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Sepsis in pregnancy

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https://www.readbyqxmd.com/read/29790271/correlation-between-neonatal-outcomes-of-twins-depends-on-the-outcome-secondary-analysis-of-twelve-randomised-controlled-trials
#1
Lisa N Yelland, Ewoud Schuit, Javier Zamora, Philippa F Middleton, Arianne C Lim, Anwar H Nassar, Line Rode, Vicente Serra, Elizabeth A Thom, Christophe Vayssière, Ben Wj Mol, Simon Gates
OBJECTIVE: To estimate the magnitude of the correlation between neonatal outcomes of twins and demonstrate how this information can be used in the design of randomised controlled trials (RCTs) in women with twin pregnancies. DESIGN: Secondary analysis of data from 12 RCTs. SETTING: Obstetric care in multiple countries, 2004-2012. POPULATION OR SAMPLE: 4504 twin pairs born to women who participated in RCTs to assess treatments given during pregnancy...
May 22, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29780817/clinical-profile-and-outcome-of-patients-with-acute-kidney-injury-requiring-hemodialysis-two-years-experience-at-a-tertiary-hospital-in-rwanda
#2
Grace Igiraneza, Benedicte Ndayishimiye, Menelas Nkeshimana, Vincent Dusabejambo, Onyema Ogbuagu
Introduction: Acute kidney injury (AKI) requiring renal replacement therapy is associated with high mortality. The study assessed the impact of the introduction of hemodialysis (HD) on outcomes of patients with AKI in Rwanda. Methods: A single center retrospective study that evaluated the clinical profile and survival outcomes of patients with AKI requiring HD [AKI-D] at a tertiary hospital in Rwanda. Data was collected on patients who received HD for AKI from September 2014 to December 2016...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29764255/knot-positioning-during-mcdonald-cervical-cerclage-does-it-make-a-difference-a-cohort-study
#3
Hytham Atia, Mohamed Ellaithy, Ahmed Altraigey, Heba Ibrahim
OBJECTIVE: To study the effect of McDonald cerclage knot position on the different maternal and neonatal outcomes. METHODS: This historical cohort study included women with singleton pregnancy who had a prophylactic McDonald cervical cerclage between 1 May 2010 and 31 September 2017. Maternal and neonatal outcome parameters were compared between the anterior and posterior knot cerclage procedures. The primary outcome measure was the rate of term birth. RESULTS: 550 Women had a prophylactic McDonald cervical cerclage, 306 with anterior knot (Group A) and 244 with posterior knot (Group B)...
May 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29761674/screening-arab-israeli-pregnant-women-for-group-b-streptococcus-by-the-amplivue-gbs-assay-are-the-rates-higher-than-the-national-average
#4
Marwan Hakim, Adel Jabour, Miriam Anton, Meggie Hakim, Sahar Kheirallah
BACKGROUND: The recommendation of the U.S. Centers for Disease Control and Prevention regarding universal screening for Group B Streptococcus (GBS) at 35-37 weeks gestational age in pregnancy is not accepted in Israel. The National Council for Obstetrics, Neonatology and Genetics recommends intrapartum prophylaxis, mainly based on risk factors, to prevent early neonatal GBS infection. This policy is based on past studies demonstrating low colonization rates of the bacteria in Israeli pregnant women and very low neonatal sepsis rates...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29751278/pregnancy-related-acute-kidney-injury-requiring-dialysis-as-an-indicator-of-severe-adverse-maternal-morbidity-at-a-tertiary-center-in-southwest-nigeria
#5
Ibraheem O Awowole, Oluseyi S Omitinde, Fatiu A Arogundade, Sekinah B Bola-Oyebamiji, Olumide A Adeniyi
OBJECTIVE: Despite being a Critical Intervention in the WHO Near-miss concept, the indications and clinical outcomes of patients with Pregnancy-Related Acute Kidney Injury (PRAKI) requiring dialysis at the Obafemi Awolowo University Teaching Hospitals Complex, Nigeria remain unknown. This retrospective review was conducted to facilitate counselling, prognostication and introduction of preventative measures by providing contemporary data on the aetiology and clinical outcomes of women with PRAKI...
