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https://www.readbyqxmd.com/read/28742677/committee-opinion-no-712-intrapartum-management-of-intraamniotic-infection
#1
(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
https://www.readbyqxmd.com/read/28742671/committee-opinion-no-712-summary-intrapartum-management-of-intraamniotic-infection
#2
(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
https://www.readbyqxmd.com/read/28690864/surgical-site-infections-after-cesarean-delivery-epidemiology-prevention-and-treatment
#3
REVIEW
Tetsuya Kawakita, Helain J Landy
Cesarean delivery (CD) is one of the most common procedures performed in the United States, accounting for 32% of all deliveries. Postpartum surgical site infection (SSI), wound infection and endometritis is a major cause of prolonged hospital stay and poses a burden to the health care system. SSIs complicate a significant number of patients who undergo CD - 2-7% will experience sound infections and 2-16% will develop endometritis. Many risk factors for SSI have been described. These include maternal factors (such as tobacco use; limited prenatal care; obesity; corticosteroid use; nulliparity; twin gestations; and previous CD), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged rupture of membranes; prolonged labor, particularly prolonged second stage; large incision length; subcutaneous tissue thickness > 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; emergency delivery; and excessive blood loss), and obstetrical care on the teaching service of an academic institution...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28663282/are-postnatal-ampicillin-levels-actually-related-to-the-duration-of-intrapartum-antibiotic-prophylaxis-prior-to-delivery-a-pharmacokinetic-study-in-120-neonates
#4
Alberto Berardi, Zaira Pietrangiolillo, Maria Letizia Bacchi Reggiani, Valentina Bianco, Daniela Gallesi, Katia Rossi, Fabio Facchinetti, Fabrizio Ferrari
OBJECTIVE: To assess ampicillin levels according to the duration of intrapartum antibiotic prophylaxis (IAP). DESIGN: Prospective cohort single-centre study. SETTING: Tertiary care centre (Modena, Italy). PATIENTS: 120 neonates≥35 weeks' gestation exposed to IAP. INTERVENTIONS: Neonates were divided into four groups, according to the duration of IAP prior to delivery: group 1 (n=30; <1 hour), group 2 (n=30; ≥1 and <2 hours), group 3 (n=30; ≥2 and <4 hours) and group 4 (n=30; ≥2 doses, ≥4 hours)...
June 29, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28633864/perinatal-group-b-streptococcal-infections-virulence-factors-immunity-and-prevention-strategies
#5
REVIEW
Jay Vornhagen, Kristina M Adams Waldorf, Lakshmi Rajagopal
Group B streptococcus (GBS) or Streptococcus agalactiae is a β-hemolytic, Gram-positive bacterium that is a leading cause of neonatal infections. GBS commonly colonizes the lower gastrointestinal and genital tracts and, during pregnancy, neonates are at risk of infection. Although intrapartum antibiotic prophylaxis during labor and delivery has decreased the incidence of early-onset neonatal infection, these measures do not prevent ascending infection that can occur earlier in pregnancy leading to preterm births, stillbirths, or late-onset neonatal infections...
June 17, 2017: Trends in Microbiology
https://www.readbyqxmd.com/read/28621047/clinical-value-of-polymerase-chain-reaction-in-detecting-group-b-streptococcus-during-labor
#6
Dorothea Maria Koppes, Antonius Arnoldus Cornelis Maria Vriends, Michiel van Rijn, Antonine Dimphne van Heesewijk
AIM: To reduce the intrapartum use of antibiotics in women with prolonged rupture of the membranes (PROM) by restriction of antibiotics to women who are colonized with group B streptococci (GBS), as identified with the Cepheid Gene Xpert polymerase chain reaction (PCR) for detecting GBS. METHODS: We conducted a randomized controlled trial among full-term delivering women with PROM. Fifty-four women were enrolled, based on a power calculation with a significance level of 5% and a power of 95%...
