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management septic abortion

Salvatore Butticè, Antonio Simone Laganà, Salvatore Giovanni Vitale, Christopher Netsch, Yiloren Tanidir, Francesco Cantiello, Laurian Dragos, Michele Talso, Esteban Emiliani, Rosa Pappalardo, Tarik Emre Sener
OBJECTIVE: Clinical presentation of ureteral stones during pregnancy is generally with renal colic pain. The aim of this study is to present our experience in the management of renal colic during pregnancy in emergency settings. MATERIALS AND METHODS: 208 pregnant patients who presented to emergency department with renal colic pain and underwent ureteroscopy (URS) due to failed conservative therapy were enrolled in the study. Urinary tract stones were diagnosed either with ultrasound (US) examination or during URS...
December 31, 2017: Archivio Italiano di Urologia, Andrologia
Nino Berdzuli, Ekaterine Pestvenidze, Nino Lomia, Babill Stray-Pedersen
OBJECTIVES: In Georgia, which has a longstanding, liberalised abortion law, the abortion procedure is generally safe if it is performed in a medical facility. However, when socioeconomic barriers prevent women from seeking safe abortion services, some risk their life by self-terminating an unintended pregnancy. We present a case of maternal mortality after a self-induced medical abortion, with the aim to investigate the underlying non-clinical causes of maternal death and the relevant policy implications...
October 2017: European Journal of Contraception & Reproductive Health Care
Denis Rwabizi, Stephen Rulisa, Aidan Findlater, Maria Small
BACKGROUND: The objective of this study is to evaluate 'near miss' and mortality in women with postpartum infections. METHODS: We performed a retrospective review of all patients referred to the University Teaching Hospital of Kigali (CHUK) between January 2012 and December 2013. We identified 117 patients with postpartum infections. Demographic data, length of admission, location of referral, initial surgery and subsequent treatment modalities including antibiotic administration and secondary surgery were recorded...
July 20, 2016: BMC Pregnancy and Childbirth
Atim Udoh, Emmanuel E Effa, Olabisi Oduwole, Babasola O Okusanya, Obiamaka Okafo
BACKGROUND: A septic abortion refers to any abortion (spontaneous or induced) complicated by upper genital tract infection including endometritis or parametritis. The mainstay of treatment of septic abortion is antibiotic therapy alone or in combination with evacuation of retained products of conception. Regimens including broad-spectrum antibiotics are routinely recommended for treatment. However, there is no consensus on the most effective antibiotics alone or in combination to treat septic abortion...
July 1, 2016: Cochrane Database of Systematic Reviews
F Daney de Marcillac, L Lecointre, A Guillaume, N Sananes, G Fritz, B Viville, E Boudier, I Nisand, A Gaudineau, B Langer, C Y Akladios
BACKGROUND: High risk of morbidly adherent placenta increased during past years. Their management is controversial. Cesarean hysterectomy, considered the gold standard treatment by American Society, is associated with high risk of maternal morbimortality. Conservative management has been sought to reduce maternal morbidity associated with caesarean hysterectomy while maintaining fertility. It consists of leaving the placenta in place but long-term monitoring. Our main objective was to determine advantage/disadvantage of conservative management on patient with an antenatal diagnosis of placenta accreta, increta or percreta...
October 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Jai Prakash, Vijay Pratap Singh
Renal cortical necrosis (RCN) is characterized by patchy or diffuse ischemic destruction of all the elements of renal cortex resulting from significantly diminished renal arterial perfusion due to vascular spasm and microvascular injury. In addition, direct endothelial injury particularly in setting of sepsis, eclampsia, haemolytic uremic syndrome (HUS) and snake bite may lead to endovascular thrombosis with subsequent renal ischemia. Progression to end stage renal disease is a rule in diffuse cortical necrosis...
November 6, 2015: World Journal of Nephrology
José Luis Martínez-Ordaz, Magdely Yazmin Morales-Camacho, Sócrates Centellas-Hinojosa, Eduardo Román-Ramírez, Teodoro Romero-Hernández, Mauricio de la Fuente-Lira
BACKGROUND: Choledochal cysts are rare. They usually present during childhood in women, but it can also be seen during pregnancy. Clinical signs and symptoms are obscured during this time, thus it can complicate the diagnosis and represent a life threatening complication for both the mother and the child. OBJECTIVE: To communicate the case of 3 pregnant patients with choledochal cyst. CLINICAL CASES: Three pregnant women in which choledochal cyst were diagnosed...
