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Sepsis in pregnancy

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https://www.readbyqxmd.com/read/28720399/prenatal-and-postnatal-administration-of-prebiotics-and-probiotics
#1
REVIEW
Kristin Sohn, Mark A Underwood
Colonization of the neonatal gut by beneficial bacteria is important for the establishment and maintenance of the mucosal barrier, thus protecting the neonate from enteric pathogens and local and systemic inflammation. The neonatal microbiome is influenced by infant diet, environment, and the maternal microbiome. Dysbiosis in pregnancy increases the risk of pre-eclampsia, diabetes, infection, preterm labor, and later childhood atopy. Dysbiosis of the neonatal gut plays an important role in colic in the term infant, in the disease processes which plague preterm infants, including necrotizing enterocolitis and sepsis, and in the long-term outcomes of neonates...
July 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28719429/maternal-salvage-with-extracorporeal-life-support-lessons-learned-in-a-single-center
#2
Philippe Biderman, Uri Carmi, Eric Setton, Michael Fainblut, Oren Bachar, Sharon Einav
The American Heart Association scientific statement on cardiac arrest in pregnancy did not endorse extracorporeal life support for lack of cohort data. We studied all pregnancy and peripartum cases of extracorporeal life support in 1 medical center (n = 11), including collapse due to infection (n = 6, 55%), thromboembolism (n = 3, 27%), and cardiac disease (n = 2, 18%). Half of the cases (n = 5, 45%) involved extracorporeal cardiopulmonary resuscitation. Most mothers survived (n = 7, 64% [95% confidence interval, 32%-88%])...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28716993/low-soluble-fms-like-tyrosine-kinase-1-endoglin-and-endothelin-1-levels-in-women-with-confirmed-or-suspected-preeclampsia-using-proton-pump-inhibitors
#3
Langeza Saleh, Raaho Samantar, Ingrid M Garrelds, Anton H van den Meiracker, Willy Visser, A H Jan Danser
Patients with preeclampsia display elevated placenta-derived sFlt-1 (soluble Fms-like tyrosine kinase-1) and endoglin levels and decreased placental growth factor levels. Proton pump inhibitors (PPIs) decrease trophoblast sFlt-1 and endoglin secretion in vitro. PPIs are used during pregnancy to combat reflux disease. Here, we investigated whether PPIs affect sFlt-1 in women with confirmed/suspected preeclampsia, making use of a prospective cohort study involving 430 women. Of these women, 40 took PPIs (6 esomeprazole, 32 omeprazole, and 2 pantoprazole) for 8 to 45 (median 29) days before sFlt-1 measurement...
July 17, 2017: Hypertension
https://www.readbyqxmd.com/read/28715801/fetal-urine-production-rate-in-preterm-premature-rupture-of-membranes-is-associated-with-adverse-neonatal-outcome-a-pilot-study
#4
Tehila Avitan, Lior Drukker, Hadass Pri-Chen, Ron Rabinowitz, Nurit Algur, Michael S Schimmel, Letizia Schreiber, Tali Bdolah-Abram, Arnon Samueloff, Sorina Grisaru-Granovsky
AIM: In this study, we evaluate the associations between fetal urinary production rate (FUPR), measured by ultrasound, and adverse neonatal outcome in women with preterm premature rupture of membranes (PPROM). METHODS: We conducted a prospective pilot cohort of singleton pregnancies complicated by PPROM occurring at gestational week 24 or later managed until spontaneous labor (after 48 h of admission), chorioamnionitis, or induction by protocol at 35 + 0 weeks. FUPR was evaluated by 2D sonography at admission (corrected for gestational age)...
July 18, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28712189/maternal-mortality-in-pakistan-is-there-any-metamorphosis-towards-betterment
#5
Nusrat Nisar, Razia Mustafa Abbasi, Shehla Raza Chana, Noushaba Rizwan, Razia Badar
BACKGROUND: Every year more than half million mother die due to pregnancy related preventable causes like haemorrhage, hypertensive disorders, sepsis, and obstructed labour and unsafe abortion. Among these deaths 99% occur in developing countries. The study was conducted to assess the maternal death rate and to analyse its trends over a period of 20 years in tertiary care hospital in Sindh Province Pakistan. METHODS: A retrospective analysis of maternal mortality records were carried out for a period of 20 years from 1986-1995 and 2011-2015 at the Department of Obstetrics and gynaecology Liaquat University of Medical and Health Sciences Hyderabad Sindh Pakistan...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28695270/maternal-use-of-prednisolone-is-unlikely-to-be-associated-with-neonatal-adrenal-suppression-a-single-center-study-of-16-cases
#6
Leanne de Vetten, Margriet van Stuijvenberg, Ido P Kema, Gianni Bocca
The use of supra-physiological, exogenous corticosteroids in pregnancy may lead to neonatal adrenal suppression. We report on a single-center, case series study carried out between 2006 and 2014, which included all newborns (n = 16) of mothers using prednisolone ≥10 mg/day during pregnancy. Newborns were routinely assessed according to hospital protocol, with follow-up until 6 weeks after birth. We investigated the clinical symptoms and biochemical findings of adrenal suppression occurring in the newborns...