May 2, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29747214/intestinal-perforation-due-to-deep-infiltrating-endometriosis-during-pregnancy-case-report
#6
Márcia Mendonça Carneiro, Luciana Maria Pyramo Costa, Maria Das Graças Torres, Patrícia Salomé Gouvea, Ivete de Ávila
We report the case of a 33 year-old woman who complained of severe dysmenorrhea since menarche. From 2003 to 2009, she underwent 4 laparoscopies for the treatment of pain associated with endometriosis. After all four interventions, the pain recurred despite the use of gonadotropin-releasing hormone (GnRH) analogues and the insertion of a levonorgestrel intrauterine system (LNG-IUS). Finally, a colonoscopy performed in 2010 revealed rectosigmoid stenosis probably due to extrinsic compression. The patient was advised to get pregnant before treating the intestinal lesion...
April 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29733491/recognition-and-treatment-of-sepsis-in-pregnancy
#7
Anthony M Kendle, Judette Louis
Sepsis that occurs in the context of pregnancy is associated with significant maternal morbidity and mortality. International and multidisciplinary organizations have advocated for expedient diagnosis and initiation of treatment in patients with sepsis. However, the physiologic changes of pregnancy complicate both identification and treatment of maternal sepsis. This article describes a case of a woman presenting with symptoms of sepsis progressing to septic shock. Strategies for identifying and treating women with presumed sepsis are reviewed, and recent data regarding maternal and fetal outcomes are discussed...
May 7, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29725629/acute-kidney-injury-in-pregnancy-the-changing-landscape-for-the-21st-century
#8
REVIEW
Swati Rao, Belinda Jim
Pregnancy-related acute kidney injury (Pr-AKI) remains a large public health problem, with decreasing incidences in developing countries but seemingly increasing incidences in the United States and Canada. These epidemiologic changes are reflective of the advances in medical and obstetric care, as well as changes in underlying maternal risk factors. The risk factors associated with advanced maternal age, such as hypertension, diabetes, chronic kidney disease, and those associated with reproductive technologies such as multiple gestations, are increasing...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29678837/infections-and-risk-of-peripartum-stroke-during-delivery-admissions
#9
Eliza C Miller, Marisa Gallo, Erin R Kulick, Alexander M Friedman, Mitchell S V Elkind, Amelia K Boehme
BACKGROUND AND PURPOSE: Peripartum strokes during delivery admissions are rare but have high maternal morbidity. Infections have been proposed as a possible stroke trigger. We hypothesized that women who had infections diagnosed at the time of delivery admission would have higher risk of stroke during their delivery hospitalization. METHODS: We conducted a case-control study using state inpatient administrative databases for California (2007-2011), Florida (2009-2011), and New York (2009-2011)...
April 20, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29676341/the-prevalence-and-risk-factors-for-trichomonas-vaginalis-infection-amongst-human-immunodeficiency-virus-infected-pregnant-women-attending-the-antenatal-clinics-of-a-university-teaching-hospital-in-lagos-south-western-nigeria
#10
Olaolopin Ijasan, Kehinde Sharafadeen Okunade, Ayodeji Ayotunde Oluwole
Background: Trichomonas vaginalis infection is the most prevalent non-viral sexually transmitted infection worldwide. Interactions between this infection and human immunodeficiency virus (HIV) may cause adverse pregnancy outcomes such as preterm labour, premature rupture of membranes, chorioamnionitis, low birth weight and post-abortal sepsis. Aims: This study was aimed to determine the prevalence and risk factors of T. vaginalis infection amongst HIV-positive pregnant women attending antenatal care at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria...
