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Sepsis in pregnancy

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https://www.readbyqxmd.com/read/27911391/a-murine-model-of-group-b-streptococcus-vaginal-colonization
#1
Kathryn A Patras, Kelly S Doran
Streptococcus agalactiae (group B Streptococcus, GBS), is a Gram-positive, asymptomatic colonizer of the human gastrointestinal tract and vaginal tract of 10 - 30% of adults. In immune-compromised individuals, including neonates, pregnant women, and the elderly, GBS may switch to an invasive pathogen causing sepsis, arthritis, pneumonia, and meningitis. Because GBS is a leading bacterial pathogen of neonates, current prophylaxis is comprised of late gestation screening for GBS vaginal colonization and subsequent peripartum antibiotic treatment of GBS-positive mothers...
November 16, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27908330/sepsis-in-special-populations
#2
REVIEW
Matthew P Borloz, Khalief E Hamden
Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present. Baseline changes in vital signs and chronic medications often mask clues to the severity of illness. The physiologic, hematologic, and biochemical adjustments that accompany pregnancy and the puerperium introduce similar challenges...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27899925/increased-risk-of-group-b-streptococcus-invasive-infection-in-hiv-exposed-but-uninfected-infants-a-review-of-the-evidence-and-possible-mechanisms
#3
REVIEW
Nicolas Dauby, Mustapha Chamekh, Pierrette Melin, Amy L Slogrove, Tessa Goetghebuer
Group B Streptococcus (GBS) is a major cause of neonatal sepsis and mortality worldwide. Studies from both developed and developing countries have shown that HIV-exposed but uninfected (HEU) infants are at increased risk of infectious morbidity, as compared to HIV-unexposed uninfected infants (HUU). A higher susceptibility to GBS infections has been reported in HEU infants, particularly late-onset diseases and more severe manifestations of GBS diseases. We review here the possible explanations for increased susceptibility to GBS infection...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27887021/an-unusual-presentation-of-a-rare-disease-posterior-reversible-encephalopathy-syndrome-following-abdominal-sepsis
#4
Carly R N Richards, Robert C McMurray, Erik T Criman, Margaret E Clark, Suzanne Gillern
Posterior reversible encephalopathy syndrome (PRES) is an unusual disease of unknown incidence and cause. There are a wide range of associated, predisposing medical causes to include pregnancy, renal failure, immunosuppressive medication administration and hypertension. The diagnosis is made following the radiographic identification of characteristic vasogenic edema in the setting of neurologic impairment. A significant portion of patients will have long-term, if not permanent, sequelae of the disease. We present a patient who developed PRES following a hemicolectomy that was complicated by an anastomotic leak...
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27885296/outcome-of-twin-deliveries-at-a-tertiary-care-centre-of-eastern-nepal
#5
S Chaudhary, R R Singh, G S Shah, J Agrawal, S Kafle, L Shah
BACKGROUND: Twins, compared to singletons, have higher perinatal mortality and morbidity. The aim of this study was to describe the twinning rate, epidemiological variables and hospital outcome of twin deliveries and to find out ways of better management of twins in our part. METHODS: A retrospective evaluation of the outcome of 92 twin pregnancies during one year study period (1st January 2014 to 31st December 2014) was conducted at BPKIHS. Twins delivered within the institution were included but cases less than 28 weeks gestation were excluded...