March 2016: Cirugia y Cirujanos
Natja Mellerup, Bjarke L Sørensen, Gideon K Kuriigamba, Martin Rudnicki
BACKGROUND: Complications of unsafe abortion are a major contributor to maternal deaths in developing countries. This study aimed to evaluate the clinical assessment for life-threatening complications and the following management in women admitted with complications from abortions at a rural hospital in Uganda. METHODS: A partially completed criterion-based audit was conducted comparing actual to optimal care. The audit criteria cover initial clinical assessment of vital signs and management of common severe complications such as sepsis and haemorrhage...
September 20, 2015: BMC Women's Health
Hennie Lombaard, Sumaiya Adam, Jennifer Makin, Patricia Sebola
BACKGROUND: Septic incomplete miscarriages remain a cause of maternal deaths in South Africa. There was an initial decline in mortality when a strict protocol based approach and the Choice of Termination of Pregnancy Act in South Africa were implemented in this country. However, a recent unpublished audit at the Pretoria Academic Complex (Kalafong and Steve Biko Academic Hospitals) suggested that maternal mortality due to this condition is increasing. The objective of this investigation is to do a retrospective audit with the purpose of identifying the reasons for the deteriorating mortality index attributed to septic incomplete miscarriage at Steve Biko Academic Hospital...
April 2, 2015: BMC Pregnancy and Childbirth
Offer Erez, Salvatore Andrea Mastrolia, Jecko Thachil
Disseminated intravascular coagulation (DIC) is a life-threatening situation that can arise from a variety of obstetrical and nonobstetrical causes. Obstetrical DIC has been associated with a series of pregnancy complications including the following: (1) acute peripartum hemorrhage (uterine atony, cervical and vaginal lacerations, and uterine rupture); (2) placental abruption; (3) preeclampsia/eclampsia/hemolysis, elevated liver enzymes, and low platelet count syndrome; (4) retained stillbirth; (5) septic abortion and intrauterine infection; (6) amniotic fluid embolism; and (7) acute fatty liver of pregnancy...
October 2015: American Journal of Obstetrics and Gynecology
Alexander G Duarte
Acute respiratory distress syndrome (ARDS) is an uncommon condition in pregnant patients. The causes of ARDS are associated with obstetric causes such as amniotic fluid embolism, preeclampsia, septic abortion, and retained products of conception or nonobstetric causes that include sepsis, aspiration pneumonitis, influenza pneumonia, blood transfusions, and trauma. An essential component in management of ARDS involves good communication between the obstetrics team and critical care specialist and a fundamental understanding of mechanical ventilatory support...
December 2014: Clinical Obstetrics and Gynecology
B Begum, F B Sherin, T Chowdhury
At maternity worldwide we recognize the complexity and interlinking nature of the many different factors which can prevent women and girls from being able to have access to high quality maternal and family planning care. Our integrated maternal health approach draws on the Three Delays Model which recognizes the different barriers women face in achieving the timely and effective medical care needed to prevent deaths occurring in pregnancy and childbirth. The three delay model proposed by Main in 1993 depicts the roles of communities and the health system as emergency service to protect safe motherhood...
July 2014: Mymensingh Medical Journal: MMJ
Alia Jabeen, Nasira Sabiha Dawood, Shazia Riaz, Shamaila Tanveer
BACKGROUND: To study the methods used for the termination of pregnancy and associated complications of induced abortion. METHODS: This descriptive study was conducted in the department of obstetrics and gynaecology, Fauji Foundation Hospital Rawalpindi. One Hundred patients were included in the study who was admitted with the history of induced abortion. The patients were assessed by detailed history and thorough clinical examination according to the study protocol...
