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Chorioamnionitis

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https://www.readbyqxmd.com/read/28187059/clinical-and-microbiologic-characteristics-of-early-onset-sepsis-among-vlbw-infants-opportunities-for-antibiotic-stewardship
#1
Sagori Mukhopadhyay, Karen M Puopolo
BACKGROUND: Most very-low birth weight (birth weight <1500 grams, VLBW) infants receive empiric antibiotics for risk of early-onset sepsis (EOS). The objective of this study was to determine the characteristics of VLBW infants with culture-confirmed EOS at a single center during 25 years, to identify opportunities for antibiotic stewardship. METHODS: Retrospective cohort study including VLBW infants admitted from 1990-2015. EOS was defined as isolation of a pathogen in blood or cerebrospinal fluid culture obtained < 72 hours of age...
February 9, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28179485/variation-in-sepsis-evaluation-across-a-national-network-of-nurseries
#2
Sagori Mukhopadhyay, James A Taylor, Isabelle Von Kohorn, Valerie Flaherman, Anthony E Burgos, Carrie A Phillipi, Nui Dhepyasuwan, Elizabeth King, Miren Dhudasia, Karen M Puopolo
BACKGROUND AND OBJECTIVES: The extent to which clinicians use currently available guidelines for early-onset sepsis (EOS) screening has not been described. The Better Outcomes through Research for Newborns network represents 97 nurseries in 34 states across the United States. The objective of this study was to describe EOS risk management strategies across a national sample of newborn nurseries. METHODS: A Web-based survey was sent to each Better Outcomes through Research for Newborns network nursery site representative...
February 8, 2017: Pediatrics
https://www.readbyqxmd.com/read/28178107/late-onset-neonatal-sepsis-a-10-year-review-from-north-queensland-australia
#3
Harsha Gowda, Robert Norton, Andrew White, Yogavijayan Kandasamy
OBJECTIVE: Late-onset sepsis (LOS) in neonates contributes significantly to both morbidity and mortality. To determine the incidence of LOS, risk factors for disease, and the impact on subsequent hospital course, we evaluated a cohort of 6340 neonates admitted to the neonatal intensive care unit and of neonates (3-28 days) admitted from the community between January 2005 and January 2016. METHODS: This was a retrospective case review of all neonates admitted with suspected LOS who had positive blood culture and/or cerebrospinal fluid (CSF) cultures, for an organism determined to be a pathogen...
February 1, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28178054/safety-of-tetanus-diphtheria-and-pertussis-vaccination-during-pregnancy-a-systematic-review
#4
Mark McMillan, Michelle Clarke, Adriana Parrella, Deshayne B Fell, Gayatri Amirthalingam, Helen S Marshall
OBJECTIVE: To assess antenatal, birth, and infant outcomes for pregnant women, fetuses, and infants after antenatal vaccination with any antigen present in combination pertussis vaccines. DATA SOURCES: PubMed, EMBASE, Literature in the Health Sciences in Latin America and the Caribbean, ClinicalTrials.gov, Cochrane Library, and World Health Organization (inception to May 5, 2016). METHODS OF STUDY SELECTION: Studies reporting outcomes for pregnant women, their fetus, or infant after antenatal exposure to either monovalent or combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) or inactivated polio vaccines were considered for inclusion...
February 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28161068/distribution-and-potential-significance-of-intravillous-and-intrafibrinous-particulate-microcalcification
#5
Jennifer Zeng, Alan Marcus, Tatiana Buhtoiarova, Khushbakhat Mittal
Radiologic studies indicate that placental calcifications seen at 28-32 weeks' gestation are associated with adverse fetal outcome. One type of placental calcification is typically located at the basement membrane of chorionic villi. It has a fine particulate appearance and can only be seen microscopically. We have designated these calcifications as Intravillous and Intrafibrinous Particulate MicroCalcification (IPMC). In this study we examined the distribution and potential significance of IPMC. Placentas from 14 groups of fetal and maternal outcomes are examined histologically for IPMC...
