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sepsis obstetrics

Kiren Ghag, Cathy Winter, Rachna Bahl, Mary Lynch, Nayda Bautista, Rogelio Ilagan, Timothy J Draycott
OBJECTIVE: To describe the adaptation of an obstetric emergencies training program to align with local clinical practice. METHODS: A feasibility study was conducted to investigate the potential implementation of the PRactical Obstetric Multi-Professional Training (PROMPT) program at eight urban tertiary hospitals in the Philippines. Multi-professional teams attended a 2-day course on September 23 and 24, 2015, that comprised a demonstration PROMPT course (day 1) and a Train-the-Trainers session (day 2)...
February 22, 2018: International Journal of Gynaecology and Obstetrics
Gabriella Comunián-Carrasco, Guiomar E Peña-Martí, Arturo J Martí-Carvajal
BACKGROUND: Gonorrhoea is a sexually transmitted infection that is caused by Neisseria gonorrhoeae, and is a major public health challenge today. N gonorrhoeae can be transmitted from the mother's genital tract to the newborn during birth, and can cause gonococcal ophthalmia neonatorum as well as systemic neonatal infections. It can also cause endometritis and pelvic sepsis in the mother. This review updates and replaces an earlier Cochrane Review on antibiotics for treating this infectious condition...
February 21, 2018: Cochrane Database of Systematic Reviews
Arthur Jason Vaught
Sepsis is a leading cause of maternal morbidity and mortality in developed and developing nations. Obstetric practitioners should be familiar with guidelines that promote the safe and expeditious recovery of those affected. This article will provide the reader with rational steps to aid in the recovery of such a patient.
February 2018: Seminars in Perinatology
Sam Lepine, Beverley Lawton, Stacie Geller, Peter Abels, Evelyn J MacDonald
BACKGROUND: Sepsis is a life-threatening systemic condition that appears to be increasing in the obstetric population. Clinical detection can be difficult and may result in increased morbidity via delays in the continuum of patient care. AIMS: To describe the burden of severe maternal morbidity (SMM) caused by sepsis in New Zealand and investigate the potential preventability. METHODS: A multidisciplinary expert review panel was established to review cases of obstetric sepsis admitted to intensive care or high-dependency units over an 18 month span in New Zealand...
February 20, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Howieda Fouly, Fayza Ahmed Abdou, Ahmed M Abbas, Ayat Masoud Omar
Maternal deaths remain high, numbers at the facility level are relatively low. AIM: To evaluate effect of management guidelines on occurrence of maternal near miss in Women's Health Hospital. DESIGN: A cross-sectional study. SETTING: ICU of Women's Health Hospital's at Assiut Main University Hospital and Al-fayoum University Hospital. SUBJECTS: Convenient sample of 93 maternal near-miss cases including (Pregnancy or postpartum complications)...
February 2018: Applied Nursing Research: ANR
William R Cooke, Ulla K Hemmilä, Alison L Craik, Chimwemwe J Mandula, Priscilla Mvula, Ausbert Msusa, Gavin Dreyer, Rhys Evans
BACKGROUND: Obstetric-related acute kidney injury (AKI) is thought to be a key contributor to the overall burden of AKI in low resource settings, causing significant and preventable morbidity and mortality. However, epidemiological data to corroborate these hypotheses is sparse. This prospective observational study aims to determine the incidence, aetiology and maternal-fetal outcomes of obstetric-related AKI in Malawi. METHODS: Women greater than 20 weeks gestation or less than 6 weeks postpartum admitted to obstetric wards at a tertiary hospital in Blantyre, Malawi, and at high-risk of AKI were recruited between 21st September and 11th December 2015...
February 2, 2018: BMC Nephrology
Mercedes Bonet, Joao Paulo Souza, Edgardo Abalos, Bukola Fawole, Marian Knight, Seni Kouanda, Pisake Lumbiganon, Ashraf Nabhan, Ruta Nadisauskiene, Vanessa Brizuela, A Metin Gülmezoglu
BACKGROUND: Maternal sepsis is the underlying cause of 11% of all maternal deaths and a significant contributor to many deaths attributed to other underlying conditions. The effective prevention, early identification and adequate management of maternal and neonatal infections and sepsis can contribute to reducing the burden of infection as an underlying and contributing cause of morbidity and mortality. The objectives of the Global Maternal Sepsis Study (GLOSS) include: the development and validation of identification criteria for possible severe maternal infection and maternal sepsis; assessment of the frequency of use of a core set of practices recommended for prevention, early identification and management of maternal sepsis; further understanding of mother-to-child transmission of bacterial infection; assessment of the level of awareness about maternal and neonatal sepsis among health care providers; and establishment of a network of health care facilities to implement quality improvement strategies for better identification and management of maternal and early neonatal sepsis...