June 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28601683/prenatal-intrapartum-and-postnatal-factors-are-associated-with-pediatric-eosinophilic-esophagitis
#7
Elizabeth T Jensen, Jonathan T Kuhl, Lisa J Martin, Marc E Rothenberg, Evan S Dellon
BACKGROUND: Multiple lines of evidence point to the potential importance of early-life environmental factors in the rapid rise in incidence of eosinophilic esophagitis (EoE), but potential exposures have not been extensively studied. OBJECTIVE: To assess the association between prenatal, intrapartum, and postnatal factors and the development of pediatric EoE using a case-control study. METHODS: Cases of EoE were recruited from an existing registry at Cincinnati Children's Hospital Medical Center (CCHMC)...
June 7, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28562753/group-b-streptococcus-detection-in-pregnant-women-via-culture-and-pcr-methods
#8
Cláudia Wollheim, Rosa Dea Sperhacke, Sabrina Kahler Ribeiro Fontana, Andréa Cristina Vanni, Sérgio Kakuta Kato, Patricia Regina de Araújo, Afonso Luis Barth, José Mauro Madi
INTRODUCTION: Group B Streptococcus (GBS), a source of neonatal infection, colonizes the gastrointestinal and genitourinary tracts of pregnant women. Routine screening for maternal GBS in late pregnancy and consequent intrapartum antibiotic prophylaxis have reduced the incidence of early-onset GBS neonatal infection. The aim of this study was to evaluate the performance of PCR, compared to culture (gold standard), in GBS colonization screening of pregnant women, and to establish the prevalence of GBS colonization among this population...
March 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/28504863/diagnostic-accuracy-of-polymerase-chain-reaction-for-intrapartum-detection-of-group-b-streptococcus-colonization
#9
Rikke Bek Helmig, Jan Berg Gertsen
Many pregnant women are treated with antibiotics during labor to prevent transmission of group B Streptococcus (GBS, Streptococcus agalactiae) to their baby during the passage of the birth canal, and thus reducing the risk of serious infection of the newborn. Methods for intrapartum testing for GBS has been introduced to select women for whom intrapartum antibiotic prophylaxis should be offered. For such an intrapartum test to be useful in clinical practice, it has to be specific as well as sensitive. The aim of the present study is to evaluate the accuracy of the polymerase chain reaction (PCR) assay compared to an optimized culture method for GBS MATERIAL AND METHODS: In the period from 12...
May 15, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28443284/fecal-short-chain-fatty-acid-variations-by-breastfeeding-status-in-infants-at-4%C3%A2-months-differences-in-relative-versus-absolute-concentrations
#10
Sarah L Bridgman, Meghan B Azad, Catherine J Field, Andrea M Haqq, Allan B Becker, Piushkumar J Mandhane, Padmaja Subbarao, Stuart E Turvey, Malcolm R Sears, James A Scott, David S Wishart, Anita L Kozyrskyj
Our gut microbiota provide a number of important functions, one of which is the metabolism of dietary fiber and other macronutrients that are undigested by the host. The main products of this fermentation process are short-chain fatty acids (SCFAs) and other intermediate metabolites including lactate and succinate. Production of these metabolites is dependent on diet and gut microbiota composition. There is increasing evidence for the role of SCFAs in host physiology and metabolic processes as well as chronic inflammatory conditions such as allergic disease and obesity...
2017: Frontiers in Nutrition
https://www.readbyqxmd.com/read/28439022/structure-of-a-protective-epitope-of-group-b-streptococcus-type-iii-capsular-polysaccharide
#11
Filippo Carboni, Roberto Adamo, Monica Fabbrini, Riccardo De Ricco, Vittorio Cattaneo, Barbara Brogioni, Daniele Veggi, Vittoria Pinto, Irene Passalacqua, Davide Oldrini, Rino Rappuoli, Enrico Malito, Immaculada Y Ros Margarit, Francesco Berti
Despite substantial progress in the prevention of group B Streptococcus (GBS) disease with the introduction of intrapartum antibiotic prophylaxis, this pathogen remains a leading cause of neonatal infection. Capsular polysaccharide conjugate vaccines have been tested in phase I/II clinical studies, showing promise for further development. Mapping of epitopes recognized by protective antibodies is crucial for understanding the mechanism of action of vaccines and for enabling antigen design. In this study, we report the structure of the epitope recognized by a monoclonal antibody with opsonophagocytic activity and representative of the protective response against type III GBS polysaccharide...
