-coxsackievirus-b-infection-a-call-to-raise-suspicion-of-this-important-complication-as-an-end-stage-of-enterovirus-sepsis-in-preterm-twin-neonates
#11
Rotem Orbach, Dror Mandel, Ronit Lubetzky, Amit Ovental, Alon Haham, Ora Halutz, Galia Grisaru-Soen
BACKGROUND: Prematurity is an important risk factor for the fulminate form of neonatal enteroviral infection. Pulmonary hemorrhage is a morbid complication that should be anticipated and managed aggressively due to its fatal outcome. OBJECTIVE: To emphasize the significance of pulmonary hemorrhage as a complication of severe enterovirus infection in preterm neonates. STUDY DESIGN: This report is a description of the clinical history, medical management and clinical outcomes of two pairs of preterm twin newborns (30 weeks and 36 weeks) with fulminant infection due to Coxsackievirus B (CBV) infection...
September 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/27400016/outcomes-of-pregnancies-complicated-by-preterm-premature-rupture-of-membranes-between-20-and-24-weeks-of-gestation
#12
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
#13
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...
2016: Reproductive Health
https://www.readbyqxmd.com/read/27310552/evaluation-of-perinatal-outcomes-in-pregnant-women-with-preterm-premature-rupture-of-membranes
#14
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/27307961/antibiotic-therapy-for-very-low-birth-weigh-newborns-in-nicu
#15
Seyyed-Abolfazl Afjeh, Mohammad-Kazem Sabzehei, Seyyed-Ali-Reza Fahimzad, Farideh Shiva, Ahmad-Reza Shamshiri, Fatemeh Esmaili
BACKGROUND: Prolonged empiric antibiotics therapy in neonates results in several adverse consequences including widespread antibiotic resistance, late onset sepsis (LOS), necrotizing enterocolitis (NEC), prolonged hospital course (HC) and increase in mortality rates. OBJECTIVES: To assess the risk factors and the outcome of prolonged empiric antibiotic therapy in very low birth weight (VLBW) newborns. MATERIALS AND METHODS: Prospective study in VLBW neonates admitted to NICU and survived > 2 W, from July 2011 - June 2012...
April 2016: Iranian Journal of Pediatrics
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
#16
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/27104603/group-a-streptococcal-infection-in-pregnancy-and-the-puerperium
#17
Mary Ellen Burke Sosa
There has been an increasing incidence worldwide of invasive group A streptococcal disease in pregnancy and the puerperal period over the past 30 years. Group A Streptococcus (GAS) was identified as the major cause of maternal morbidity and mortality from sepsis before the identification that hand washing techniques could prevent the transmission of the bacteria. Hand washing remains the cornerstone of prevention as transmission can occur directly from an asymptomatic colonized healthcare provider, other patients, or a community-acquired source...
April 2016: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/27088752/apheresis-and-intravenous-immunoglobulins-used-in-addition-to-conventional-therapy-to-treat-high-risk-pregnant-antiphospholipid-antibody-syndrome-patients-a-prospective-study
#18
Amelia Ruffatti, Maria Favaro, Ariela Hoxha, Alessandra Zambon, Piero Marson, Teresa Del Ross, Antonia Calligaro, Marta Tonello, Giovanni B Nardelli
Pregnant women with triple antibody positive antiphospholipid syndrome (APS) who have had thrombosis or a history of early, severe pregnancy complications are generally considered at high risk of pregnancy loss. The objectives of this study were to investigate the efficacy and safety of a relatively new treatment protocol used in addition to conventional therapy in high-risk pregnant patients affected with primary APS. The study's two inclusion criteria were: (1) the presence of triple antiphospholipid positivity, (2) previous thrombosis and/or a history of one or more early, severe pregnancy complications...
June 2016: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/27067934/early-recognition-and-management-of-maternal-sepsis
#19
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/27052970/relationship-of-maternal-mean-platelet-volume-with-fetal-doppler-parameters-and-neonatal-complications-in-pregnancies-with-and-without-intrauterine-growth-restriction
#20
Isin Ureyen, Ozgur Ozyuncu, Nihal Sahin-Uysal, Ozgur Kara, Derman Basaran, Mert Turgal, Ozgur Deren
OBJECTIVE: In this study, we investigated the relationship of mean platelet volume (MPV) with the presence and the severity of intrauterine growth restriction (IUGR) and with neonatal complications. METHODS: The pregnancies with and without IUGR, that were followed-up in our hospital between 2003 and 2009 were analyzed retrospectively. Pregnancies which resulted in birth of a newborn with a birthweight less than 10th percentile for the gestational age were selected for IUGR group...
April 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
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