Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute renal failure of obstetric origin is common among North Indian patients and comprised 72 (22.1%) of 325 patients undergoing dialysis over an 11-year period. Of these, 46 gravidas had developed renal failure following abortion, and 29 cases were due to complications of late pregnancy. The most striking feature of this study was a high incidence of irreversible renal lesions of bilateral diffuse cortical necrosis in early (18.6%) as well as late pregnancy (37.8%). Overall incidence of diffuse cortical necrosis was 25%. In the remainder, acute tubular necrosis was seen in 52 (72.2%), patchy cortical necrosis in 1 (1.4%), and tubular necrosis along with glomerular involvement in 1 patient (1.4%). Pathogenetic factors which contributed to the development of renal failure, either singly or in combination, were loss of blood failure, either singly or in combination, were loss of blood (79.1%), septicemia (31.9%), hypotension due th hemorrhagic and septicemic shock (51.4%), eclamptic toxemia (11.1%), and disseminated intravascular coagulation in 12.5% patients. Infrequent occurrence of disseminated intravascular coagulation in the septic anc eclamptic patients who developed diffuse cortical necrosis was an interesting finding, as was the fact that coagulopathy was more frequently observed in acute tubular necrosis. Late referral, frequent sepsis, and high incidence of bilateral diffuse cortical necrosis contributed significantly to a high mortality (55.3%).
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PMID:Acute renal failure of obstetric origin. 108 92

A series of 100 consecutive patients seeking pregnancy termination in pregnancy weeks 7-20 were treated with a schedule of 20-mg vaginal suppositories containing prostaglandin E2 (PGE2); the schedule was being tested for its efficacy, specifically reduction of total dose and related side effects. 94 of the 100 patients were aborted within an arbitrary time span of 36 hours. Total drug dose ranged from 40-160 mg. 31 patients received augmentative intravenous oxytocin. Induction-abortion interval varied from 6-32.5 hours. Of the 97 successes, 76 were classified as complete abortions. No significant differences were noted in midtrimester groups based on increasing parity, although parous patients in gestation week 13-15 seemed to have the best results, based on average interval time. No sepsis or need for transfusion was encountered. Side effects were emesis (n-75), diarrhea (n=17), and drug fever (n=66); less frequent side effects included headache, breast tenderness, and vasomotor symptoms (n=13, 1, and 1, respectively). The midtrimester patient results compared favorably with results of studies using saline for abortifacient. The number of first trimester patients was too small to yield any conclusion.
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PMID:Vaginally administered prostaglandin E2 as a first and second trimester abortifacient. 111 58

Thirty-one consecutive pregnant women with intrauterine contraceptive devices in situ were studied. The devices consisted of the coil, loop, or bow. The pregnancies showed a high incidence of abortion, ectopic pregnancy, premature labor, premature rupture of the membranes, sepsis, and hemorrhage. Associated with these maternal complications was a high incidnece of fetal wastage. A recommendation is made for early interruption of the pregnancy.
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PMID:Complications of pregnancy with an intrauterine contraceptive device in situ. 111 56

An alarming number of recent reports concern the Dalkon shield and development of septic abortions in women who become pregnant while wearing this IUD. The manufacturers of the shield, A. H. Robins Ltd, stated in a letter that out of 36 second-trimester septic abortions in the USA there were 4 maternal deaths. On the other hand, the Food and Drug Administration has reported 209 septic abortions associated with Dalkon shields with 11 maternal deaths. Usage in the past 3 years is 1.3 million and yields an incidence for septic abortions with the IUD of about 1:6500 women. The manufacturer's publicized failure rate (1.1%) compares with much higher failure rates from other studies such as 2.6% pregnancy rate for 479 nulliparous women and 1.5% failure rate in 2730 multiparous women. An unpublished report from the United Kingdom reported a 2.8% pregnancy rate in 4191 shield users. A paper presented at an International Family Planning Research Association meeting reported that such a high failure rate in the Dalkon shield resulted in its withdrawal from a Florida State Public Health Family Planning Program. A rate of 1 septic abortion per 70 women who become pregnant with a Dalkon shield gives an idea of sepsis risk and should influence policies regarding termination for IUD failures.
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PMID:Letter: Dalkon shield and septic abortion. 112 73

The recent report of 209 cases of septic spontaneous abortion and 11 maternal deaths in the United States in women using the Dalkon Shield intrauterine device (IUD) raised the question about a possible causal relationship between the IUD and pelvic sepsis. It is essential to determine whether or not this sipsis is unique to the Dalkon Shield or generic to all types of IUDs. Our studies permit the conclusion that the tail of the Dalkon Shield is structurally and functionally different from the tails of the four other IUDs tested. The unique characteristics of the Dalkon tail theoretically could provide a mechanism whereby pathogenic bacteria from the vagina enter the uterine cavity and cause sepsis.
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PMID:The Dalkon Shield controversy. Structural and bacteriological studies of IUD tails. 117 60