May 9, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28420662/outcome-of-a-screening-programme-for-the-prevention-of-neonatal-invasive-early-onset-group-b-streptococcus-infection-in-a-uk-maternity-unit-an-observational-study
#12
G Gopal Rao, G Nartey, T McAree, A O'Reilly, S Hiles, T Lee, S Wallace, R Batura, P Khanna, H Abbas, C Tilsed, R Nicholl, T Lamagni, P Bassett
BACKGROUND: Against a background of failure to prevent neonatal invasive early-onset group B Streptococcus infections (GBS) in our maternity unit using risk-based approach for intrapartum antibiotic prophylaxis, we introduced an antenatal GBS carriage screening programme to identify additional women to target for prophylaxis. OBJECTIVES: To describe the implementation and outcome of an antepartum screening programme for prevention of invasive early-onset GBS infection in a UK maternity unit...
April 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28397205/assessment-of-the-implementation-of-the-infectious-diseases-screening-programmes-among-pregnant-women-in-the-lesser-poland-region-and-comparison-with-similar-programmes-conducted-in-other-european-union-countries
#13
Małgorzata Radoń-Pokracka, Maciej Piasecki, Alicja Lachowska, Sebastian Baczkowski, Joanna Spaczyńska, Magdalena Górecka, Magdalena Nowak, Hubert Huras
OBJECTIVES: The aim of the study was to assess the level of implementation of recommendations of the Ministry of Health regarding infectious disease screening during pregnancy. MATERIAL AND METHODS: The study included 477 patients who were admitted to the delivery room between December 2015 and February 2016. Data on screening test results were collected based on medical records covering the period before the admission. RESULTS: The Human Immunodeficiency Virus (HIV) screening was conducted in 410 (86%)...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28381231/exposure-to-household-furry-pets-influences-the-gut-microbiota-of-infant-at-3-4%C3%A2-months-following-various-birth-scenarios
#14
Hein M Tun, Theodore Konya, Tim K Takaro, Jeffrey R Brook, Radha Chari, Catherine J Field, David S Guttman, Allan B Becker, Piush J Mandhane, Stuart E Turvey, Padmaja Subbarao, Malcolm R Sears, James A Scott, Anita L Kozyrskyj
BACKGROUND: Early-life exposure to household pets has the capacity to reduce risk for overweight and allergic disease, especially following caesarean delivery. Since there is some evidence that pets also alter the gut microbial composition of infants, changes to the gut microbiome are putative pathways by which pet exposure can reduce these risks to health. To investigate the impact of pre- and postnatal pet exposure on infant gut microbiota following various birth scenarios, this study employed a large subsample of 746 infants from the Canadian Healthy Infant Longitudinal Development Study (CHILD) cohort, whose mothers were enrolled during pregnancy between 2009 and 2012...
April 6, 2017: Microbiome
https://www.readbyqxmd.com/read/28370230/interventions-to-reduce-neonatal-mortality-a-mathematical-model-to-evaluate-impact-of-interventions-in-sub-saharan-africa
#15
Jennifer B Griffin, Elizabeth M McClure, Beena D Kamath-Rayne, Bonnie M Hepler, Doris J Rouse, Alan H Jobe, Robert L Goldenberg
AIM: To determine which interventions would have the greatest impact on reducing neonatal mortality in sub-Saharan Africa in 2012. METHODS: We used MANDATE, a mathematical model, to evaluate scenarios for the impact of available interventions on neonatal deaths from primary causes, including: (i) for birth asphyxia - obstetric care preventing intrapartum asphyxia, newborn resuscitation and treatment of asphyxiated infants; (ii) for preterm birth - corticosteroids, oxygen, continuous positive air pressure and surfactant; and, (iii) for serious newborn infection - clean delivery, chlorhexidine cord care and antibiotics...
