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

One hundred forty-three cases of septic abortion managed over 5 years are reviewed. Sepsis was more common after induced abortion often performed by non-gynecologists. Instrumentation was commonly performed in the homes, chemists and poorly equipped private clinics. Complications were generally severe and maternal mortality was 8.4%. Treatment was individualized but there was no standard antimicrobial regime.
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PMID:Septic abortion at University College Hospital, Ibadan, Nigeria. 168 13

Eight-two bovine Pasteurella haemolytica strains were serotyped. The majority of the strains were isolated from calves which had died from fibrinous pneumonia and small numbers from cases of pleuritis, sepsis and abortion. A total of eight different serotypes were noticed. Serotype A1 was found to be the most prevalent 37.8 per cent, followed by serotype A2 with 20.7 per cent. Antibiotic resistance was found for sulfonamide, tetracycline and penicillin in about half of all strains. Conventional combination of biotype to serotype per strain was not confirmed by the results of arabinose and trehalose fermentation.
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PMID:[Pasteurella haemolytica serotypes in cattle]. 173 33

Maternal mortality is examined from June 1980 to December 1986 at Mulago, Nsambyo, Old Kampala, Rubaga, and Mengo Hospitals in Kampala, Uganda. Clinical or immediate causes, direct and indirect, were recorded from case summary forms based on ICD9 definitions of obstetric complications. The nonabortion maternal mortality rate (NAMMR) was 2.65/1000 deliveries (580 deaths); the abortion-related maternal mortality rate (ARMMR) was 3.58/1000 abortions. The hospital maternal mortality rate was 2.0/1000 deliveries. 75% of maternal deaths of women of 28 weeks' gestation or more had delivered outside the hospital. NAMMR doubled between 1980-86, a statistically significant increase. ARMMR increases were almost significant. 75% were direct obstetric and 21% were indirect obstetric causes. 38% had clinical anemia, 29% had some sepsis, 18% had substantial bleeding, and 14% had obstructed labor. Other contributing conditions were pneumonia, ruptured uterus, laparotomy, evacuations and curettage, malaria, preeclampsia, sickle cell anemia, pulmonary embolism, malnutrition, tetanus, meningitis, prolonged labor, and hepatitis. At admission, 48% were in poor condition, 30% in good condition, and 22% in fair condition. 27% had sickle cell anemia, high blood pressure, multiple pregnancy, or malaria at admission. 64% were admitted within 24 hours after delivery, 67% 1-7 days after delivery, and 92% 7-42 days after delivery. Those in good condition were all admitted 7 days postdelivery. 41% of deaths were due to lack of drugs, 7% lack of fluids, 20% with theater problems, 14% with doctor-related factors, and 3% with midwife-related factors. Better information is needed on mortality before delivery, mortality in hospitals vs. outside, and mortality from abortion, and ectopic and hydatidiform molar pregnancies. An explanation given for the increase in maternal mortality is the decline in economic conditions. Abortion complications may be due to the concealment practiced. Causes are consistent with trends from the 1950s, 1960s, and 1970s in Uganda and developing countries in general. Availability and accessibility of gynecological and obstetric services needs great improvement. Training traditional birth attendants and obtaining rural ambulance services are also needed. Health workers lack creativity and imagination for developing country conditions; scarce resources are not the only problem.
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PMID:Incidence and causes of maternal mortality in five Kampala hospitals, 1980-1986. 176 15