4 maternal deaths from abortion that took place during the 6-year period from March 1968 to February 1974 in the University Hospital, Kuala Lumpur are reviewed with focus on the avoidable causes and preventive aspects. The total maternal deaths from all causes for the 1699 admission was 13. The mortality rate from abortion during this period was 0.241/1000 pregnancies. The number of abortion cases admitted into the hospital during the 6-year period increased steadily. Of the 4 abortion deaths, 3 patients admitted to attempts at inducing abortion. 1 patient denied having induced abortion, although her husband felt that it could have occurred. All 4 cases of abortion deaths occurred in patients with septic abortions and were, theoretically, avoidable deaths. It is most important to prevent sepsis in a case of abortion. Patients with endotoxic shock are often given intravenous steroids in pharmacological doses every 4-6 hours.
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PMID:Maternal mortality from septic abortions in University Hospital, Kuala Lumpur from March 1968 to February 1974. 120 33

After a criminal abortion, a 21-year-old woman developed clostridial sepsis, massive hemolysis, shock, and protracted renal failure. Anuria was present for 3 weeks and hemodialysis was required for 35 days. Because of the prolonged anuria, the patient was thought to have irreversible renal cortical necrosis. A renal biopsy demonstrated tubular necrosis only. Shortly after the biopsy procedure, urinary volumes began to increase, and renal function gradually returned to normal levels. This case demonstrates that a protracted course of renal failure following clostridial infection is not necessarily due to cortical necrosis but may result from tubular necrosis, and renal function may return to normal.
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PMID:Recovery after prolonged anuria following septic abortion. 124 89

An evaluation of maternal mortality statistics in California from 1967-1971 has been performed. There has been a fall in the maternal mortality rate following the institution of a therapeutic abortion act. However, analysis of the data reveals that there was an increase in the deaths due to hemorrhage and sepsis. At this same time the maternal mortality study committee was discontinued. It is strongly felt that the data demonstrate the need for a continuing review of maternal deaths. A proposal is made to redesign the maternal mortality study committee so that it can fully meet the needs of the medical profession and the patient.
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PMID:Maternal deaths in California from 1967 to 1971. A demonstration of the need for mortality review. 127 29

Eighteen cases of alloimmune neonatal neutropenia (ANN) were analysed for their clinical and serological properties. Pregnancy was normal in all cases, but a 50% incidence of abortion is recorded. With the exception of two premature babies, all newborns were delivered at term. Omphalitis and mild infections of the skin were predominantly present. None of the new-borns died by overwhelming sepsis. The average duration of neutropenia was 11 weeks (range 3-28 weeks). Intravenous IgG therapy was followed by transient remission in 2 of 4 affected newborns. Antibody differentiation revealed in five sera NA1-, in four sera NA2- and in two sera NB1-specific antibodies. In two sera only HLA antibodies were detectable. Complement activating antibodies were determined in 72% of the sera. Screening for granulocyte-specific antibodies in 1016 postpartum sera of unselected women revealed a total of 11 sera (1.1%) reacting selectively with granulocytes, but only four (0.4%) were directed against a known granulocyte-specific antigen. None of the new-born of mothers alloimmunized to granulocyte antigens developed neutropenia, which suggests an incidence of ANN below 0.1%.
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PMID:Serological and clinical aspects of granulocyte antibodies leading to alloimmune neonatal neutropenia. 128 78

In September 1989 in Thyolo district in southern Malawi, 5 field teams used the Sisterhood Method to interview 4124 people older than 15 in 7 traditional authorities to estimate the lifetime risk (LTR) of maternal death and the maternal mortality ratio (MMR) in this area. The teams also administered an in-depth questionnaire to respondents who knew about 140 of the 150 maternal deaths to determine the causes of maternal death. The LTR of maternal death stood at 1 in 36 (1/.0282). The MMR was 409/100,000 live births. 22% of all maternal deaths occurred within the last 5 years. The field team was able to accurately determine the cause of death in 98 (65%) cases. The leading causes of death were excess hemorrhaging (25%), obstructed labor (20%), abortion (18%), sepsis (13%), cesarean section (7%), and eclampsia (4%). 56% of all reported maternal deaths and 45% of maternal deaths within the last 5 years occurred outside a health facility. 99% of maternal death cases did not receive medical attention while their health deteriorated because the health facility was far away and therefore not accessible or there was no way to transport the women to the health facility. 87% of abortion-related deaths took place outside a health facility as did 67% of eclampsia cases, 56% of hemorrhage cases, 50% of obstructed labor cases, and 47% of sepsis cases. These findings should prove useful to community and health leaders in designing intervention strategies to reduce maternal mortality in the area. Further, key locations should have adequate transportation, e.g., bicycle ambulances of stretchers, to transport pregnant women to a primary or referral center.
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PMID:Maternal mortality in the Thyolo District of southern Malawi. 129 32


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