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sepsis and endometritis

Natnael Etsay Assefa, Hailemariam Berhe, Fiseha Girma, Kidanemariam Berhe, Yodit Zewdie Berhe, Gidiom Gebreheat, Weldu Mamu Werid, Almaz Berhe, Hagos B Rufae, Guesh Welu
BACKGROUND: The incidence of premature rupture of membranes ranges from about 5% to 10% of all deliveries. A woman with premature rupture of membranes is at risk of intra-amniotic infection, postpartum infection, endometritis, and death. A neonate born from premature rupture of membranes mother is at high risk of respiratory distress syndrome, sepsis, intraventricular hemorrhage and death. Little is known regarding the risk factors in Ethiopia. Therefore, this study was conducted to identify risk factors of premature rupture of membranes among pregnant women admitted to public hospitals in Mekelle city, Tigray, Ethiopia...
September 29, 2018: BMC Pregnancy and Childbirth
Melissa E Bauer, Michelle Housey, Samuel T Bauer, Sydney Behrmann, Anthony Chau, Caitlin Clancy, Erin A S Clark, Sharon Einav, Elizabeth Langen, Lisa Leffert, Stephanie Lin, Manokanth Madapu, Michael D Maile, Emily McQuaid-Hanson, Kristina Priessnitz, Hen Y Sela, Anuj Shah, Paul Sobolewski, Paloma Toledo, Lawrence C Tsen, Brian T Bateman
BACKGROUND: Given the significant morbidity and mortality of maternal sepsis, early identification is key to improve outcomes. This study aims to evaluate the performance characteristics of the systemic inflammatory response syndrome (SIRS), quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA), and maternal early warning (MEW) criteria for identifying cases of impending sepsis in parturients. The secondary objective of this study is to identify etiologies and risk factors for maternal sepsis and to assess timing of antibiotics in patients diagnosed with sepsis...
August 29, 2018: Anesthesia and Analgesia
Marian Knight, Linda Mottram, Shan Gray, Christopher Partlett, Ed Juszczak
BACKGROUND: Sepsis is one of the most important causes of maternal death and severe morbidity worldwide. Studies conducted both in the UK and US have documented an additional risk associated with operative vaginal delivery. However, a Cochrane review, updated in 2017, identified only one small trial of prophylactic antibiotics following operative vaginal delivery, which included a total of 393 women. Given the small size of that trial, it recommended that further robust evidence is needed...
July 24, 2018: Trials
Lachmi R Kodan, Kim J C Verschueren, Humphrey H H Kanhai, Jos J M van Roosmalen, Kitty W M Bloemenkamp, Marcus J Rijken
BACKGROUND: Sepsis was the main cause of maternal mortality in Suriname, a middle-income country. Objective of this study was to perform a qualitative analysis of the clinical and management aspects of sepsis-related maternal deaths with a focus on the 'golden hour' principle of antibiotic therapy. METHODS: A nationwide reproductive age mortality survey was performed from 2010 to 2014 to identify and audit all maternal deaths in Suriname. All sepsis-related deaths were reviewed by a local expert committee to assess socio-demographic characteristics, clinical aspects and substandard care...
2018: PloS One
Joseph Ngonzi, Lisa M Bebell, Yarine Fajardo, Adeline A Boatin, Mark J Siedner, Ingrid V Bassett, Yves Jacquemyn, Jean-Pierre Van Geertruyden, Jerome Kabakyenga, Blair J Wylie, David R Bangsberg, Laura E Riley
BACKGROUND: There is a paucity of recent prospective data on the incidence of postpartum infections and associated risk factors in sub-Saharan Africa. Retrospective studies estimate that puerperal sepsis causes approximately 10% of maternal deaths in Africa. METHODS: We enrolled 4231 women presenting to a Ugandan regional referral hospital for delivery or postpartum care into a prospective cohort and measured vital signs postpartum. Women developing fever (> 38...
June 28, 2018: BMC Pregnancy and Childbirth
V Hodgetts Morton, A Wilson, C Hewitt, A Weckesser, N Farmer, D Lissauer, P Hardy, R K Morris
Background: Worldwide caesarean section (CS) delivery is the most common major operation. Approximately 25% of pregnant women undergo a CS in the UK for delivery of their babies. Sepsis and post-natal infection constitute significant maternal mortality and morbidity. Infection following a CS has a number of primary sources including endometritis occurring in 7-17% of women. Sepsis reduction and reduction in antibiotic use have been identified as a national and international priority. The overarching aim of this research is to reduce infectious morbidity from caesarean sections...
2018: Pilot and Feasibility Studies
Mary J Kao, Madhuchhanda Roy, Josephine Harter, Ryan J Spencer
Clostridium perfringens is an anaerobic gram positive rod that is found in normal vaginal and cervical flora in 1-10% of healthy women. Uterine infection with Clostridium perfringens is seen rarely but is often related to underlying uterine pathology and can progress quickly to sepsis. Early recognition of sepsis, prompt treatment with antibiotics, and source control with surgical management allow for optimal chance of recovery. We present a case of a postmenopausal woman who presented with sepsis, vaginal bleeding, and back pain who was found to have Clostridium perfringens infection in the setting of undifferentiated uterine sarcoma...
2018: Case Reports in Obstetrics and Gynecology
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
Gabriella Comunián-Carrasco, Guiomar E Peña-Martí, Arturo J Martí-Carvajal
BACKGROUND: Gonorrhoea is a sexually transmitted infection that is caused by Neisseria gonorrhoeae, and is a major public health challenge today. N gonorrhoeae can be transmitted from the mother's genital tract to the newborn during birth, and can cause gonococcal ophthalmia neonatorum as well as systemic neonatal infections. It can also cause endometritis and pelvic sepsis in the mother. This review updates and replaces an earlier Cochrane Review on antibiotics for treating this infectious condition...