In this commentary, the impact of the introduction of manual vacuum aspiration (MVA) for incomplete abortion patients and for early uterine evacuation is discussed for the University Teaching Hospital in Lusaka, Zambia. This 3-year training and service delivery program was begun in 1988 after it was clear that 15% of maternal deaths were due to illegally induced abortion. The prior procedure of dilation and curettage (D and C) required use of the main operating room and general anesthesia, which resulted in severe congestion and treatment delays. As a result of the new MVA procedure, congestion has decreased substantially, treatment is safer and more timely, and the staff's ability to provide abortions has increased. Family planning counseling is provided to postabortion patients in a more thorough fashion, and the savings in time has improved the quality of patient-staff interactions. Specifically, the patient flow has improved from a 12-hour wait to a 4-6 hour wait and rarely requires overnight hospitalization. The demand for the main operating room had decreased which frees space, time, and commodities for other gynecological treatment. The shorter procedure and release time means a minimal loss of earnings and productivity, and allows for greater privacy in explaining absences to families, schools, or employers. The improved quality of are is reflected in the figures for number treated, i.e., in 1989, 74% were treated with MVA for incomplete abortion 12 weeks and pregnancy termination 8 weeks compared with 26% treated with D and C. In 1990, the figures were 86% with MVA and 14% with D and C. The likelihood of complications from hemorrhage and sepsis have also been reduced. The MVA procedure is also less traumatic for the patient. The increased access to safe legal abortion services is reflected in the ratio of induced to incomplete abortions between 1988-1990 (1:25 to 1:5). Family planning counseling is provided by a full-time counselor who counsels preabortion and postabortion and schedules 2-week follow-up appointment. These achievements have been made in spite of a declining economy and difficulties in the health sector. Unfortunately, conditions throughout Zambia are such that access to safe abortion is restricted. Effort is underway to expand this MVA training and service delivery in provincial hospitals and to conduct research on other effective strategies to reduced unsafe abortion and improve family planning care.
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PMID:Improving abortion care in Zambia. 179 79

Maternal mortality in the USSR in 1988 stood at 43/100,000 population. this figure broke down into mortality from ectopic pregnancy (5%); from induced and self-induced abortion (29.1%); and, from 28 weeks of gestation, mortality from births as well as during the postpartum period (65.9%). Prior to 1991, in 3 years 2020 women died of abortion-related causes, 76.7% of them in connection with non-medical abortions. The original medical documentation of 342 women who died of abortion was analyzed. 69.6% of the women died in connection with non-medical abortion. 72.6% of these women died during the period of 13-27 weeks of gestation. It was especially noteworthy that 58.8% of the women died in cases where their pregnancy was up to 12 weeks of duration and termination of pregnancy could have been performed. Contributory factors were intervention with the purpose of abortion outside of a medical facility, belated provision of medical help, and inadequate equipment at the medical facility. 78/1% of the deaths of non-medical abortions were caused by introduction of catheters or solutions into the uterine cavity and by the opening of the fetal sack through the use of drugs. 32 women carried out the intervention themselves, and 34 were done by strangers, including 18 medical personnel. Sepsis and peritonitis caused 88.6% of the deaths, and hemorrhage caused 6.7%. After induced medical abortions, 44.2% of women died from peritonitis and sepsis, 17.4% from extragenital diseases, and 26.9% from other causes. Only 22.7% of the cases were selected as case studies for medical conferences. Measures regarding the lowering of mortality from abortions have to be directed primarily at the prevention of non-medical or criminal abortions.
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PMID:[The organizational aspects of reducing mortality from abortions]. 181 18

The causes (medical, reproductive factors, health care delivery system, and socioeconomic factors) of maternal mortality in India and strategies for reducing maternal mortality are presented. Maternal mortality rates (MMR) are very high in Asia and Africa compared with Northern Europe's 4/100,000 live births. An Indian hospital study found the MMR to be 4.21/1000 live births. 50-98% of maternal deaths are caused by direct obstetric causes (hemorrhage, infection, and hypertensive disorders, ruptured uterus, hepatitis, and anemia). 50% of maternal deaths due to sepsis are related to illegal induced abortion. MMR in India has not declined significantly in the past 15 years. Age, primi and grande multiparity, unplanned pregnancy, and related illegal abortion are the reproductive causes. In 1985 WHO reported that 63-80% of maternal deaths due to direct obstetric causes and 88-98% of all maternal deaths could probably have been prevented with proper handling. In India, coordination between levels in the delivery system and fragmentation of care account for the poor quality of maternal health care. Mass illiteracy is another cause. Effective strategies for reducing the MMR are 1) to place a high priority on maternal and child health (MCH) services and integrate vertical programs (e.g., family planning) related to MCH; 2) to give attention to care during labor and delivery, which is the most critical period for complications; 3) to provide community-based delivery huts which can provide a clean and safe delivery place close to home, and maternity waiting rooms in hospitals for high risk mothers; 4) to improve the quality of MCH care at the rural community level (proper history taking, palpation, blood pressure and fetal heart screening, risk factor screening, and referral); 5) to improve quality of care at the primary health care level (emergency care and proper referral); 6) to include in the postpartum program MCH and family planning services; 7) to examine the feasibility of a national blood transfusion service network; 8) to improve transportation; 9) to educate young girls on health and sex; 10) to informally educate the masses on MCH; 11) to focus obstetrics and gynecology training primarily on practical skills in management of labor and delivery; 12) to research reproductive behavior; and 13) to assure every women the right to safe motherhood.
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PMID:Maternal mortality in India: current status and strategies for reduction. 181 58