January 2018: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29674201/placental-histopathological-lesions-in-correlation-with-neonatal-outcome-in-preeclampsia-with-and-without-severe-features
#11
Eran Weiner, Ohad Feldstein, Liliya Tamayev, Ehud Grinstein, Elad Barber, Jacob Bar, Letizia Schreiber, Michal Kovo
OBJECTIVE: We aimed to compare pregnancy outcome and placental histopathology in women with preeclampsia (PE) with and without severe features. METHODS: The medical records and placental pathology reports of all pregnancies complicated by PE during 2008-2016, were reviewed. Results were compared between those with and without severe features (severe PE vs. mild PE groups), according to current ACOG guidelines. Placental lesions were classified to maternal/fetal vascular supply lesions, and maternal/fetal inflammatory responses...
February 7, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29667377/the-usefulness-of-determination-of-the-procalcitonin-pct-concentration-in-gbs-piositive-pregnant-womens-blood-serum-for-anticipations-of-infections-in-newborns
#12
Wojciech Cnota, Dominika Mucha, Jan Mucha
Group-B streptococci (GBS) are commensal bacteria of the human body. They may, however, pose a serious life hazard to pregnant women. During labour, newborns of GBS-positive mothers run the risk of infections that may eventually lead to severe complications, sepsis or even death. For this reason, it is very important to find new diagnostic markers that will enable fast and effective diagnostics and control of the disease process. The level of procalcitonin emerges as a promising diagnostic parameter. AIM. Analysis of the impact of the procalcitonin (PCT) level in GBS-positive pregnant women on the possibility of complications and infections in mothers and newborns MATERIAL AND METHODS...
2018: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/29642754/daily-gentamicin-using-ideal-body-weight-demonstrates-lower-risk-of-postpartum-endometritis-and-increased-chance-of-successful-outcome-compared-with-traditional-8-hour-dosing-for-the-treatment-of-intrapartum-chorioamnionitis
#13
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
https://www.readbyqxmd.com/read/29621007/disseminated-intravascular-coagulation-is-it-fact-or-fancy
#14
Jae C Chang
: 'Disseminated intravascular coagulation (DIC)' occurs commonly in critical illnesses such as sepsis, trauma, cancer, and complications of surgery and pregnancy. Mortality is very high. The pathogenesis has been ascribed to tissue factor-initiated coagulation disorder, resulting in disseminated microblood clots that are made of platelets, plasma factors, fibrins, and blood cells. True DIC depletes coagulation factors and consumes platelets, and activates fibrinolysis. 'DIC' is assumed to orchestrate thrombocytopenia, microangiopathic hemolytic anemia and hypoxic multiorgan dysfunction syndrome, and causes hemorrhagic disorder due to depleted coagulation factors...
April 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29587875/evaluation-of-a-novel-device-for-the-management-of-high-blood-pressure-and-shock-in-pregnancy-in-low-resource-settings-study-protocol-for-a-stepped-wedge-cluster-randomised-controlled-trial-cradle-3-trial
#15
Hannah L Nathan, Kate Duhig, Nicola Vousden, Elodie Lawley, Paul T Seed, Jane Sandall, Mrutyunjaya B Bellad, Adrian C Brown, Lucy C Chappell, Shivaprasad S Goudar, Muchabayiwa F Gidiri, Andrew H Shennan
BACKGROUND: Obstetric haemorrhage, sepsis and pregnancy hypertension account for more than 50% of maternal deaths worldwide. Early detection and effective management of these conditions relies on vital signs. The Microlife® CRADLE Vital Sign Alert (VSA) is an easy-to-use, accurate device that measures blood pressure and pulse. It incorporates a traffic-light early warning system that alerts all levels of healthcare provider to the need for escalation of care in women with obstetric haemorrhage, sepsis or pregnancy hypertension, thereby aiding early recognition of haemodynamic instability and preventing maternal mortality and morbidity...
