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sepsis obstetrics

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https://www.readbyqxmd.com/read/28403049/clinical-and-microbiologic-characteristics-of-early-onset-sepsis-among-very-low-birth-weight-infants-opportunities-for-antibiotic-stewardship
#1
Sagori Mukhopadhyay, Karen M Puopolo
BACKGROUND: Most very low birth weight (VLBW, birth weight <1500 g) infants receive empiric antibiotics for risk of early-onset sepsis (EOS). The objective of this study was to determine the characteristics of VLBW infants with culture-confirmed EOS at a single center during 25 years and to identify opportunities for antibiotic stewardship. METHODS: Retrospective cohort study includes VLBW infants admitted from 1990 to 2015. EOS was defined as isolation of a pathogen in blood or cerebrospinal fluid culture obtained at <72 hours of age...
May 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28398928/anesthetic-management-of-mitochondrial-encephalopathy-with-lactic-acidosis-and-stroke-like-episodes-melas-syndrome-in-a-high-risk-pregnancy-a-case-report
#2
Josh D Bell, Kushlin Higgie, Mital Joshi, Joshua Rucker, Sahar Farzi, Naveed Siddiqui
MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered...
April 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28398913/sepsis-in-obstetrics-treatment-prognosis-and-prevention
#3
Sheryl E Parfitt, Mary L Bogat, Cheryl Roth
Sepsis during pregnancy is one of the five leading causes of maternal mortality worldwide. Early recognition and prompt treatment of maternal sepsis is necessary to improve patient outcomes. Patient education on practices that reduce infections may be helpful in decreasing rates of sepsis. Education of nurses about early signs and symptoms of sepsis in pregnancy and use of obstetric-specific tools can assist in timely identification and better outcomes. Although the Surviving Sepsis Campaign (SSC) criteria for diagnosis of sepsis in the general population are not pertinent for obstetric patients, their treatment bundles (guidelines) are applicable and can be used to guide care of obstetric patients who develop sepsis...
April 10, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28386951/neonatal-characteristics-and-perinatal-complications-in-neonates-with-down-syndrome
#4
Zivanit Ergaz-Shaltiel, Offra Engel, Ira Erlichman, Yaron Naveh, Michael S Schimmel, Ariel Tenenbaum
The annual rate of Down syndrome (DS) births in Jerusalem is stable, regardless of prenatal screening, and diagnostic measures. We aimed to evaluate our historical cohort for obstetrical characteristics and the neonatal course and complications. We reviewed computerized medical files of neonates with the diagnosis of DS born in the four main hospitals in Jerusalem between the years 2000 and 2010 and evaluated for maternal history and primary neonatal hospitalization. A total of 403 neonates were diagnosed with DS...
April 6, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28355654/experience-of-point-of-care-devices-in-obstetrical-care
#5
Ove Karlsson
During pregnancy and puerperium, there are pronounced hemostatic changes characterized by increased coagulability and decreased fibrinolysis. In addition, hemostasis can change dramatically during obstetric complications. Several reports have described substandard management of hemostatic defects in this setting and state the need for guidelines and better care. Point-of-care devices can assess hemostatic status and are especially suitable in perioperative settings. Using point-of-care devices, no time is required for transportation, allowing faster availability of results and providing potential for better care of the patient...
March 29, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28352008/spectrum-of-renal-injury-in-pregnancy-induced-hypertension-experience-from-a-single-center-in-india
#6
Mahesh Eswarappa, Madhyastha Rakesh, Puri Sonika, K Snigdha, M Midhun, K Kaushik, Gurudev Konana Chennabasappa, Bande Sujeeth
Pregnancy-induced hypertension (PIH) is a known complication of late pregnancy and is an important cause of maternal and fetal morbidity and mortality. Data on clinical profile, especially renal profile of preeclampsia and eclampsia in Indian women are lacking. The aim of our study was to examine the renal profile and clinical outcomes of patients diagnosed with PIH in our institution with a focus on the spectrum of acute kidney injury (AKI). In this prospective, observational study, 347 patients with a diagnosis of preeclampsia-eclampsia, who were undergoing treatment at the M...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28347852/first-report-of-human-parechovirus-type-3-infection-in-a-pregnant-woman
#7
Makiko Shinomoto, Tatsuya Kawasaki, Takuya Sugahara, Keiko Nakata, Tomoya Kotani, Hidetaka Yoshitake, Kento Yuasa, Masashi Saeki, Yasuhiro Fujiwara
Human parechovirus type 3 (HPeV3) can cause serious conditions in neonates, such as sepsis and encephalitis, but data for adults are lacking. The case of a pregnant woman with HPeV3 infection is reported herein. A 28-year-old woman at 36 weeks of pregnancy was admitted because of myalgia and muscle weakness. Her grip strength was 6.0kg for her right hand and 2.5kg for her left hand. The patient's symptoms, probably due to fasciitis and not myositis, improved gradually with conservative treatment, however labor pains with genital bleeding developed unexpectedly 3 days after admission...
