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Chorioamnionitis And Neonatal Sepsis

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https://www.readbyqxmd.com/read/30517235/assessment-of-oxidative-damage-and-enzymatic-antioxidant-system-activity-on-the-umbilical-cord-blood-and-saliva-from-preterm-newborns-with-risk-factors-for-early-onset-neonatal-sepsis
#1
Fábio Gonçalves Coutinho, Edna Maria de Albuquerque Diniz, Ingrid Kandler, Marco Antônio Cianciarullo, Natália Rodrigues Dos Santos
BACKGROUND: To determine the concentration of the Lipid Peroxidation Marker: Malondialdehyde (MDA), and Antioxidant Markers: Superoxide Dismutase (SOD), Glutathione Peroxidase (GPX), Catalase (CAL) in umbilical cord blood and in unstimulated saliva in the first 24 and 48 hours of life in the PTNB of mothers with and without risk factors for early-onset neonatal sepsis. METHODS: Cross-sectional study with the signing of informed consent by the pregnant women and application of a standard questionnaire classifying the PTNB in Group 1 or 2...
October 2018: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/30517142/components-of-the-antepartum-intrapartum-and-postpartum-exposome-impact-on-distinct-short-term-adverse-neonatal-outcomes-of-premature-infants-a-prospective-cohort-study
#2
Unzila Ali Nayeri, Catalin S Buhimschi, Guomao Zhao, Irina A Buhimschi, Vineet Bhandari
We aimed to test the hypothesis that determinants of the perinatal clinical exposome related to the underlying etiology of premature birth (PTB) impact differently on select neonatal outcomes. We conducted a prospective longitudinal study of 377 singleton preterm neonates [gestational age (GA) at birth: 23-34 weeks] separated into three distinct contemporaneous newborn cohorts: i) spontaneous PTB in the setting of intra-amniotic infection/inflammation (yes-IAI, n = 116); ii) spontaneous PTB in the absence of IAI (no-IAI, n = 130), and iii) iatrogenic PTB for preeclampsia (iPTB-PE, n = 131)...
2018: PloS One
https://www.readbyqxmd.com/read/30459195/streptococcus-agalactiae-induces-placental-macrophages-to-release-extracellular-traps-loaded-with-tissue-remodeling-enzymes-via-an-oxidative-burst-dependent-mechanism
#3
Ryan S Doster, Jessica A Sutton, Lisa M Rogers, David M Aronoff, Jennifer A Gaddy
Streptococcus agalactiae , or group B Streptococcus (GBS), is a common perinatal pathogen. GBS colonization of the vaginal mucosa during pregnancy is a risk factor for invasive infection of the fetal membranes (chorioamnionitis) and its consequences such as membrane rupture, preterm labor, stillbirth, and neonatal sepsis. Placental macrophages, or Hofbauer cells, are fetally derived macrophages present within placental and fetal membrane tissues that perform vital functions for fetal and placental development, including supporting angiogenesis, tissue remodeling, and regulation of maternal-fetal tolerance...
November 20, 2018: MBio
https://www.readbyqxmd.com/read/30334666/spectrum-of-changes-seen-with-placental-intravascular-organisms
#4
Pawel T Schubert, Deidre Mason, Roosacelis Martines, Marlene Deleon-Carnes, Sherif R Zaki, Drucilla J Roberts
Fetal bacterial infections are a common cause of fetal/neonatal morbidity and mortality. The pathologic correlates of congenital bacterial infection include acute chorioamnionitis, acute villitis, and acute intervillositis. The strength of the association of congenital bacterial infection differs among these pathologies. Acute chorioamnionitis results usually from an ascending infection, and damage to the fetus is thought to be cytokine driven rather than damage secondary to bacteremia. Acute villitis is strongly associated with fetal sepsis due to congenital infections...
October 18, 2018: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/30224839/new-evidence-to-support-antibiotic-prophylaxis-in-meconium-stained-amniotic-fluid-in-low-risk-women-in-labor-a-prospective-cohort-study
#5
Kavitha Abraham, Elsy Thomas, Jessie Lionel
Purpose of study: To assess the maternal and perinatal complications associated with meconium-stained amniotic fluid (MSAF) in low-risk women in labor. Methods: This prospective cohort study was conducted at CMC Hospital, Vellore, India. Two hundred low-risk women who had artificial or spontaneous rupture of membranes after admission with MSAF were included in the study. Two hundred similar women with clear liquor were taken as controls. The primary outcomes considered were the incidence of chorioamnionitis and endomyometritis in the mothers...