May 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/27882751/-septic-shock-in-pregnancy-on-the-basis-of-an-acute-pyelonephritis
#6
Z Kokrdová, A Pařízek, M Koucký, A Pašková, B Boudová
OBJECTIVE: According to the World Health Organisation, sepsis is one of the four main causes of pregnancy-related mortality worldwide, together with hemorrhage, hypertensive disease and abortion. The main goal of this paper is an analysis of one case of septic shock in pregnancy. DESIGN: A case report. SETTING: Department of Obstetrics and Gynaecology of the First Faculty of Medicine and General Teaching Hospital, Prague. METHODS AND RESULTS: Authors would like to draw attention to the pitfalls of diagnosis and treatment of septic shock which developed in 25th week of pregnancy on the basis of pyelonephritis due to E...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27867063/neonatal-listeriosis-in-the-uk-2004-2014
#7
Shari Sapuan, Christina Kortsalioudaki, Mark Anthony, John Chang, Nicholas D Embleton, Ruppa M Geethanath, Jim Gray, Anne Greenough, Mithilesh K Lal, Suzanne Luck, Santosh Pattnayak, Peter Reynolds, Allison B Russell, Timothy Scorrer, Mark Turner, Paul T Heath, Stefania Vergnano
OBJECTIVE: To define the clinical features and outcomes of neonatal listeriosis, and identify the maternal risk factors to seek scope for improvement. METHODS: Neonatal listeriosis was identified prospectively from a United Kingdom neonatal infection surveillance network (neonIN) between 2004 and 2014. The participating neonatal units completed a study-specific proforma. RESULTS: The incidence of neonatal listeriosis was 3.4 per 100,000 live births...
November 17, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27865977/racial-ethnic-differences-in-preterm-perinatal-outcomes
#8
Maeve E Wallace, Pauline Mendola, Sung Soo Kim, Nikira Epps, Zhen Chen, Melissa Smarr, Stefanie N Hinkle, Yeyi Zhu, Katherine L Grantz
BACKGROUND: Racial disparities in preterm birth and infant mortality have been well documented. Less is known about racial disparities in neonatal morbidities among infants born prior to 37 weeks. OBJECTIVE: The purpose of this study was to determine if risk for morbidity and mortality among infants born preterm differs by maternal race. STUDY DESIGN: A retrospective cohort design included medical records from preterm deliveries of 19,325 Black, Hispanic, and White women in the Consortium on Safe Labor...
November 16, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27862576/foetal-ureaplasma-parvum-bacteraemia-as-a-function-of-gestation-dependent-complement-insufficiency-evidence-from-a-sheep-model-of-pregnancy
#9
Matthew W Kemp, Shatha Ahmed, Michael L Beeton, Matthew S Payne, Masatoshi Saito, Yuichiro Miura, Haruo Usuda, Suhas G Kallapur, Boris W Kramer, Sarah J Stock, Alan H Jobe, John P Newnham, Owen B Spiller
PROBLEM: Complement is a central defence against sepsis, and increasing complement insufficiency in neonates of greater prematurity may predispose to increased sepsis. Ureaplasma spp. are the most frequently cultured bacteria from preterm blood samples. METHOD OF STUDY: A sheep model of intrauterine Ureaplasma parvum infection was used to examine in vivo Ureaplasma bacteraemia at early and late gestational ages. Complement function and Ureaplasma killing assays were used to determine the correlation between complement potency and bactericidal activity of sera ex vivo...
November 14, 2016: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/27835031/cardiogenic-shock-in-pregnancy-analysis-from-the-national-inpatient-sample
#10
Jennifer Banayan, Sarosh Rana, Ariel Mueller, Avery Tung, Hadi Ramadan, Zoltan Arany, Junaid Nizamuddin, Victor Novack, Barbara Scavone, Samuel M Brown, Sajid Shahul
OBJECTIVE: Cardiogenic shock (CS) may occur during pregnancy and dramatically worsen peripartum outcomes. METHODS: We analyzed the National Inpatient Sample from 2002 to 2013 to describe the incidence of, risk factors for and outcomes of CS during pregnancy. RESULTS: Of the 53,794,192 hospitalizations analyzed, 2044 were complicated by CS. The mortality rate in peripartum women with CS was 18.81% versus 0.02% without. It occurs more often during postpartum (58...
November 11, 2016: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/27825282/relationship-between-maternal-c-reactive-protein-level-and-neonatal-outcome-in-patients-with-preterm-premature-rupture-of-membranes-treated-with-ampicillin-and-azithromycin
#11
Mehmet Serdar Kutuk, Osman Bastug, Ahmet Ozdemir, Mehmet Adnan Ozturk, Mahmut Tuncay Ozgun, Mustafa Basbug, Tamer Gunes, Selim Kurtoglu
This historical cohort study aimed to assess the relationship between antenatal maternal C-reactive protein (CRP) level and neonatal outcome preterm premature rupture of membranes (PPROM). We reviewed the records of 70 singleton pregnancies with PPROM between 24 and 34 weeks. Maternal CRP levels of neonates with respiratory distress syndrome, neonatal sepsis, grade 3-4 intraventricular haemorrhage and stage 2-3 necrotizing enterocolitis, perinatal mortality were compared with those without these complications...