February 2017: Placenta
https://www.readbyqxmd.com/read/28161060/histological-changes-in-the-umbilical-artery-following-severe-chorioamnionitis-and-funisitis-may-be-indicative-of-early-atherosclerosis
#6
Anthony R Rafferty, Colleen D'Arcy, Leonie Cann, Jan Pyman, Peter Rogers, Peter G Davis, Cameron Nowell, David Burgner
We investigated whether histological evidence of early atherosclerosis was present in the umbilical artery of 21 pregnancies complicated by severe perinatal inflammation, and 21 controls matched for gestational age, sex and birth weight. Severe chorioamnionitis with funisitis was associated with increased numbers of CD68 and CD45 positive cells (both P < 0.01), indicating accumulation of monocyte-derived macrophages in lesion-susceptible regions. A down-regulation of SMA expression (P = 0.01) was also observed...
February 2017: Placenta
https://www.readbyqxmd.com/read/28160689/predictive-value-of-vaginal-il-6-and-tnf%C3%AE-bedside-tests-repeated-until-delivery-for-the-prediction-of-maternal-fetal-infection-in-cases-of-premature-rupture-of-membranes
#7
Gilles Kayem, Frederic Batteux, Noémie Girard, Thomas Schmitz, Marion Willaime, Francoise Maillard, Pierre Henri Jarreau, Francois Goffinet
OBJECTIVE: Examine the predictive value for maternal-fetal infection of routine bedside tests detecting the proinflammatory cytokines, TNFα and IL-6, in the vaginal secretions of women with premature rupture of the membranes (PROM). STUDY DESIGN: This prospective two-center cohort study included all women hospitalized for PROM over a 2-year period. A bedside test assessed IL-6 and TNFα in vaginal secretions. Both centers routinely tested CRP and leukocytes, assaying both in maternal serum, and analyzed vaginal bacterial flora; all samples were repeated twice weekly until delivery...
January 12, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28153660/attempted-operative-vaginal-delivery-versus-repeat-cesarean-in-the-second-stage-among-women-undergoing-a-trial-of-labor-after-cesarean-delivery
#8
Moeun Son, Archana Roy, William A Grobman
BACKGROUND: It is not well characterized whether attempting operative vaginal delivery (OVD) is a safe and effective alternative among women undergoing a trial of labor after cesarean delivery (TOLAC) who are unable to complete second-stage labor with a spontaneous vaginal delivery. OBJECTIVE: To compare maternal and neonatal outcomes associated with attempted OVD to those associated with second-stage repeat cesarean delivery (RCD) without OVD attempt among women undergoing a TOLAC...
January 28, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28151754/maternal-risks-of-fetal-therapy
#9
Alyaa Al-Refai, Greg Ryan, Tim Van Mieghem
PURPOSE OF REVIEW: Although most fetal disorders can be treated after birth, a few conditions that predictably lead to fetal or neonatal death, or that progress significantly before birth, are ideally treated prenatally. The number of centers offering fetal therapeutic procedures is gradually increasing worldwide. Patients and caregivers should be aware of the potential maternal risks of these interventions. RECENT FINDINGS: For transplacental medical therapy (corticosteroids, antiarrhythmics and immunoglobulins), severe maternal adverse events are rare, when done in expert centers...
February 1, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28150393/acquired-hemophilia-a-manifesting-as-plasma-transfusion-uncontrolled-severe-bleeding-2-weeks-after-chorioamnionitis-induced-abortion
#10
Ayumi Matsuoka, Hiromasa Sasaki, Chiharu Sugimori, Shinya Hirabuki, Tsutomu Hoshiba, Hiroshi Fujiwara
Acquired hemophilia A (AHA) is a serious and rare complication of pregnancy, caused by autoantibodies to coagulation factor VIII after delivery. We here report the case of a 36-year-old primigravida woman who developed AHA following chorioamnionitis-caused miscarriage in the second trimester. Thirteen days after abortion, sudden, massive vaginal bleeding occurred with marked prolongation of activated partial thromboplastin time (APTT) in the absence of other abnormal coagulation data. Sequential transfusion of fresh frozen plasma did not achieve normalization of APTT...