October 2018: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/30158677/implementation-of-the-sepsis-risk-score-for-chorioamnionitis-exposed-newborns
#6
Ladawna L Gievers, Jennifer Sedler, Carrie A Phillipi, Dmitry Dukhovny, Jonah Geddes, Peter Graven, Benjamin Chan, Sheevaun Khaki
BACKGROUND: To prevent early onset sepsis (EOS), ~10% of neonates receive antibiotics based on CDC recommendations regarding chorioamnionitis exposure. A sepsis risk score (SRS) predicts EOS and spares unnecessary evaluation and treatment. LOCAL PROBLEM: Chorioamnionitis-exposed neonates utilize significant resources. METHODS: An SRS algorithm was implemented to decrease resource utilization in chorioamnionitis-exposed neonates ≥35 weeks'...
November 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/30130819/infants-born-to-mothers-with-clinical-chorioamnionitis-a-cross-sectional-survey-on-the-use-of-early-onset-sepsis-risk-calculator-and-prolonged-use-of-antibiotics
#7
Marina Ayrapetyan, David Carola, Satyan Lakshminrusimha, Vineet Bhandari, Zubair H Aghai
OBJECTIVE:  To evaluate variations in practice for the management of neonates born to mothers with clinical chorioamnionitis. METHODS:  This was a prospective cross-sectional survey consisting of 10 multiple choice questionnaires distributed to 2,900 members of the Perinatal Section of American Academy of Pediatrics. Variations in responses were assessed and compared between the various groups. RESULTS:  A total of 682 members (23.5%) completed the survey; 169 (24...
August 21, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/30027150/cervical-bacterial-colonization-in-women-with-preterm-premature-rupture-of-membrane-and-pregnancy-outcomes-a-cohort-study
#8
Nafiseh Saghafi, Leila Pourali, Kiarash Ghazvini, Asieh Maleki, Mahdis Ghavidel, Mohsen Karbalaeizadeh Babaki
Background: One of the most important etiologies in pretermpremature rupture of membranes (PPROM) is cervical bacterial colonization. Objective: This study evaluated cervical bacterial colonization in women with PPROM and the pregnancy outcomes. Materials and Methods: In this cohort study, 200 pregnant women with PPROM at 27-37 wk of gestation who were admitted in an academic hospital of Mashhad University of Medical Sciences from March 2015 to July 2016 were studied...
May 2018: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/30021557/determinants-of-perinatal-mortality-among-cohorts-of-pregnant-women-in-three-districts-of-north-showa-zone-oromia-region-ethiopia-community-based-nested-case-control-study
#9
Elias Merdassa Roro, Mitike Molla Sisay, Lynn M Sibley
BACKGROUND: Statistics indicate that Ethiopia has made remarkable progress in reducing child mortality. It is however estimated that there is high rate of perinatal mortality although there is scarcity of data due to a lack of vital registration in the country. This study was conducted with the purpose of assessing the determinants and causes of perinatal mortality among babies born from cohorts of pregnant women in three selected districts of North Showa Zone, Oromia Region, Ethiopia...
July 18, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29792103/prolonged-use-of-antibiotics-after-birth-is-associated-with-increased-morbidity-in-preterm-infants-with-negative-cultures
#10
Carlos Fajardo, Belal Alshaikh, Andrei Harabor
BACKGROUND: Most preterm infants are exposed to a variable duration of antibiotic therapy after birth despite negative cultures. Data is emerging about the risks of prolonged antibiotics. We sought to assess the association between length of initial antibiotic course and neonatal outcomes in a cohort from a single large perinatal center. METHODS: Retrospective cohort study of prospectively collected data on all infants with a birth weight of less than 1250 g hospitalized in our NICU in a 4 year window and who had negative blood and CSF cultures in the first 2 days of life...
June 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29792096/neonatal-outcome-in-preterm-deliveries-before-34-week-gestation-the-influence-of-the-mechanism-of-labor-onset
#11
Sara Pinto, Maria Filipa Malheiro, Ana Vaz, Teresa Rodrigues, Nuno Montenegro, Hercília Guimarães
PURPOSE: To evaluate neonatal outcomes in preterm infants with less than 34 weeks after spontaneous labor, preterm premature rupture of membranes (PPROM) or iatrogenic delivery and to clarify whether the mechanism of labor onset is a risk factor for adverse short-term neonatal outcome. METHODS: We performed a retrospective case-control study, which included 266 preterm newborns with less than 34-week gestation, between 2011 and 2015. Neonatal outcomes were compared according to the mechanism of labor onset...
