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

To compare the risk of death from first trimester induced abortions in hospitals and nonhospital facilities (outpatient clinics and physicians' offices), the death-to-case rates by type of facility were calculated for abortions performed in the U.S. in 1974-1975. Data were derived from the Center for Disease Control's nationwide surveillance of abortion mortality and the Alan Guttmacher Institute's surveys of abortion providers. The data indicated 12 deaths from abortion-related complications in hospitals and 11 deaths in nonhospital settings (crude death-to-case rates of 2.1 and 1.0 deaths/100,000 abortions, respectively). However, 2 distorting factors were found to elevate the hospital rate: preexisting medical conditions, and concurrent sterilization. Adjustments for these factors yielded a hospital death-to-case rate of 1.1 deaths/100,000 abortions, indicating that the mortality risk is similar in both settings. These rates have 2 important limitations: 1) small changes in the already small number of deaths result in relatively large increases in the death-to-case rates, restricting extrapolation from these statistics; and 2) confounding variables influencing abortion mortality, e.g., patient's age and gestational age, cannot be controlled. Causes of death common to both facilities included adverse reaction to anesthesia, sepsis, hemorrhage, and pulmonary embollism, with no one cause disproportionally represented in either setting. Since over 90% of life-threatening complications developed either during the abortion or within 3 days, earlier patient follow-up is advised.
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PMID:Comparative risk of death from legally induced abortion in hospitals and nonhospital facilities. 62 34

The patterns of endogenous bacterial participation, particularly of Bacteroides fragilis, in the condition called progressive anaerobic syndrome and their clinical consequences are discussed. B. fragilis is an anaerobe recently resistant to tetracycline, which before 1970, was the drug of choice. Presently, clindamycin is the drug of choice for severe Bacteroides infections, though diarrheal side effects often interfere with administration; if contraindicated or side effects occur which are intolerable, doxycycline is indicated, for this -OH-substituted form rarely shares cross-resistances with other tetracyclines. A Bacteroides infection almost invariably involves organisms that have been present within the patient's own microbiologic environment, especially mucosal areas such as the female genital tract and the gastrointestinal tract. In the course of disease, whether spontaneous or due to iatrogenic factors, certain conditions are created that may select for the Bacteriodaceae by virtue of creating a low oxidation-reduction potential: 1) creation of new tissue spaces, i.e., hematomas; 2) necrotic tissues that might be present with incomplete abortion or retained products of conception, criminal abortion, degenerating tumor masses, crush injury, or devitalization of previously healthy tissue; 3) penetration of the gastrointestinal tract with spillage of fecal material; and 4) alteration of the microbiologic environment by Neisseria gonorrhoeae. Clinical consequences include the continuum of endometritis--septic thrombophlebitis--septicemia and puerperal septic abortion.
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PMID:Infectious morbidity due to Bacteroides fragilis in obstetric patients. 76 27

A single extra-amniotic injection of prostaglandin (PG) E2 or F2alpha in a highly viscous gel was administered to 230 patients to induce abortion between 9 and 24 weeks gestation. PGE2 doses of 1-0, 1-5, 2-0 or 3-0 mg induced abortion within 24 hours in 30 per cent, 75 per cent, 76 per cent and 70 per cent of patients respectively. The incidence of gastrointestinal side-effects was dose dependent, being 20 per cent, 35 per cent, 45 per cent and 70 per cent in the respective groups. A 10-0 Pmg dose of PGF2alpha induced abortion within 24 hours in 66 per cent of patients and 45 per cent had gastrointestinal side-effects. Abortion was more often complete with PGE2 (76 per cent) than with PGF2alpha (36 per cent). Immediate withdrawal of the catheter following PG administration did not influence induction-abortion intervals or 24-hour abortion success rates. This technique significantly reduced individual patient care and minimized the potential risk of intrauterine sepsis associated with extra-amniotic techniques requiring repeated or continuous PG administration.
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PMID:Single extra-amniotic injection of prostaglandins in viscous gel to induce abortion. 77 9

Twenty-six women were admitted to National Women's Hospital with complications following therapeutic abortion at the Auckland Medical Aid Centre, during its first year of operation. This represents 1.4 percent of the total number of cases at the Centre that year. The principal early complicatons were pelvic sepsis, suspected uterine perforation and incomplete abortion. The complication rate appears to be low and compares favourably with reports from other centres. During the same period, 17 women (8.4 percent) whose pregnancies were terminated at National Women's Hospital had significant complications. All 43 complicated cases are analysed.
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PMID:Morbidity of therapeutic abortion in Auckland. 82 74