February 2, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28140620/effects-of-lactoferrin-in-6-patients-with-refractory-bacterial-vaginosis
#11
Katsufumi Otsuki, Noriaki Imai
We previously reported that lactoferrin (LF) could be effective for preventing preterm delivery and intrauterine infections, based on data derived from mice and rabbits. Here we describe 6 women with a history of multiple pregnancy losses or preterm delivery and refractory bacterial vaginosis, who received prebiotic LF therapy and delivered an infant normally. Five of the women were pregnant and one was not at the time of this study. The Ethics Committee at Showa University Hospital and Showa University Koto Toyosu Hospital approved the therapeutic protocol...
February 2017: Biochemistry and Cell Biology, Biochimie et Biologie Cellulaire
https://www.readbyqxmd.com/read/28134708/chorioamnionitis-time-for-a-new-approach
#12
Tara M Randis, Richard A Polin, George Saade
PURPOSE OF REVIEW: The association between maternal chorioamnionitis and early-onset sepsis in the newborn has long been recognized, and established guidelines recommend treating all exposed infants with broad-spectrum antibiotics until infection can be ruled out. However, recent data suggest that close observation of well appearing term and late-preterm newborns may be a preferable alternative. The present review addresses the evidence in favor of newly proposed changes to the diagnosis and management of women and newborns following a maternal diagnosis of chorioamnionitis...
January 27, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28130929/use-of-antenatal-corticosteroids-in-special-circumstances-a-comprehensive-review
#13
Everett F Magann, Kjell Haram, Songthip Ounpraseuth, Jan Helge Mortensen, Horace J Spencer, John C Morrison
OBJECTIVE: To determine in pregnancies complicated by preterm premature rupture of membranes (PPROM), hypertension, intrauterine growth restriction, multi-fetal gestations and pregnancies 23- 26 weeks≥ 34 weeks gestation whether antenatal corticosteroids benefit the fetus. DATA SOURCES: Literature review using PubMed, Web of Science, Clinical trials. gov, Cochrane Database of Systematic Reviews (1990 - 2015). METHODS OF STUDY SELECTION: Search terms linked special circumstances with corticosteroids...
January 28, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28122480/a-role-for-the-inflammasome-in-spontaneous-preterm-labor-with-acute-histologic-chorioamnionitis
#14
Nardhy Gomez-Lopez, Roberto Romero, Yi Xu, Olesya Plazyo, Ronald Unkel, Yaozhu Leng, Nandor Gabor Than, Tinnakorn Chaiworapongsa, Bogdan Panaitescu, Zhong Dong, Adi L Tarca, Vikki M Abrahams, Lami Yeo, Sonia S Hassan
Inflammasomes are cytosolic multiprotein complexes that orchestrate inflammation in response to pathogens and endogenous danger signals. Herein, we determined whether the chorioamniotic membranes from women in spontaneous preterm labor with acute histologic chorioamnionitis (1) express major inflammasome components; (2) express caspase (CASP)-1 and CASP-4 as well as their active forms; (3) exhibit apoptosis-associated speck-like protein containing a CARD (ASC)/CASP-1 complex formation; and (4) release the mature forms of interleukin (IL)-1β and IL-18...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28095812/maternal-sepsis-complicating-arabin-cervical-pessary-placement-for-the-prevention-of-preterm-birth-a-case-report
#15
Begoña Martinez de Tejada
BACKGROUND: Preterm delivery is a major health problem and contributes to more than 50% of all neonatal and infant deaths. Recently, there has been a renewed interest in the use of cervical pessaries as a safe and effective intervention with few maternal side-effects for the prevention of preterm birth in both single and twin pregnancies. CASE PRESENTATION: A 43-year-old gravida 5, para 1 (previous preterm birth at 24 weeks) patient with an in vitro fertilization twin pregnancy had an Arabin cervical pessary placed at 19 weeks of pregnancy due to the presence of cervical funneling identified by ultrasound screening...