March 31, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28367139/antibiotic-prevention-for-maternal-group-b-streptococcal-colonization-on-neonatal-gbs-related-adverse-outcomes-a-meta-analysis
#16
REVIEW
Shunming Li, Jingya Huang, Zhiyao Chen, Dan Guo, Zhenjiang Yao, Xiaohua Ye
Maternal colonization with group B Streptococcus (GBS) during pregnancy increases the risk of neonatal infection by vertical transmission. However, it remains unclear whether treating all colonized women during labor exposes a large number of their neonates to possible adverse effects without benefit. We performed a meta-analysis to assess the effect of intrapartum antibiotic prophylaxis on neonatal adverse outcomes. We identified studies by searching several English and Chinese electronic databases and reviewing relevant articles...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28316118/late-preterm-birth-has-direct-and-indirect-effects-on-infant-gut-microbiota-development-during-the-first-six-months-of-life
#17
M Forsgren, E Isolauri, S Salminen, S Rautava
AIM: Preterm infants display aberrant gut microbial colonisation. We investigated whether the differences in gut microbiota between late preterm and full-term infants results from prematurity or external exposures. METHODS: This study comprised 43 late preterm infants (34(0/7) -36(6/7) ) and 75 full-term infants based on faecal samples collected following birth and at two to four weeks and six months of age. We assessed clinically relevant bacteria using quantitative polymerase chain reaction...
March 17, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28274774/group-b-streptococcal-colonization-and-transmission-dynamics-in-pregnant-women-and-their-newborns-in-nigeria-implications-for-prevention-strategies
#18
N Medugu, K C Iregbu, R E Parker, J Plemmons, P Singh, L I Audu, E Efetie, H D Davies, S D Manning
OBJECTIVES: Because few studies have been conducted on group B Streptococcus (GBS) in Nigeria, we sought to estimate GBS colonization and transmission frequencies for 500 women and their newborns and identify risk factors for both outcomes. METHODS: GBS strains were characterized for antibiotic susceptibilities, capsule (cps) genotype, pilus island profile and multilocus sequence type (ST). RESULTS: In all, 171 (34.2%) mothers and 95 (19.0%) of their newborns were colonized with GBS; the vertical transmission rate was 48...
March 6, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28242541/fetal-health-stagnation-have-health-conditions-in-utero-improved-in-the-united-states-and-western-and-northern-europe-over-the-past-150-years
#19
Eric B Schneider
Many empirical studies have shown that health conditions in utero can have long lasting consequences for health across the life course. However, despite this evidence, there is no clear consensus about how fetal health has changed in the very long run. This paper analyses historical birth weights and perinatal mortality rates to construct a coherent picture of how health conditions in utero have changed over the past 150 years. In short, the evidence suggests that fetal health has been relatively stagnant. Limited evidence on birth weights shows that they had already reached their current levels in North America and Northern and Western Europe by the late nineteenth century, and they have changed very little in between...
February 17, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28240736/antibiotic-treatment-at-delivery-shapes-the-initial-oral-microbiome-in-neonates
#20
Luisa F Gomez-Arango, Helen L Barrett, H David McIntyre, Leonie K Callaway, Mark Morrison, Marloes Dekker Nitert
Oral microorganisms are important determinants of health and disease. The source of the initial neonatal microbiome and the factors dictating initial human oral microbiota development are unknown. This study aimed to investigate this in placental, oral and gut microbiome profiles from 36 overweight or obese mother-baby dyads as determined by 16S rRNA sequencing. Expression of five antibiotic resistance genes of the β-lactamase class was analysed in the infant oral microbiota samples by QPCR. The neonatal oral microbiota was 65...
February 27, 2017: Scientific Reports
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