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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of clostridial endomyometritis and sepsis necessitating total abdominal hysterectomy which occurred 12 hours following abortion induced with intraamniotic administration of prostaglandin F2 alpha and laminaria tent insertion is discussed. Cultures from cervical, blood, and surgical specimens all yielded Clostridium perfringens. Intrauterine contamination with this microorganism most likely followed the insertion of laminaria tents through the cervical os, which was colonized with C. perfringens. Since C. perfringens may be present in the microflora of the lower female genital tract, great care must be taken to cleanse this area prior to intracervical laminaria tent insertion.
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PMID:Clostridial sepsis after abortion with PGF2alpha and intracervical laminaria tents--a case report. 2 7

The risk of hypernatremia and related postabortion complications resulting from the intraamniotic administration of a 20-25% hypertonic saline solution, a widely used procedure all over the world, prompted this trial of 5% saline. Midtrimester abortion was induced in 150 women with a 5% saline solution administered intraamniotically at the National Medical College, Calcutta, India, from August 1974 to October 1975. The abortion was complete within 48 hours in 90% of the cases. All the fetuses were delivered dead. In one case, hysterotomy was performed because of severe bleeding. The immediate complication rate was 36% (12% serious). The follow-up complication rate was 2%. One patient died on the seventh postabortal day due to severe, uncontrolled septicemia. The authors conclude that because this procedure is simple and low cost and because it reduces the risk of hypernatremia it should be a welcome addition to service programs in developing countries.
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PMID:Second trimester abortion with 5% intraamniotic saline--a pilot study. 2 79

The main benefits of intrauterine devices (IUDs) are a lack of adverse systemic effects, excellent effectiveness, high continuation rates and the single act of motivation required for use. First year failure rates range from 2% to 3%, but decline steadily thereafter to a cumulative annual failure rate of less than 1% after six years. The risks of IUDs include increased blood loss, uterine perforation, pelvic infection and pregnancy-related complications. The incidence of perforation of the uterine fundus ranges from 1:1000 to 1:2500 insertions, while that of cervical perforation with the copper devices ranges from 1:600 to 1:1000. IUD use is associated with about a three-fold increased incidence of developing acute salpingitis in comparison with use of oral contraceptives and diaphragms. If pregnancy occurs with an IUD in place, there is a three-fold increased risk of spontaneous abortion, a ten-fold increased risk of ectopic pregnancy (5% of all IUD pregnancies) and a possible increased incidence of sepsis during the pregnancy.
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PMID:Intrauterine devices: medicated and nonmedicated. 3 13

The triennial Confidential Enquiries into Maternal Deaths in England and Wales report 235 maternal deaths directly due to pregnancy or childbirth in 1973-75. The inquiry covers 94% of maternal deaths, and the figure is 4 times lower than the 1950s report. 37 deaths were attributed to obstetric anesthesia, some of which could have been prevented if the practising house officer had been more knowledgeable. Amniotic fluid deaths numbered 15 and were largely unpreventable. While maternal mortality rates have declined, amniotic fluid embolisms have remained steady since the 1960s. From 1973-75 the causes of death were as follows: hypertensive disease of pregnancy, 47; pulmonary embolism, 61; abortion, 81; sepsis, 70; ectopic pregnancy, 34; uterine hemorrhage, 27.
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PMID:George Stroh. 9 Mar 22

Sepsis and non-septic shock in pregnancy show characteristic modifications which are caused a) by physiologic changes in hemostasis primarily in the third trimester of pregnancy, b) by etiologic distinctions of shock regarded as pregnancy-specific, c) by hemodynamic changes in the circulation during pregnancy, d) by the ability of the healthy, young organism to compensate adequately. In the dead fetus syndrome and in non-septic shock, i.e., in amnionic fluid embolism and in abruptio placentae, the clinical picture is often governed by marked secundary fibrinolysis. Retroplacental hematoma, the characteristic feature of premature placental separation, remains controversial as either the cause or sequela of the hemostatic disorder. Etiologic, pathogenetic, and morphologic similarities exist between septic abortion, chorioamnionitis, and puerperal sepsis, but the varying response of the maternal organism during the course of pregnancy leads to different clinical and morphologic pictures. Due to a decrease in fibrinolytic activity as a consequence of pregnancy, the hypercoagulability state in a septic endotoxic shock predisposes the kidneys to bilateral renal cortical necrosis, principally in the amnion infection syndrome.
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PMID:Shock in pregnancy: pathophysiology and morphologic findings. 39 33

The maternal deaths occurring in the Kilimanjaro Christian Medical Center (KCMC), which serves as a supraregional reference hospital for the 5 regions of Northern and Central Tanzania, are reviewed for the 1971-1977 period and avoidable factors are discussed. All deaths occurring within the hospital during pregnancy or the first 6 weeks of the puerperium were included in this survey. Postmortem examination was performed in 35% of the cases. In the remaining cases the diagnosis was made on clinical grounds. During the period under review, there were 10 deaths among 83 cases, a mortality of 12%. The major cause of rupture was obstructed labor associated with a contracted pelvis or abnormal lie. 25% of the patients had had a previous cesarean section scar give way. 2 other deaths were attributed to anesthetic accidents and 1 was probably due to pulmonary embolism. The primary cause of death in the 7 remaining cases was hemorrhage (4) and sepsis (3). If deaths from ruptured uterus are to be avoided, early diagnosis is essential. 1044 cases of moderate and severe EPH gestosis (preeclampsia) were treated in KCMC during the period under review together with 54 cases of eclampsia. There were 5 deaths among the patients with eclampsia, a mortality of 9%. In addition to the 11 sepsis deaths there were 3 others included among the cases of ruptured uterus. There were 4 cases of septic abortion and 3 of those admitted to criminal interference. Preexisting anemia was a complicating factor in 5 cases, all of whom died within 15 minutes of arrival. There were 4 deaths among 251 cases of ruptured ectopic pregnancy. There were 10 deaths associated with cesarean section among 1271 sections peformed during the period under review. Deaths from associated diseases included the following: enterocolitis (12 deaths); renal and hypertensive disease (4 deaths); cardiac disease (2 deaths); anemia (2 deaths); malaria (2 deaths); tuberculous meningitis (2 deaths); and miscellaneous associated conditions (11 deaths).
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PMID:Maternal deaths in the Kilimanjaro region of Tanzania. 47 24