January 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28094842/impact-of-microbial-invasion-of-amniotic-cavity-and-the-type-of-microorganisms-on-short-term-neonatal-outcome-in-women-with-preterm-labor-and-intact-membranes
#16
Teresa Cobo, Irene Vives, Adriano Rodríguez-Trujillo, Clara Murillo, Martina A Ángeles, Jordi Bosch, Andrea Vergara, Eduard Gratacós, Montse Palacio
INTRODUCTION: The objective was to evaluate the impact of microbial invasion of the amniotic cavity (MIAC) and the type of microorganisms on pregnancy and short-term neonatal outcomes in women with preterm labor (PTL). MATERIAL AND METHODS: Prospective observational cohort study including women with PTL from 22.0-36.0 weeks. MIAC was defined based on amniotic fluid aerobic/anaerobic/mycoplasmas cultures and intra-amniotic inflammation (IAI) based on amniotic fluid Interleukin-6 levels...
January 17, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28077516/early-onset-invasive-candidiasis-in-extremely-low-birth-weight-infants-perinatal-acquisition-predicts-poor-outcome
#17
Michelle Barton, Alex Shen, Karel O'Brien, Joan L Robinson, H Dele Davies, Kim Simpson, Elizabeth Asztalos, Joanne Langley, Nicole Le Saux, Reginald Sauve, Anne Synnes, Ben Tan, Louis de Repentigny, Earl Rubin, Chuck Hui, Lajos Kovacs, Yvonne Cw Yau, Susan E Richardson
BACKGROUND: Neonatal invasive candidiasis (IC)presenting in the first week of life is less common and less well described than later onset IC. Risk factors, clinical features and disease outcomeshave not been studied in early onset disease (EOD, ≤7d) or compared to late onset disease (LOD, >7d). METHODS: All extremely low birth weight (ELBW, <1000g) cases with IC and controls froma multicentre study of neonatal candidiasisenrolledfrom 2001 to 2003were included in this study...
January 11, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28072390/a-molecular-portrait-of-maternal-sepsis-from-byzantine-troy
#18
Alison M Devault, Tatum D Mortimer, Andrew Kitchen, Henrike Kiesewetter, Jacob M Enk, G Brian Golding, John Southon, Melanie Kuch, Ana T Duggan, William Aylward, Shea N Gardner, Jonathan E Allen, Andrew M King, Gerard Wright, Makoto Kuroda, Kengo Kato, Derek Eg Briggs, Gino Fornaciari, Edward C Holmes, Hendrik N Poinar, Caitlin S Pepperell
Pregnancy complications are poorly represented in the archeological record, despite their importance in contemporary and ancient societies. While excavating a Byzantine cemetery in Troy, we discovered calcified abscesses among a woman's remains. Scanning electron microscopy of the tissue revealed 'ghost cells', resulting from dystrophic calcification, which preserved ancient maternal, fetal and bacterial DNA of a severe infection, likely chorioamnionitis. Gardnerella vaginalis and Staphylococcus saprophyticus dominated the abscesses...
January 10, 2017: ELife
https://www.readbyqxmd.com/read/28065815/neonatal-outcomes-following-preterm-birth-classified-according-to-placental-features
#19
Janet M Catov, Christina M Scifres, Steve N Caritis, Marnie Bertolet, Jacob Larkin, W Tony Parks
BACKGROUND: Preterm birth has staggering health implications, and yet the causes of most cases are still unknown. Placental features have been understudied as an etiology for preterm birth, and the association between placental pathologic lesions and neonatal outcomes are incompletely understood. OBJECTIVE: To characterize births according to placental pathology and relate these to adverse neonatal outcomes. STUDY DESIGN: We studied 20,091 births (15,710 term and 4,381 preterm) with placental evaluations...
January 5, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28050900/planned-early-birth-versus-expectant-management-waiting-for-prelabour-rupture-of-membranes-at-term-37-weeks-or-more
#20
REVIEW
Philippa Middleton, Emily Shepherd, Vicki Flenady, Rosemary D McBain, Caroline A Crowther
BACKGROUND: Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour. OBJECTIVES: The objective of this review is to assess the effects of planned early birth (immediate intervention or intervention within 24 hours) when compared with expectant management (no planned intervention within 24 hours) for women with term PROM on maternal, fetal and neonatal outcomes...
January 4, 2017: Cochrane Database of Systematic Reviews
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