January 30, 2018: Reproductive Health
Giacomo Biasucci, Nicola Morelli, Federica Natacci, Massimo Mastrangelo
BACKGROUND: Perinatal asphyxia (PA) occurs in about 2 to 10 per 1000 live full-term births. Although neonatal epileptic seizures are observed in up to 60% of cases, PA may mimic or subtend other conditions. Hypoxia related brain injury is particularly relevant, as it may have permanent effects on neuropsychomotor development. Antepartum obstetric conditions, may, in turn, lead to hypoxic-ischemic damage to the fetus and the newborn, often underlying PA. Herein, a case of PA that hid and triggered signs and symptoms of Glutaric Aciduria type I (GA-I), is reported...
January 15, 2018: Italian Journal of Pediatrics
Jacob Ruiter-Ligeti, Sophie Vincent, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim
OBJECTIVE: To evaluate the risk factors, incidence, and morbidity associated with the diagnosis of obstetric Clostridium difficile infection. METHODS: We performed a retrospective cohort study on women admitted for delivery using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from the United States. The delivery admission records of pregnant women were reviewed between 1999 and 2013. After adjusting for demographic and clinical characteristics, we assessed risk factors for the diagnosis of C difficile infection using unconditional logistic regression...
January 9, 2018: Obstetrics and Gynecology
Geraldo Bezerra da Silva Junior, Suzanne Vieira Saintrain, Gabriel de Castro Castelo, Vanessa Ribeiro de Vasconcelos, Juliana Gomes Ramalho de Oliveira, Amanda Maria Timbó Rocha, Adolfo Gomes Vasconcelos Júnior, Maria Vieira de Lima Saintrain, Elizabeth De Francesco Daher
INTRODUCTION: Acute kidney injury (AKI) is a complication still poorly studied in the setting of obstetric patients, which is associated with increased mortality. Objective: The aim of this study was to investigate the frequency and risk factors of AKI among critically ill obstetric patients. METHODS: A cross-sectional study was conducted with all patients admitted to an intensive care unit (ICU) due to obstetric complications, in Fortaleza, Brazil, in the period between January 2012 and December 2014...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Sam Nahas, Anne McKirdy, Arjuna Imbuldeniya
A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1 day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392 mg/L, and white cell count was 32×109/L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics...
January 6, 2018: BMJ Case Reports
Jai Prakash, Vivek C Ganiger, Suraj Prakash, Mohammad Iqbal, Deba Prasad Kar, Usha Singh, Ashish Verma
INTRODUCTION: There are numerous reports in the literature describing acute kidney injury in pregnancy (P-AKI) due to various obstetric complications. However, there is a dearth of studies on AKI related to pregnancy-specific disorders from India. We aimed to analyze clinical features and outcome of P-AKI related to pregnancy-specific disorders compared to total pregnancy, in India. METHOD: All pregnant women attending the department of Obstetrics and Gynecology from November 2014 to July 2016 were screened for AKI based on: (1) sudden elevation of serum creatinine ≥ 1 mg/dl; (2) oligoanuria for > 12 h; and (3) need for dialysis...
January 4, 2018: Journal of Nephrology
Michelle J Wang, Spencer G Kuper, Robin Steele, Rachel A Sievert, Alan T Tita, Lorie M Harper
OBJECTIVE: We aim to examine whether outcomes of preterm birth (PTB) are further modified by the indication for delivery. STUDY DESIGN: We performed a retrospective cohort study of all singletons delivered at 23 to 34 weeks from 2011 to 2014. Women were classified by their primary indication for delivery: maternal (preeclampsia) or fetal/obstetric (growth restriction, nonreassuring fetal status, and vaginal bleeding). The primary neonatal outcome was a composite of neonatal death, cord pH <7 or base excess < - 12, 5-minute Apgar ≤3, C-reactive protein during resuscitation, culture-proven sepsis, intraventricular hemorrhage, and necrotizing enterocolitis...