January 2013: Journal of Ayub Medical College, Abbottabad: JAMC
Sherelle L Laifer-Narin, Ellie Kwak, Hyonah Kim, Elizabeth M Hecht, Jeffrey H Newhouse
Postpartum and posttermination complications are common causes of morbidity and mortality in women of reproductive age. These complications can be broadly categorized into vascular, infectious, surgical, and neoplastic etiologies, or are due to ectopic implantation of placental or endometrial tissue. Causes of postpartum vascular complications include retained products of conception, arteriovenous malformation, and pseudoaneurysm. Infectious entities include endometritis, abscess, wound cellulitis, and pelvic septic thrombophlebitis...
November 2014: Current Problems in Diagnostic Radiology
Ruqqia Sultana, Shehla Noor, Ali Fawwad, Nasreen Abbasi, Rubina Bashir
BACKGROUND: Unsafe abortion is one of the greatest neglected problems of health care in developing countries like Pakistan. In countries where abortions are restricted women have to resort to clandestine interventions to have an unwanted pregnancy terminated. The study was conducted to find out the prevalence of septic induced abortion and the associated morbidity and mortality and to highlight the measures to reduce it. METHODS: This cross-sectional descriptive study was carried out in Obs/Gyn B Unit, Ayub Teaching Hospital, Abbottabad from January 2007 to December 2011...
July 2012: Journal of Ayub Medical College, Abbottabad: JAMC
Prasanta Kumar Nayak, Subarna Mitra, Alaganandam Padma, Sarita Agrawal
A majority of the unsafe abortions are performed by untrained birth attendants or quacks leading to complications in a large proportion of these cases. Complications like bowel injury, bladder injury, uterine perforation, and septic abortion are mostly caused by unskilled hands and are detected immediately or within few days of the procedure, owing to the need for tertiary level care. Here we present a very interesting case of unsafe abortion induced by a Ryle's tube in a 32-year-old lady, which was diagnosed five years after the procedure...
2014: Case Reports in Obstetrics and Gynecology
N Arulkumaran, M Singer
Infections during pregnancy are relatively prevalent, and the majority of cases are managed well in the community. Occasionally, however, infections may be life-threatening. Sepsis may be associated with multiple organ dysfunction and a high mortality. The treatment of sepsis is time critical and requires early fluid resuscitation and antibiotics. Early involvement of other specialties and allied health-care professionals to provide a multidisciplinary approach to patient care is important. Continuous monitoring of maternal vital signs and provision of supportive care for multiple organ dysfunction are best done within the intensive care unit...
December 2013: Best Practice & Research. Clinical Obstetrics & Gynaecology
Anjali Acharya, Jolina Santos, Brian Linde, Kisra Anis
Pregnancy-related acute kidney injury (PR-AKI) causes significant maternal and fetal morbidity and mortality. Management of PR-AKI warrants a thorough understanding of the physiologic adaptations in the kidney and the urinary tract. Categorization of etiologies of PR-AKI is similar to that of acute kidney injury (AKI) in the nonpregnant population. The causes differ between developed and developing countries, with thrombotic microangiopathies (TMAs) being common in the former and septic abortion and puerperal sepsis in the latter...
May 2013: Advances in Chronic Kidney Disease
Jamie Morgan, Scott Roberts
Maternal sepsis is relatively common. Most of these infections are the result of tissue damage during labor and delivery and physiologic changes normally occurring during pregnancy. These infections, whether directly pregnancy-related or simply aggravated by normal pregnancy physiology, ultimately have the potential to progress to severe sepsis and septic shock. This article discusses commonly encountered entities and septic shock. The expeditious recognition of common maternal sepsis and meticulous attention to appropriate management to prevent the progression to severe sepsis and septic shock are emphasized...
March 2013: Obstetrics and Gynecology Clinics of North America
Rosemary Nwoko, Darko Plecas, Vesna D Garovic
Acute kidney injury (AKI) is costly and is associated with increased mortality and morbidity. An understanding of the renal physiologic changes that occur during pregnancy is essential for proper evaluation, diagnosis, and management of AKI. As in the general population, AKI can occur from prerenal, intrinsic, and post-renal causes. Major causes of pre-renal azotemia include hyperemesis gravidarum and uterine hemorrhage in the setting of placental abruption. Intrinsic etiologies include infections from acute pyelonephritis and septic abortion, bilateral cortical necrosis, and acute tubular necrosis...
December 2012: Clinical Nephrology
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