June 21, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29791315/incidence-of-early-onset-sepsis-in-infants-born-to-women-with-clinical-chorioamnionitis
#12
Tara M Randis, Madeline Murguia Rice, Leslie Myatt, Alan T N Tita, Kenneth J Leveno, Uma M Reddy, Michael W Varner, John M Thorp, Brian M Mercer, Mara J Dinsmoor, Susan M Ramin, Marshall W Carpenter, Philip Samuels, Anthony Sciscione, Jorge E Tolosa, George Saade, Yoram Sorokin
Objective To determine the frequency of sepsis and other adverse neonatal outcomes in women with a clinical diagnosis of chorioamnionitis. Methods We performed a secondary analysis of a multi-center placebo-controlled trial of vitamins C/E to prevent preeclampsia in low risk nulliparous women. Clinical chorioamnionitis was defined as either the "clinical diagnosis" of chorioamnionitis or antibiotic administration during labor because of an elevated temperature or uterine tenderness in the absence of another cause...
October 25, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29642754/daily-gentamicin-using-ideal-body-weight-demonstrates-lower-risk-of-postpartum-endometritis-and-increased-chance-of-successful-outcome-compared-with-traditional-8-hour-dosing-for-the-treatment-of-intrapartum-chorioamnionitis
#13
Daniel Martingano, Audrey Renson, Sharon Rogoff, Shailini Singh, Meera Kesavan Nasir, Juliette Kim, Jeanne Carey
BACKGROUND: Clinical chorioamnionitis complicates approximately 1-4% of pregnancies overall. Although universal agreement does not exist regarding the antibiotic regimen of choice, most studies have evaluated intravenous ampicillin dosed at 2 g every 6 hours plus gentamicin dosed every 8 hours. Only three studies have examined daily gentamicin for the treatment of intrapartum chorioamnionitis and thus is insufficiently investigated. OBJECTIVE: This study seeks to determine whether daily dosing of gentamicin using ideal body weight for the treatment of intrapartum chorioamnionitis is more or equivalently efficacious when compared to traditional 8-hour dosing regimens...
April 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29606026/strategies-for-preventing-early-onset-sepsis-and-for-managing-neonates-at-risk-wide-variability-across-six-western-countries
#14
Alberto Berardi, Cecilia Rossi, Caterina Spada, Giulia Vellani, Isotta Guidotti, Angela Lanzoni, Milena Azzalli, Irene Papa, Chiara Giugno, Laura Lucaccioni
OBJECTIVE: Group B streptococcus (GBS) early-onset sepsis (EOS) has declined after widespread intrapartum antibiotic prophylaxis. However, strategies for preventing EOS may differ across countries. The analysis of their strategies allows to compare the effectiveness of prevention in different countries and suggests opportunities for improvement. METHODS: We compared six western countries. Prevention strategies, incidence rates of EOS and approaches for managing neonates at-risk were analysed...
April 1, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29563816/the-diagnostic-utility-of-procalcitonin-interleukin-6-and-interleukin-8-and-hyaluronic-acid-in-the-norwegian-consensus-definition-for-early-onset-neonatal-sepsis-eons
#15
Britt Nakstad
Introduction: A key challenge in identifying serious bacterial infection in new born infants is the nonspecific clinical presentation of early-onset neonatal sepsis (EONS). Routinely used C-reactive protein, white blood cell count, and platelets are nonspecific. We assessed the diagnostic utility of single biomarkers or combinations of procalcitonin (PCT), interleukin (IL)-6, IL-8, and hyaluronic acid (HA) in newborn infant with EONS, and in human umbilical cord blood (HUCB) from deliveries with chorioamnionitis...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29533486/exposure-to-chorioamnionitis-alters-the-monocyte-transcriptional-response-to-the-neonatal-pathogen-staphylococcus-epidermidis
#16
Emma de Jong, David G Hancock, Christine Wells, Peter Richmond, Karen Simmer, David Burgner, Tobias Strunk, Andrew J Currie
Preterm infants are uniquely susceptible to late-onset sepsis that is frequently caused by the skin commensal Staphylococcus epidermidis. Innate immune responses, particularly from monocytes, are a key protective mechanism. Impaired cytokine production by preterm infant monocytes is well described, but few studies have comprehensively assessed the corresponding monocyte transcriptional response. Innate immune responses in preterm infants may be modulated by inflammation such as prenatal exposure to histologic chorioamnionitis which complicates 40-70% of preterm pregnancies...