I refer for termination anyone who requests it for--pace Mr V Tunkel, (28 July, p 253)--the law is generally regarded as being one of "abortion on demand." I have some misgivings as I do not believe that women in early pregnancy are always in a fit state to make a considered decision, and they cannot in the nature of things be given time. I have, however, become increasingly worried about the morbidity arising from the procedure, and it is interesting that letters on the subject (25 August, pp 495 and 496) should be followed by one reporting rupture of the uterus during prostaglandin-induced abortion--yet another complication to add to those of cervical incompetence, pelvic sepsis, and permanent neurological damage. In so far as these tragedies usually follow late terminations Mr John Corrie's Bill is to be welcomed. A few further points. I am not so cynical as to think that every impregnation is the result of a thoughtless act of male lust. Unlike Professor Peter Huntingford (25 August, p 496), I listen to men as well as women, and many of them are deeply involved emotionally in the pregnancy they have helped to produce. Certainly I think a man should have the right to be consulted if his wife is to undergo a procedure that might damage her health. It is unfair contemptuously to dismiss as "whims" opinions that differ from ones own. These may result from genuine conscientious doubts or inability to cope from overwork and understaffing. Abortion is quite the most expensive form of contraception, and perhaps in these days of financial stringency this should be taken into account. "Bigotry" is defined in my dictionary as "blind zeal." This could be said of those who enthusiastically promote a course of action without regard to circumstances, safety, or cost.
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PMID:Abortion. 49 70

Relevant data on death from abortion that occurred between 1968 and 1976 were collected from the annual reports of the Registrar of Births and Deaths in Singapore in order to analyze abortion deaths. Additional information was obtained from case records of these deaths that occurred in Kandang Kerbau Hospital for Women; this accounted for 57% of the total number of abortion deaths in Singapore. The abortion deaths were grouped into 3 trienniel periods for analysis on trends in relation to 2 major events -- the limited liberalization of abortion legislation in 1970 and the complete liberalization of abortion legislation in 1974. There was a progressive decline in the number of abortion deaths from 15 in the 1st triennium to 9 in the 3rd triennium, a 40% decline, yet abortion continued to be the primary cause of maternal death in Singapore. In 1974-1976 abortion was responsible for 34.6% of all maternal deaths. The number of obstetric deaths declined by 62.5% between the 1st and 3rd triennium. The number of deaths from illegally induced abortions declined from 8 in 1968-1970 period to 1 in 1974-1976, yet there were abortion deaths in each triennium that were not specified as induced or spontaneous. The majority of abortion deaths occurred in the active reproductive age group of 20-39 years. The primary cause of abortion deaths was sepsis. Out of a total of 37 abortion deaths in Singapore, 21 occurred in the Kandang Kerbau Hospital for Women. None of the deaths that occurred in the 3rd triennium was the result of criminal abortion.
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PMID:Abortion deaths in Singapore (1968-1976). 50 38

Many self-induced abortion cases are admitted to hospitals under the pretext of being spontaneous. On examination most of these cases are diagnosed septic. Serious morbidity and high mortality rates result. 350 cases of spontaneous abortion were registered between September 1972-August 1973 at 2 Calcutta hospitals. Most of the women were of low socieoconomic status and illiterate. 46 cases (13.1%) could be determined as self-induced. The common method of interference was by insertion of a stick from a shrub. All cases were contacted within 2 months of abortion and followed up every 3 months for 1 year following abortion either at home or at clinics. The women were queried closely about complaints or complications subsequent to abortion. Women with spontaneous abortions were generally 3 years younger than those with self-induced abortions. Average age at marriage was 14.6 for self-induceds, 15.5 for spontaneous cases. The self-induced cases had more pregnancies and live births than the spontaneous. 99% of spontaneous cases reported bleeding as the major complaint. Among the self-induced group the major complaint was fever with signs and symptoms of sepsis (58.7%). The average period suffered was 8.9 days for spontaneous and 14 for self-induced. 92.1% and 69.6% of the spontaneous and self-induced respectively experienced no complications. The liberalization of abortion laws should reduce the numbers of clandestine, illegal abortions.
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PMID:A comparative study of spontaneous and self-induced abortion cases in married women. 54 95

During the period 1957 - 1977 there were 421 deaths recorded in the gynaecological wards of Groote Schuur Hospital, Cape Town. Nearly 50% of the patients were Coloureds, 25% were Whites, and 14% were Blacks; in 14% the ethnic group was not stated. Seventy-four per cent were more than 40 years and 25% were more than 70 years of age. The causes of death in order of frequency were: malignant disease of the cervix (30%), malignant disease of the ovary (17%), incomplete abortion (15%), non-gynaecological conditions (11%), malignant disease of the corpus uteri (8%), intra-abdominal malignancy (6%), pulmonary embolism (3%), sepsis not associated with abortion (3%), malignant disease of the vulva (2%), and other conditions (5%). The six commonest causes of death varied in the three ethnic groups.
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PMID:Deaths in gynaecological wards at Groote Schuur Hospital, Cape Town, 1957 - 1977. 55 Mar 99


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