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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Congenital pneumonia, originating in an amniotic fluid bacterial infection, is a common cause of perinatal death in industrial societies. A study of perinatal mortality was undertaken in Addis Ababa, Ethiopia, in 1974-1975 in the hospitals and clinics affiliated with the Addis Ababa University Faculty of Medicine. 72% of the perinatal deaths had postmortem examinations and the pregnancies associated with the 1019 autopsied infants were compared with 586 systematically selected successful pregnancies drawn from a cross section of the delivery population by using the 1st deliveries after 7:00 a.m. each day. Hospital and clinic records in conjunction with a detained maternal interview and physical examination on the day following delivery provided 124 separate items of information for analysis. Autopsy prosections and gross placental examinations were performed by 1 Ethiopian and 4 US medical students. Amniotic fluid infection syndrome was identified as the prime diagnosis responsible for deaths in 339 cases for a frequency of 21.8/1000 live births. The fatal disorder had a frequency of 0.10%/week at midgestation with little subsequent change until 39 weeks when it markedly increased. 69% of the deaths were stillborn and the rest neonatal. 76% of lung and 66% of placental cultures were positive for 1 or more organisms in the amniotic fluid infection cases. Only 17% of the placentas from control cases had positive cultures. Fatal amniotic fluid infections had a frequency of 1.75% in single born infants and 12.9% in twins. The fatal infections had a frequency of 1.2% when women made clinic visits for prenatal medical care, and 4.2% when they made no such visits. The disorder was 5 times more frequent in the gravid women who had no education than in those who had 12 or more years of education. The influence of mother's education on the frequency of the fatal infections was largely independent on the influence of poverty. There was an excessive frequency of the fatal infections when women reported prior fetal losses. Acute inflammation of the extraplacental fetal membranes was present in 31% of the control cases, acute funisitis in 11%, and acute inflammation of the chorionic plate of the placenta in 13%. Among the perinatal deaths attributed to amniotic fluid infections, all had congenital pneumonia, 86% acute inflammation of the extraplacental fetal membranes, 61% acute funisitis, and 84% acute inflammation of the chorionic plate of the placenta.
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PMID:Amniotic fluid infections in an African city. 85 70

Congenital pneumonia in preterm infants is often associated with respiratory insufficiency requiring mechanical ventilation. This study was performed to show whether pneumonia in these infants is associated with an inhibition or deficiency of surfactant. The ratio of lecithin and sphingomyelin (L/S ratio) and minimal surface tension were determined in pharyngeal aspirates from 90 term born infants (healthy) and in tracheal aspirates from preterm infants with wet lung (n = 13), congenital pneumonia (n = 21) and respiratory distress syndrome (RDS) (n = 90). The L/S ratio was lower (p < 0.0001) in the RDS group (8.6) when compared with healthy (48.6), wet lung (42.9) and pneumonia (28.9). Surface tension was higher (p < 0.001) in RDS (37 mN/m) and pneumonia (33.7) when compared with healthy (22.9) or wet lung (21.2). For infants with RDS, L/S ratio <16.5 detects surfactant deficiency with 96% specificity and 70% sensitivity, surface tension >29 mN/m represents surfactant inhibition (specificity 97%, sensitivity 92%). Using these cut-off values in infants with pneumonia, 81% had a sufficient amount of surfactant but only 21% of infants with pneumonia had appropriate surface tension. Our study shows that lung effluent of respiratory insufficient infants with pneumonia, who need mechanical ventilation, has disturbed surface properties despite a sufficient amount of surfactant. In these infants, surfactant substitution could be beneficial.
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PMID:Disturbed surface properties in preterm infants with pneumonia. 1122 46