December 29, 2017: American Journal of Perinatology
Friday Okonofua, Donald Imosemi, Brian Igboin, Adegboyega Adeyemi, Chioma Chibuko, Adewale Idowu, Wilson Imongan
The objective of the study was to investigate the results of Maternal and Perinatal Death Surveillance and Response (MPDSR) conducted in three referral hospitals in Lagos State, Nigeria over a two-year period and to report the outcomes and the lessons learned. MPDRS panels were constituted in the three hospitals, and beginning from January 2015, we conducted monthly MPDSR in the three hospitals using a nationally approved protocol. Data on births and deaths and causes of deaths as identified by the MPDSR panels were collated in the hospitals...
2017: PloS One
Marie Cavaignac-Vitalis, Fabien Vidal, Caroline Simon-Toulza, Pierre Boulot, Paul Guerby, Elodie Chantalat, Olivier Parant
OBJECTIVE: HELLP syndrome exposes to severe maternal and fetal complications. Prompt delivery is thus recommended after 34 weeks of gestation, or earlier in case of nonreassuring maternofetal conditions. However, no consensus has been raised in the treatment of HELLP syndrome occurring before 34 weeks of gestation, when both maternal and fetal conditions are stable: it remains still unclear whether an active attitude should be prioritized over expectant management. Herein, we aimed to compare mother and child outcomes according to the type of obstetrical management, either active or conservative...
December 21, 2017: Journal of Maternal-fetal & Neonatal Medicine
E V Guzovskaya, S N Serebrennikova
DIC is a severe complication, often resulting in multi-organ failure and fatal outcome. As any syndrome, it is polyethiologic, while a big number of its causes logically leads to various mechanisms of its forming. Main manifestations of the disseminated intravascular blood coagulation syndrome are clottage and haemorrhage. A result of a massive clottage in microcirculatory bed of internal organs is development of dystrophic changes in them and organ failure. Haemorrhage in its turn, results in decreased volume of circulating blood, arterial hypotension and hemic hypoxia, in most severe cases leading to the fatal outcome...
April 2017: Patologicheskaia Fiziologiia i èksperimental'naia Terapiia
Sri Djuwitaningsih, Setyowati
Alarming incidents of maternal deaths in Indonesia are due to three major causes: bleeding, sepsis, and hypertension, in addition to other non-obstetric causes and unsafe abortions. Adolescent girls contributed to maternal mortality based on early marriage, unwanted pregnancy, and childbirth. Prevention efforts have been taken through government programs and non-governmental organizations, but in practice those were considered ineffective. Thus, a preventative effort in the form of health education should be made, preferably embedded in a popular mobile application that most teenagers would be apt to use...
2017: Comprehensive Child and Adolescent Nursing
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the society for Obstetric anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
William A Grobman, Jennifer Bailit, Yinglei Lai, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Kenneth J Leveno, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
BACKGROUND: While there are well-accepted standards for the diagnosis of arrested active-phase labor, the definition of a "failed" induction of labor remains less certain. One approach to diagnosing a failed induction is based on the duration of the latent phase. However, a standard for the minimum duration that the latent phase of a labor induction should continue, absent acute maternal or fetal indications for cesarean delivery, remains lacking. OBJECTIVE: The objective of this study was to determine the frequency of adverse maternal and perinatal outcomes as a function of the duration of the latent phase among nulliparous women undergoing labor induction...
November 11, 2017: American Journal of Obstetrics and Gynecology
Ngandji Andre, Ngo Um Meka Esther Juliette, Fokom Joel, Wandji Brigitte, Foumane Pascal
In many developing countries like Cameroon, unsafe abortion is a major public health problem. It can be responsible for severe complications including damage to the digestive and/or urinary tract, sepsis, and uterine perforation. Uterine perforation could be caused by most of the instruments that are used to evacuate the uterus. We report a case of apparent uterine perforation and subsequent migration of the plastic or rubber catheter into the peritoneal cavity during an abortion procedure performed in a setting that may have been unsafe...
2017: Case Reports in Obstetrics and Gynecology
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