July 10, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28681433/prevalence-of-positive-direct-antiglobulin-test-and-clinical-outcomes-in-surinamese-newborns-from-d-negative-women
#7
Rens Zonneveld, Margriet Lamers, Henk Schonewille, Anneke Brand, Humphrey H H Kanhai, Wilco C W R Zijlmans
BACKGROUND: In low-resource countries, screening for D antibodies to detect pregnancies at risk for hemolytic disease of the newborn is not routine practice. Retrospective data showed that 5.5% of Surinamese newborns of D-negative women had a positive direct antiglobulin test (DAT), indicating the presence of maternal antibodies against fetal antigens. Here, the frequency and clinical relevance of DAT positivity is evaluated. STUDY DESIGN AND METHODS: Between April 2015 and June 2016, an observational, multicenter cohort study was undertaken among Surinamese newborns born to D-negative women...
July 5, 2017: Transfusion
https://www.readbyqxmd.com/read/28674636/diabetes-during-pregnancy-influence-of-body-mass-index-on-composite-morbidity
#8
Amy E O'Neil Dudley, Zachary B Jenner, Hector Mendez-Figueroa, Viviana S Ellis, Suneet P Chauhan
Objective  This study aims to compare composite maternal and neonatal morbidities (MM, NM) among pregnant women with diabetes mellitus whose body mass index (BMI) at delivery was < 30 (group 1), 30.0 to 39.9 (group 2), and ≥ 40 kg/m (2) (group 3). We hypothesized that increased BMI class at delivery would be associated with worsening maternal and neonatal outcomes. Methods  This is a retrospective cohort study. MM was defined as: chorioamnionitis, wound infection, eclampsia, diabetic ketoacidosis, hypoglycemia admission, third/fourth degree laceration, and/or death...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28670748/somanz-guidelines-for-the-investigation-and-management-sepsis-in-pregnancy
#9
Lucy Bowyer, Helen L Robinson, Helen Barrett, Timothy M Crozier, Michelle Giles, Irena Idel, Sandra Lowe, Karin Lust, Catherine A Marnoch, Mark R Morton, Joanne Said, Maggie Wong, Angela Makris
SOMANZ (Society of Obstetric Medicine Australia and New Zealand) has written a guideline to provide evidence-based guidance for the investigation and care of women with sepsis in pregnancy or the postpartum period. The guideline is evidence-based and incorporates recent changes in the definition of sepsis. The etiology, investigation and treatment of bacterial, viral and non-infective causes of sepsis are discussed. Obstetric considerations relevant to anaesthetic and intensive care treatment in sepsis are also addressed...
July 3, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28658852/severe-puerperal-sepsis-a-simmering-menace
#10
Sheeba Marwah, Sonam R Topden, Manjula Sharma, Ritin Mohindra, Pratima Mittal
INTRODUCTION: Even decades after the development of effective low-cost antibiotics, sepsis persists as the foremost cause of preventable maternal death worldwide. In developing countries like India, where the paramount impediment to intervention is poverty, maternal mortality due to sepsis is a continuing representation of maternal health inequality. AIM: To determine the incidence, risk factors and mortality in women presenting with puerperal sepsis in a tertiary care health facility in India...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28658507/antibiotics-for-neonates-born-through-meconium-stained-amniotic-fluid
#11
REVIEW
Lauren E Kelly, Sandesh Shivananda, Prashanth Murthy, Ravisha Srinivasjois, Prakeshkumar S Shah
BACKGROUND: Approximately 1 in 10 pregnancies is affected by meconium passage at delivery, which can result in meconium aspiration syndrome (MAS). MAS can cause respiratory complications and, very rarely, death. Antibiotics have been prescribed for neonates exposed to meconium in amniotic fluid, with the intention of preventing infection due to potential bacterial contaminants. OBJECTIVES: We conducted this review to assess the efficacy and safety of antibiotics for:1...
June 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28654446/sepsis-in-obstetrics-pathophysiology-and-diagnostic-definitions
#12
Sheryl E Parfitt, Mary L Bogat, Sandra L Hering, Cheryl Roth
In spite of many medical breakthroughs, sepsis continues to be challenging to identify, treat, and successfully resolve, including among the obstetric population. Sepsis is the result of an overactive, complex inflammatory response that is not completely understood. Currently there are no nationally agreed-upon criteria for systemic inflammatory response syndrome or sepsis in pregnant or peripartum women, as the physiologic changes of pregnancy have not been taken into consideration.This article is the first in a series of three that discuss the importance of sepsis and septic shock in pregnancy...
July 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28653615/maternal-and-neonatal-morbidity-repeat%C3%A2-cesarean-versus-a%C3%A2-trial-of-labour-after-previous%C3%A2-cesarean%C3%A2-delivery
#13
Yue-Zhou Yang, Xu-Ping Ye, Xiao-Xi Sun
PURPOSE: The purpose of this study was to perform a meta-analysis comparing the rates of uterine rupture, and other maternal and neonatal complications, between women who undergo a trial of labour (TOL) after a prior Cesarean delivery and those to undergo elective repeat Cesarean delivery (ERCD). SOURCE: Medline, Cochrane, EMBASE and Google Scholar were searched until May 6, 2015 using the keywords/phrases: trial of labour, Cesarean section, elective, repeat, pregnancy and vaginal birth...