August 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27819066/group-b-streptococcus-circumvents-neutrophils-and-neutrophil-extracellular-traps-during-amniotic-cavity-invasion-and-preterm-labor
#12
Erica Boldenow, Claire Gendrin, Lisa Ngo, Craig Bierle, Jay Vornhagen, Michelle Coleman, Sean Merillat, Blair Armistead, Christopher Whidbey, Varchita Alishetti, Veronica Santana-Ufret, Jason Ogle, Michael Gough, Sengkeo Srinouanprachanh, James W MacDonald, Theo K Bammler, Aasthaa Bansal, H Denny Liggitt, Lakshmi Rajagopal, Kristina M Adams Waldorf
Preterm birth is a leading cause of neonatal morbidity and mortality. Although microbial invasion of the amniotic cavity (MIAC) is associated with the majority of early preterm births, the temporal events that occur during MIAC and preterm labor are not known. Group B Streptococci (GBS) are β-hemolytic, gram-positive bacteria, which commonly colonize the vagina but have been recovered from the amniotic fluid in preterm birth cases. To understand temporal events that occur during MIAC, we utilized a unique chronically catheterized nonhuman primate model that closely emulates human pregnancy...
October 2016: Science Immunology
https://www.readbyqxmd.com/read/27794570/limiting-the-exposure-of-select-fetuses-to-intrauterine-infection-inflammation-improves-short-term-neonatal-outcomes-in-preterm-premature-rupture-of-membranes
#13
Karen L Archabald, Irina A Buhimschi, Mert O Bahtiyar, Antonette T Dulay, Sonya S Abdel-Razeq, Christian M Pettker, Heather S Lipkind, John T Hardy, Megan E McCarthy, Guomao Zhao, Vineet Bhandari, Catalin S Buhimschi
BACKGROUND: To improve neonatal outcomes in pregnancies at heightened risk for early-onset neonatal sepsis (EONS), there is a need to identify fetuses that benefit from expectant management as opposed to early delivery. Detectable haptoglobin and haptoglobin-related protein (Hp&HpRP switch-on status) in cord blood has been proposed as a biomarker of antenatal exposure to intra-amniotic infection and/or inflammation (IAI), an important determinant of EONS. SUBJECTS AND METHODS: We analyzed 185 singleton newborns delivered secondary to preterm premature rupture of membranes (PPROM)...
October 29, 2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27780154/maternal-and-neonatal-outcomes-following-expectant-management-of-preterm-prelabour-rupture-of-membranes-before-viability
#14
Winnie Huiyan Sim, Edward Araujo Júnior, Fabricio Da Silva Costa, Penelope Marie Sheehan
AIM: To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks' gestation and to identify prognostic indicators of this morbid presentation. METHODS: We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM...
October 25, 2016: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27776718/maternal-alcohol-use-during-pregnancy-and-associated-morbidities-in-very-low-birth-weight-newborns
#15
Theresa W Gauthier, David M Guidot, Michael S Kelleman, Courtney E McCracken, Lou Ann S Brown
BACKGROUND: We hypothesized that maternal alcohol use occurs in pregnancies that end prematurely and that in utero alcohol exposure is associated with an increased risk of morbidities of premature newborns. METHODS: In an observational study of mothers who delivered very low birth weight newborns (VLBW) ≤1,500 g, maternal alcohol use was determined via a standardized administered questionnaire. We compared the effect of maternal drinking on the odds of developing late-onset sepsis (LOS), bronchopulmonary dysplasia (BPD), death, BPD or death, days on oxygen or any morbidity (either LOS, BPD or death)...