In countries where induced abortion is permitted, national family planning programs are able to combine pre- and postconceptive fertility control methods to maximize success in achieving personally desired fertility levels and nationally desired growth levels. The proscription against induced abortion tends to produce criminal abortions and consequent morbidity and mortality which, in some countries, are often recognized as a national health problem. The International Fertility Research Program has undertaken this study of incomplete, inevitable, threatened and septic abortion cases, using a standard data collection instrument, to facilitate comparisons across institutions and countries. The data gather since 1971 in nine Asian, African and Middle Eastern hospitals includes 7,331 cases. Policies of the participating institutions with respect to what constitutes a therapeutic abortion affected the proportions of spontaneous abortions and of abortions induced outside the hospital and inside the hospital. Women treated for induced abortion tended to be of higher parity and more likely to have attained their desired family size than patients treated for spontaneous abortions. Morbidity rates were quite low for patients treated in centers where vacuum aspiration was mainly used, particularly in contrast to the morbidity rates for patients treated in centers where dilatation and curettage was used exclusively. High mortality rates in patients admitted with sepsis confirm the need not only for improvement of clinical procedures but also for reconsideration of the legal issues since many patients admitted with sepsis can be assumed to have had abortions induced.
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PMID:A study of abortion in countries where abortions are legally restricted. 83 96

Two newborn siblings, one with meningitis and one with sepsis due to Listeria monocytogenes, were born to a healthy, 33-year-old woman. She had had a spontaneous abortion prior to the birth of these infants. In spite of negative cultures, persistence of this bacterium in the mother's genital tract and perinatal acquisition of infection is suspected.
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PMID:Infection in newborn siblings. 84 61

A case of death following induction of legal abortion by catheter (Bougie technique) is reported. The procedure was performed on a 16-year-old, white, single girl, gravida 3, para 2, in a physician's clinic at 5 menstrual weeks' gestation. Death was attributed to incomplete abortion, clinical septicemia, and pulmonary edema. It is advised that blood and uterine cultures should have been obtained when the patient presented with septic shock. Disadvantages of this technique of abortion include 1) excessive times to abortion, 2) frequent need for a 2nd procedure, and 3) and a high incidence of complications.
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PMID:Death after legal abortion by catheter placement. 90 Jan 61

The following conclusions were derived from the data on obstetric and gynaecological and urologic morbidity and mortality caused by infection:--A law enacted in 1972, legalising abortion within the first twelve weeks of gestation, changed the proportion of legally induced abortions to all other types of abortion. As the law largely prevents illegally induced abortion, substantial decreases occured in the number of cases of postabortal sepsis and in the mortality from abortion.--In spite of a steady decline, pueral sepsis still accounts for a significant proportion of the maternal mortality. It occurred predominantly after Caesarean section.--Despite its relatively low current morbidity rate, the possible effect of puerperal mastitis should not be neglected.--The high incidence of urinary tract infections calls for wellbalanced, but effective preventive, diagnostic and therapeutic action.
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PMID:[Morbidity and mortality due to infection in the obstetrico-gynecological field]. 91 65

A comparative histologic study of plancentas aborted after infusion of hypertonic saline or prostaglandin F2alpha into the amniotic cavity toinduce abortion is presented. Five placentas from spontaneous abortions served as controls. Saline abortion produced edema of the membranes; congested,dilated, thrombotic blood vessels; and subchorionic necrosis. Prostaglandin did not produce edema, but created marked vasospasm as evidenced by thickened vessels without subchorionic necrosis. The absence of serious sepsis and defibrination in prostaglandin-induced abortions is probably related to the absence of tissue necrosis.
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PMID:A histologic study of the placentas of patients with saline- and prostaglandin-induced abortion. 94 Jun 54

Actinobacillus equuli was isolated from an aborted porcine fetus. Fetal lesions of peracute embolic septicemia were similar to those seen in septicemic actinobacillosis of older swine and other species. This case represented an individual rather than a herd abortion problem.
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PMID:Porcine abortion caused by Actinobacillus equuli. 96 91


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