March 13, 2018: Immunology and Cell Biology
https://www.readbyqxmd.com/read/29526138/comparison-between-two-doses-of-betamethasone-administration-with-12-hours-vs-24-hours-intervals-on-prevention-of-respiratory-distress-syndrome-a-randomised-trial
#17
RANDOMIZED CONTROLLED TRIAL
Maryam Kashanian, Nooshin Eshraghi, Narges Sheikhansari, Arash Bordbar, Elahehsadat Khatami
The purpose of the present study was to compare the effect of a two-dose administration of betamethasone with 12 hours interval vs. 24 hours interval on neonatal respiratory distress syndrome (RDS). The study was performed as a randomised clinical trial on 201 pregnant women with a gestational age of 26-34 weeks. In one group 12 mg of betamethasone every 12 hours for two doses and in the other group 12 mg of betamethasone every 24 hours for two doses were prescribed intramuscularly. There were no significant differences between the two groups according to maternal age, parity, gravidity, BMI, neonatal sex, need to surfactant, NICU admission, NICU stay, neonatal death, neonatal sepsis and Apgar score at minutes 1 and 5, but the gestational age at the beginning of the study and delivery receiving complete course of betamethasone and neonatal weight were lower in 24 hours group...
August 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29526120/discharge-breastmilk-feeding-rates-in-asymptomatic-term-newborns-admitted-to-the-neonatal-intensive-care-unit-for-maternal-chorioamnionitis
#18
Miry Shim, Sara Yang, Catherine R Messina, Jonathan P Mintzer
PURPOSE: To compare discharge breastmilk feeding rates among asymptomatic term newborns receiving 48-hour versus >48-hour antibiotics in the neonatal intensive care unit (NICU) and a cohort of well-baby nursery (WBN) newborns. MATERIALS AND METHODS: This retrospective review included asymptomatic term neonates admitted to the NICU due to maternal chorioamnionitis and a comparison group of WBN neonates between January 2012 and December 2015. Demographic, birth, feeding, and lactation consultant visit data were analyzed in univariate and multivariate models...
March 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29501938/the-strong-correlation-between-neonatal-early-onset-group-b-streptococcal-disease-and-necrotizing-enterocolitis
#19
Irene A Stafford, Eliza Rodrigue, Alexandra Berra, Wesley Adams, Asha J Heard, Joseph L Hagan, Shawn J Stafford
BACKGROUND: Necrotizing enterocolitis (NEC) is a leading cause of newborn gastrointestinal emergencies, affecting 1-3 per 1000 live births. Although NEC has been linked to a microbial etiology, associations with maternal intrapartum and resultant newborn early-onset invasive Group B streptococcus (EO-GBS) have been weakly defined. OBJECTIVE: The study aim was to determine the relationship between EO-GBS and NEC. STUDY DESIGN: Data from 2008 to 2015 were collected from pediatric records with ICD diagnosis codes consistent with all stages of NEC, with the exception of neonatal EO-GBS data (only available 2011-2015)...
April 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29426264/comparison-between-maternal-and-neonatal-outcome-of-pprom-in-the-cases-of-amniotic-fluid-index-afi-of-more-and-less-than-5-cm
#20
COMPARATIVE STUDY
Ashraf Sadat Mousavi, Neda Hashemi, Maryam Kashanian, Narges Sheikhansari, Arash Bordbar, Shayesteh Parashi
The study was performed on pregnant women with a gestational age of 26-32 weeks of pregnancy, who had been admitted to the hospital with a confirmed diagnosis of premature rupture of membranes. In all eligible women, ultrasounds were performed for the evaluation of amniotic fluid index. Then, the women were divided into two groups according to amniotic fluid index of ≥5 cm and <5 cm. These women were followed and monitored up to delivery. The women of the two groups did not have significant difference between them according to age, gestational age at the time of ruptured membrane, body mass index, gravidity, parity, gestational age at delivery and route of delivery...
July 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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