October 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27734505/amniotic-fluid-discordance-in-monochorionic-diamniotic-twin-pregnancies-is-associated-with-increased-risk-for-twin-anemia-polycythemia-sequence
#16
Liran Hiersch, Mayan Eitan, Eran Ashwal, Boaz Weisz, Benny Chayen, Shlomo Lipitz, Yoav Yinon
OBJECTIVE: To estimate the risk for twin anemia-polycythemia sequence (TAPS) and adverse perinatal outcome in monochorionic diamniotic (MCDA) twin pregnancies with amniotic fluid discordance (AFD). METHODS: Retrospective cohort study of 34 MCDA pregnancies with AFD (intertwin difference of ≥3 cm in maximal vertical pocket measurement) without meeting the criteria for twin to twin transfusion syndrome (TTTS) or selective intrauterine growth restriction (sIUGR)...
October 12, 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27724950/use-of-existing-systematic-reviews-for-evidence-assessments-in-infectious-disease-prevention-a-comparative-case-study
#17
Thomas Harder, Cornelius Remschmidt, Sebastian Haller, Tim Eckmanns, Ole Wichmann
BACKGROUND: Given limited resources and time constraints, the use of existing systematic reviews (SR) for the development of evidence-based public health recommendations has become increasingly important. Recently, a five-step approach for identifying, analyzing, appraising and using existing SRs based on recent guidance by the US Agency for Healthcare Research and Quality (AHRQ) was proposed within the Project on a Framework for Rating Evidence in Public Health (PRECEPT). However, case studies are needed to test whether this approach is useful, what challenges arise and how problems can be solved...
October 11, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27721728/spontaneous-bacterial-peritonitis-and-anasarca-in-a-female-patient-with-ovarian-hyperstimulation-syndrome-complicated-by-respiratory-and-kidney-failure
#18
Muhammad Abdul Mabood Khalil, Muhammad Salman Ghazni, Jackson Tan, Nazish Naseer, Muhammad Ashhad Ullah Khalil
Ovarian hyperstimulation syndrome (OHSS) was first described in 1960. It may occur as a complication of gonadotropin hormone therapy during assisted pregnancy or for primary infertility. A 26-year-old female patient with polycystic ovarian syndrome and primary infertility was treated to conceive. She received intravenous gonadotropin-releasing hormone (GnRH) along with follicle-stimulating hormone in an outside private clinic. She presented to the emergency department with abdominal and chest pain, loose stool, vomiting, shortness of breath and decreasing urine output...
May 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27658456/bacterial-vaginosis-and-adverse-outcomes-among-full-term-infants-a-cohort-study
#19
Adam S Dingens, Tessa S Fairfortune, Susan Reed, Caroline Mitchell
BACKGROUND: Bacterial vaginosis (BV) during pregnancy is a well-established risk factor for preterm birth and other preterm pregnancy complications. Little is known about adverse neonatal outcomes associated with BV exposure in full-term births, nor its influence on adverse outcomes independent of its effect on gestational age. The purpose of this study was to examine the relationship between BV during pregnancy and adverse neonatal outcomes among full-term and preterm infants. METHODS: We conducted a retrospective cohort study of Washington State mother/infant pairs from 2003-2013, stratified by full-term (primary outcomes) and preterm births (secondary outcomes)...
September 22, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27651605/a-single-centre-experience-of-obstetric-acute-kidney-injury
#20
V Mishra Vineet, A Goyal Preeti, S Aggarwal Rohina, S Choudhary, Tanvir Tanvir, D Dharaiya Nisarg, A Gaddagi Rashmi
BACKGROUND: Acute kidney injury (AKI) is a clinical syndrome characterized by a sudden decline in glomerular filtration rate leading to decreased excretion of nitrogenous waste products. It continues to be a common problem in developing countries. AIMS: The aim of this study was to understand AKI characteristics in pregnancy and identify the factors related to its unfavorable outcome. STUDY DESIGN: A prospective cross-sectional study. METHODS: This prospective study was conducted between January 2013 and May 2014...
October 2016: Journal of Obstetrics and Gynaecology of India
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