February 21, 2018: Cochrane Database of Systematic Reviews
Laura Felder, Amanda Paternostro, Johanna Quist-Nelson, Jason Baxter, Vincenzo Berghella
BACKGROUND: Endometritis is a postpartum complication that is more common after cesarean delivery. It frequently requires intravenous antibiotic administration, prolonged hospital stays, and carries a risk of sepsis or abscess formation. Precesarean vaginal preparation has been shown to decrease the risk of endometritis in patients who have labored or have ruptured membranes. OBJECTIVE: The objective of this study was to assess the practical implementation of a protocol for vaginal cleansing prior to cesarean delivery and the subsequent effect on endometritis rates in a clinical setting...
January 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
Claudia Bollig, Monika Nothacker, Cornelius Lehane, Edith Motschall, Britta Lang, Joerg J Meerpohl, Christine M Schmucker
INTRODUCTION: The number of clinical trials investigating the optimal timing of prophylactic antibiotics in cesarean section has increased rapidly over the last few years. We conducted a systematic review to inform up-to-date evidence-based guidelines to prevent postpartum infectious morbidity in the mother and rule out any safety issues related to antepartum antibiotic exposure in infants. MATERIAL AND METHODS: Four bibliographic databases were searched for published reports of trials...
May 2018: Acta Obstetricia et Gynecologica Scandinavica
Janet Burton Glowicz
BACKGROUND: Serious unintended outcomes (SUOs) associated with cesarean section (CS), defined in this study as sepsis, endometritis, or wound disruption, occurring during the admission to deliver an infant by CS, or on readmission for wound disruption, are not routinely measured in a manner that continuously evaluates their impact on women's health. METHODS: The Texas Healthcare Information Collection Public Use Data File was used to investigate trends in the diagnosis of SUOs over a 5-year period from January 1, 2010-December 31, 2014...
April 2018: American Journal of Infection Control
Ashley E Skeith, Brenda Niu, Amy M Valent, Methodius G Tuuli, Aaron B Caughey
OBJECTIVE: To investigate the cost-effectiveness of adding azithromycin to standard cephalosporin regimens of cesarean delivery prophylaxis by considering the maternal outcomes in the current and potential subsequent pregnancies. METHODS: A cost-effectiveness model was created using TreeAge to compare the outcomes of using azithromycin-cephalosporin with cephalosporin alone in a theoretical cohort of 700,000 women, the approximate number of nonelective cesarean deliveries annually in the United States that occur during labor or after membrane rupture...
December 2017: Obstetrics and Gynecology
Somayeh Delfani, Mahmoud Bahmani, Reza Mohammadrezaei-Khorramabadi, Mahmoud Rafieian-Kopaei
Streptococcus agalactiae is a spherical and Gram-positive bacterium that causes postpartum sepsis, endometritis, chorioamnionitis and premature delivery in pregnant women. The use of herbs and natural ingredients for the treatment of various disorders has been common. The present review is a report on the medicinal plants with anti-Streptococcus agalactiae effects. In this review, the search was carried out in Web of Science, PubMed, Scopus, Google Scholar and Science direct by keywords such as bacteria, Streptococcus agalactiae and medicinal plants...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
(no author information available yet)
Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician-gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death...
August 2017: Obstetrics and Gynecology
(no author information available yet)
Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician-gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death...
August 2017: Obstetrics and Gynecology
Josh D Bell, Kushlin Higgie, Mital Joshi, Joshua Rucker, Sahar Farzi, Naveed Siddiqui
MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered...
July 15, 2017: A & A Case Reports
Daniel Martingano, Xin Guan, Audrey Renson, Shailini Singh, Meera Kesavan Nasir, Juliette Kim, Jeanne Carey
PURPOSE: This study aimed to determine whether daily dosing of gentamicin using ideal body weight in the treatment of chorioamnionitis is effective. MATERIALS AND METHODS: We conducted a prospective observational study and followed all women receiving treatment for chorioamnionitis which included gentamicin daily dosing calculated using 5 mg/kg ideal body weight. Patients were excluded if pathological analysis of placenta did not confirm chorioamnionitis. Our primary outcome was resolution of infection following delivery without the development of maternal endometritis and/or neonatal sepsis...
May 2018: Journal of Maternal-fetal & Neonatal Medicine
Tetsuya Kawakita, Uma M Reddy, Katherine L Grantz, Helain J Landy, Sameer Desale, Sara N Iqbal
BACKGROUND: Data on complications associated with classic cesarean delivery are conflicting. In extremely preterm cesarean delivery (22 0/7-27 6/7 weeks' gestation), the lower uterine segment is thicker. It is plausible that the rates of maternal complications may not differ between classic and low transverse cesarean. OBJECTIVE: We sought to compare maternal outcomes associated with classic versus low transverse cesarean after stratifying by gestation (23 0/7-27 6/7 and 28 0/7-31 6/7 weeks' gestation)...
March 2017: American Journal of Obstetrics and Gynecology
E Dalton, E Castillo
The epidemiology of infections in the puerperium (post partum period) is not well understood and remains underestimated because surveillance systems are often limited to the acute care setting. The most common source of persistent fever after delivery is genital tract infection for which diagnosis remains mostly clinical and antibiotic treatment empiric. This review will emphasize surgical site infections (SSIs) and endometritis. Septic thrombo-phlebitis, mastitis, urinary tract infections and rare infections will be covered in less detail...
September 2014: Obstetric Medicine
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