June 26, 2017: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/28640002/trends-in-diagnoses-among-hospitalizations-of-hiv-infected-children-and-adolescents-in-the-us-2003-2012
#14
Stacey A Hurst, Alexander C Ewing, Sascha R Ellington, Athena P Kourtis
OBJECTIVE: Using data from 2003-2012, we updated a previous analysis of trends in hospitalizations of HIV-infected children and adolescents in the US. METHODS: We used data from the Kids´ Inpatient Database of the Healthcare Cost and Utilization Project to derive nationally representative estimates of the number of hospitalizations and the rates per 1000 hospitalizations of select discharge diagnoses and procedures in 2003, 2006, 2009, and 2012 among HIV-infected and HIV-uninfected children and adolescents ≤18 years, excluding hospitalizations for conditions related to pregnancy/delivery and neonatal diagnoses...
June 20, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28633556/oxidative-stress-and-dna-damage-in-newborns-born-to-mothers-with-hyperglycemia-%C3%A2-a-prospective-cohort-study
#15
K Dulasi Durga, B Adhisivam, G Vidya, B Vishnu Bhat, Bobby Zachariahc, Chand Parkashd
BACKGROUND: Hyperglycemic mothers have increased oxidative stress during pregnancy which can adversely affect the outcome in their neonates Objectives: To measure the oxidative stress and DNA damage in newborns born to mothers with hyperglycemia and correlate their immediate outcome with the amount of oxidative stress and DNA damage. METHODS: This prospective cohort study conducted in a tertiary care teaching hospital, south India included 3 groups - newborns born to pregestational diabetic mothers (PGDM), gestational diabetic mothers (GDM) and euglycemic mothers with 24 newborns in each...
June 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#16
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28595858/risk-of-postoperative-venous-thromboembolism-among-pregnant-women
#17
Yasunori Suematsu, Yoshitsugu Obi, Akihiro Shimomura, Reza Fazl Alizadeh, Nosratola D Vaziri, Ninh T Nguyen, Michael J Stamos, Hirohito Ichii
Venous thromboembolism (VTE) is a critical complication after surgery. Although pregnancy is a known risk factor of VTE, available data on the risk of postoperative VTE are scarce. Using the American College of Surgeons National Surgical Quality Improvement Program database between 2006 and 2012, we matched 2,582 pregnant women to 103,640 nonpregnant women based on age, race, body mass index, and modified Rogers score. Pregnant women, compared with matched nonpregnant women, experienced higher incidence of VTE (0...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28594754/false-labor-at-term-in-singleton-pregnancies-discharge-after-a-standardized-assessment-and-perinatal-outcomes
#18
David B Nelson, Donald D McIntire, Kenneth J Leveno
OBJECTIVE: To evaluate perinatal outcomes in women sent home with a diagnosis of false labor at term and assess the time interval to return for delivery. METHODS: This was a prospective observational cohort study of women at 37 0/7 to 41 6/7 weeks of gestation without pre-existing medical complications who presented to our hospital-based triage unit with symptoms of labor and underwent a standardized evaluation. Women diagnosed as having false labor with a live singleton fetus in cephalic presentation without a prior cesarean delivery and sent home were compared with a group of similar women diagnosed to be in spontaneous labor...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28590928/diagnosis-of-pneumocystis-jirovecii-pneumonia-with-serum-cell-free-dna-in-non-hiv-infected-immunocompromised-patients
#19
Dong Wang, Yang Hu, Ting Li, Heng-Mo Rong, Zhao-Hui Tong
Conventional respiratory tract specimens, such as bronchoalveolar lavage (BAL) fluid and induced sputum for diagnosing Pneumocystis jirovecii pneumonia (PCP) in immunocompromised patients are difficult to obtain. Besides, bronchoscopy is an invasive procedure that carries the risk of causing rapidly progressive respiratory insufficiency. By contrast, serum cell-free DNA (cfDNA) is easy to obtain and has been proven useful in diagnosing cancer, pregnancy associated complications, parasite infection and sepsis...
May 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28578447/maternal-and-neonatal-outcomes-in-twin-and-triplet-gestations-in-western-saudi-arabia
#20
Samera F AlBasri, Ghadah M Shouib, Osama S Bajouh, Hasan A Nasrat, Ejaz Ahmad, Fahad M AlGreisi
Tocompare maternal and neonatal complications in twin and triplet gestations at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Methods: Retrospective medical records of 165 women with 144 twin and 21 triplet pregnancies from 2004 to 2011 were analyzed. Comparisons were carried out for maternal complications, gestational age at birth, neonatal birth weight, and neonatal intensive care admission. Results: Most common complications were preterm birth (49%), gestational diabetes mellitus (13.3%), and premature rupture of membrane (4...
June 2017: Saudi Medical Journal
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