March 24, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28301336/sepsis-in-obstetrics-clinical-features-and-early-warning-tools
#8
Sheryl E Parfitt, Mary L Bogat, Sandra L Hering, Charlotte Ottley, Cheryl Roth
Morbidity and mortality associated with sepsis has gained widespread attention on a local, state, and national level, yet, it remains a complicated disorder that can be difficult to identify in a timely manner. Sepsis in obstetric patients further complicates the diagnosis as alterations in physiology related to pregnancy can mask sepsis indicators normally seen in the general population. If early signs of sepsis go unrecognized, septic shock can develop, leading to organ dysfunction and potential death. Maternal early warning tools have been designed to assist clinicians in recognizing early indications of illness...
March 15, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28262236/disseminated-intravascular-coagulation-in-pregnancy-clinical-phenotypes-and-diagnostic-scores
#9
Offer Erez
During a women's life cycle, pregnancy is a period in which she is at risk for hemorrhagic events and obstetrical syndromes that may develop into disseminated intravascular coagulation (DIC). This life-threatening condition is a complication of obstetrical and non-obstetrical causes including: (1) acute peripartum hemorrhage (uterine atony, cervical and vaginal lacerations, and uterine rupture); (2) placental abruption; (3) Pre-eclampsia/HELLP syndrome; (4) retained stillbirth; (5) sepsis; (6) amniotic fluid embolism; and (7) acute fatty liver of pregnancy...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28252305/-analysis-of-maternal-morbidity-and-mortality-in-slovak-republic-in-the-years-2007-2012
#10
M Korbeľ, A Krištúfková, M Dugátová, J Daniš, B Némethová, P Kaščák, Z Nižňanská
OBJECTIVE: Analysis of maternal morbidity and mortality in Slovak Republic (SR) in the years 2007-2012. DESIGN: Epidemiological perinatological nation-wide. SETTINGS: 1st Department of Gynaecology and Obstetrics School of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic. METHODS: The analysis of selected maternal morbidity and mortality data prospective collected in the years 2007-2012 from all obstetrics hospitals in the Slovak Republic...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28231684/emergency-peripartum-hysterectomy-a-challenge-or-an-obstetrical-defeat
#11
Aneta Malinowska-Polubiec, Ewa Romejko-Wolniewicz, Julia Zareba-Szczudlik, Agnieszka Dobrowolska-Redo, Agnieszka Sotowska, Roman Smolarczyk, Jan Wilczynski, Krzysztof Czajkowski
OBJECTIVES: Peripartum hysterectomy remains an obstetric nightmare. Most obstetricians consider it a defeat. The aim of our study was to assess the prevalence, indications, procedures and complications of emergency peripartum hysterectomy (EPH) in the 2nd Department of Obstetrics & Gynecology, Medical University of Warsaw during a 7 year period (2007-2013). METHODS: A retrospective evaluation of 21,144 deliveries was performed. We analyzed all cases of EPH, including the maternal characteristics, obstetrical history, course of pregnancy and delivery, type of surgery and complications...
October 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28187059/clinical-and-microbiologic-characteristics-of-early-onset-sepsis-among-vlbw-infants-opportunities-for-antibiotic-stewardship
#12
Sagori Mukhopadhyay, Karen M Puopolo
BACKGROUND: Most very-low birth weight (birth weight <1500 grams, VLBW) infants receive empiric antibiotics for risk of early-onset sepsis (EOS). The objective of this study was to determine the characteristics of VLBW infants with culture-confirmed EOS at a single center during 25 years, to identify opportunities for antibiotic stewardship. METHODS: Retrospective cohort study including VLBW infants admitted from 1990-2015. EOS was defined as isolation of a pathogen in blood or cerebrospinal fluid culture obtained < 72 hours of age...