March 27, 2018: Trials
https://www.readbyqxmd.com/read/29579086/tuberculosis-during-pregnancy-in-the-united-states-racial-ethnic-disparities-in-pregnancy-complications-and-in-hospital-death
#16
Erika M Dennis, Yun Hao, Mabella Tamambang, Tasha N Roshan, Knubian J Gatlin, Hanane Bghigh, Oladimeji T Ogunyemi, Fatoumata Diallo, Kiara K Spooner, Jason L Salemi, Omonike A Olaleye, Kashif Z Khan, Muktar H Aliyu, Hamisu M Salihu
BACKGROUND: Despite decades of efforts to eliminate tuberculosis (TB) in the United States (US), TB still contributes to adverse ill health, especially among racial/ethnic minorities. According to the Centers for Disease Control and Prevention, in 2016, about 87% of the TB cases reported in the US were among racial and ethnic minorities. The objective of this study is to explore the risks for pregnancy complications and in-hospital death among mothers diagnosed with TB across racial/ethnic groups in the US...
2018: PloS One
https://www.readbyqxmd.com/read/29571592/risk-of-maternal-mortality-in-women-with-severe-anaemia-during-pregnancy-and-post-partum-a-multilevel-analysis
#17
Jahnavi Daru, Javier Zamora, Borja M Fernández-Félix, Joshua Vogel, Olufemi T Oladapo, Naho Morisaki, Özge Tunçalp, Maria Regina Torloni, Suneeta Mittal, Kapila Jayaratne, Pisake Lumbiganon, Ganchimeg Togoobaatar, Shakila Thangaratinam, Khalid S Khan
BACKGROUND: Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. METHODS: We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia...
May 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29570713/maternal-fetal-and-perinatal-factors-associated-with-necrotizing-enterocolitis-in-sweden-a-national-case-control-study
#18
Margareta Ahle, Peder Drott, Anders Elfvin, Roland E Andersson
OBJECTIVE: To analyze associations of maternal, fetal, gestational, and perinatal factors with necrotizing enterocolitis in a matched case-control study based on routinely collected, nationwide register data. STUDY DESIGN: All infants born in 1987 through 2009 with a diagnosis of necrotizing enterocolitis in any of the Swedish national health care registers were identified. For each case up to 6 controls, matched for birth year and gestational age, were selected...
2018: PloS One
https://www.readbyqxmd.com/read/29563816/the-diagnostic-utility-of-procalcitonin-interleukin-6-and-interleukin-8-and-hyaluronic-acid-in-the-norwegian-consensus-definition-for-early-onset-neonatal-sepsis-eons
#19
Britt Nakstad
Introduction: A key challenge in identifying serious bacterial infection in new born infants is the nonspecific clinical presentation of early-onset neonatal sepsis (EONS). Routinely used C-reactive protein, white blood cell count, and platelets are nonspecific. We assessed the diagnostic utility of single biomarkers or combinations of procalcitonin (PCT), interleukin (IL)-6, IL-8, and hyaluronic acid (HA) in newborn infant with EONS, and in human umbilical cord blood (HUCB) from deliveries with chorioamnionitis...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29562891/correlation-between-maternal-and-umbilical-cord-blood-in-pregnant-women-of-pokhara-valley-a-cross-sectional-study
#20
Sameer Timilsina, Sirisa Karki, Aajeevan Gautam, Pujan Bhusal, Gita Paudel, Deepak Sharma
BACKGROUND: Complete blood count is one of the routinely advised blood investigation during pregnancy. It is also utilized as a diagnostic tool for neonatal anemia, sepsis and determining hemostatic status of the newborn. The present study aims at estimating the complete blood count of maternal and umbilical cord blood at the time of delivery and to establish its correlation. METHOD: This cross sectional study included 114 mothers and their healthy neonates born through normal vaginal delivery...
March 21, 2018: BMC Pregnancy and Childbirth
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