February 9, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28179699/referral-pattern-of-emergencies-in-obstetrics-implications-for-defining-scope-of-services-and-policy
#13
Rahat Najam Qureshi, Rozina Sikandar, Zahra Hoodbhoy, Raffat Bano, Nigar Jabeen
OBJECTIVE: To analyse referral pattern of high-risk obstetric cases from secondary to tertiary care hospitals and to assess their maternal and neonatal outcomes. METHODS: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised all referred obstetric cases from secondary-level hospitals to tertiary-level care within and outside the Hospital between January 2011 and December 2014. Day and time of referral, reason for referral as well as maternal and neonatal outcomes were collected...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28179485/variation-in-sepsis-evaluation-across-a-national-network-of-nurseries
#14
Sagori Mukhopadhyay, James A Taylor, Isabelle Von Kohorn, Valerie Flaherman, Anthony E Burgos, Carrie A Phillipi, Nui Dhepyasuwan, Elizabeth King, Miren Dhudasia, Karen M Puopolo
BACKGROUND AND OBJECTIVES: The extent to which clinicians use currently available guidelines for early-onset sepsis (EOS) screening has not been described. The Better Outcomes through Research for Newborns network represents 97 nurseries in 34 states across the United States. The objective of this study was to describe EOS risk management strategies across a national sample of newborn nurseries. METHODS: A Web-based survey was sent to each Better Outcomes through Research for Newborns network nursery site representative...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28114513/risk-factors-and-risk-stratification-for-adverse-obstetrical-outcomes-after-appendectomy-or-cholecystectomy-during-pregnancy
#15
Adam Sachs, Jean Guglielminotti, Russell Miller, Ruth Landau, Richard Smiley, Guohua Li
Importance: Identification of risk factors for adverse obstetrical outcomes after appendectomy and cholecystectomy during pregnancy is necessary for evidence-based risk reduction and adequate patient counseling. Objectives: To identify risk factors for adverse obstetrical outcomes after appendectomy and cholecystectomy during pregnancy and stratify the risk of such outcomes. Design, Setting, and Participants: A cohort study was conducted using the Nationwide Inpatient Sample, a nationally representative sample of patients discharged from community hospitals in the United States, from January 1, 2003, to December 31, 2012...
January 18, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28099637/factors-associated-with-maternal-death-in-an-intensive-care-unit
#16
Suzanne Vieira Saintrain, Juliana Gomes Ramalho de Oliveira, Maria Vieira de Lima Saintrain, Zenilda Vieira Bruno, Juliana Lima Nogueira Borges, Elizabeth De Francesco Daher, Geraldo Bezerra da Silva
Objective: To identify factors associated with maternal death in patients admitted to an intensive care unit. Methods: A cross-sectional study was conducted in a maternal intensive care unit. All medical records of patients admitted from January 2012 to December 2014 were reviewed. Pregnant and puerperal women were included; those with diagnoses of hydatidiform mole, ectopic pregnancy, or anembryonic pregnancy were excluded, as were patients admitted for non-obstetrical reasons...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28097445/pregnancy-outcomes-in-hiv-positive-women-a-retrospective-cohort-study
#17
Kholoud Arab, Andrea R Spence, Nicholas Czuzoj-Shulman, Haim A Abenhaim
PURPOSE: In the United States, an estimated 8500 HIV (human immunodeficiency virus) positive women gave birth in 2014. This rate appears to be increasing annually. Our objective is to examine obstetrical outcomes of pregnancy among HIV-positive women. METHODS: A population-based cohort study was conducted using the Nationwide Inpatient Sample database (2003-2011) from the United States. Pregnant HIV-positive women were identified and compared to pregnant women without HIV...
January 17, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28078172/gastric-rupture-in-pregnancy-case-series-from-a-tertiary-institution-in-rwanda-and-review-of-the-literature
#18
David Ntirushwa, Stephen Rulisa, Febronie Muhorakeye, Lisa Bazzett-Matabele, Theogene Rurangwa, Maria Small
Background Gastric rupture is a rare, life-threatening condition during pregnancy. Case study We present three cases of gastric perforation during pregnancy and the puerperium. The first patient presented with gastric perforation 4 days following an uncomplicated cesarean delivery for obstetric indications. She initially complained of epigastric pain; however, those symptoms resolved. She later demonstrated worsening abdominal distension, intra-abdominal free fluid, and signs of peritonitis. At laparotomy, an ascariasis-associated gastric rupture was diagnosed...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28013100/the-impact-of-highly-active-antiretroviral-therapy-on-obstetric-conditions-a-review
#19
REVIEW
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27957708/hypertension-in-pregnancy
#20
Roopa Malik, Viral Kumar
Hypertensive disorders of pregnancy remain an unresolved and unpreventable problem in obstetrics. They remain one of the leading member of deadly triad causing maternal mortality, the other two being hemorrhage and sepsis which are preventable. The incidence of hypertensive disorders worldwide is 12 %. We have discussed various terminologies used to describe hypertension during pregnancy, risk factors, etiopathogenesis, pathophysiology, management guidelines, complications and long term consequences of hypertensive disorders of pregnancy in this chapter...
December 13, 2016: Advances in Experimental Medicine and Biology
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