In 1987-1989, researchers interviewed 192 adolescents admitted to University of Ilorin Teaching Hospital (UITH) in Nigeria for septic illegal abortions to determine the sociocultural factors of septic illegal abortions among adolescents and the effects of these abortions on the population. The 2 major complications resulting in the patients being admitted to UITH were hemorrhage (42.2%) and septicemia (30.7%). The abortion rate at UITH stood at 94.6/1000 deliveries representing an increase. Adolescents made up 74.4% of all induced abortions which accounted for 60.3% of all gynecological admissions. Most patients (72.5%) were between 15-19 years old. Just 12.5% lived with both parents--an example of the break down of the family which traditionally prepared children for integration into adult society. 81.3% had a primary education, but only around 30% of parents had a primary education. School officials expelled 50% of the patients thereby making expulsion from school the leading social consequence of adolescent septic illegal abortion. Indeed neither the education system nor the family were prepared to teach family life education to prevent these unwanted pregnancies. In Nigeria, since abortion is considered immoral, the adolescents had little choice but to seek a clandestine abortion. Moreover, many adolescents were poor so they opted for free abortion services which were often provided by charlatans. A shift from a rural society to an urban society also contributed to an increase in abortions. The government must emphasize maternal and child health services, especially liberalization of abortion. Further, it must make family planning education and services available to adolescents. In addition, the mass media should be exploited to spread information about the adverse consequences of adolescent illegal abortions.
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PMID:Socio-cultural factors in adolescent septic illicit abortions in Ilorin, Nigeria. 190 23

In comparison to normal controls, the non-sporing anaerobes were often isolated from orodental sepsis (42% to 44.4%), chronic suppurative otitis media (40%), septic abortion (40.3%), uterocervical wound (45.4%), vaginitis (50%) and cancer cervix (50%). This was true (40%) in perforating ulcers of foot in leprosy. These organisms were less frequently noted in abdominal (11%) and episiotomy (22.8%) wounds and leucorrhoea (33.3%). The role of non-sporing anaerobes was also suggested by the high percentage ratio of number of isolates to number of cases and by its primary isolation in moderate to heavy number. Barring the cases of cancer cervix, the aerobic bacteria were the most common (78.8% to 100%) in all other conditions.
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PMID:Non-sporing anaerobes in hospital sepsis. 194 Apr 15

The gram-positive bacterium Listeria monocytogenes is an ubiquitous, intracellular pathogen which has been implicated within the past decade as the causative organism in several outbreaks of foodborne disease. Listeriosis, with a mortality rate of about 24%, is found mainly among pregnant women, their fetuses, and immunocompromised persons, with symptoms of abortion, neonatal death, septicemia, and meningitis. Epidemiological investigations can make use of strain-typing procedures such as DNA restriction enzyme analysis or electrophoretic enzyme typing. The organism has a multifactorial virulence system, with the thiol-activated hemolysin, listeriolysin O, being identified as playing a crucial role in the organism's ability to multiply within host phagocytic cells and to spread from cell to cell. The organism occurs widely in food, with the highest incidences being found in meat, poultry, and seafood products. Improved methods for detecting and enumerating the organism in foodstuffs are now available, including those based on the use of monoclonal antibodies, DNA probes, or the polymerase chain reaction. As knowledge of the molecular and applied biology of L. monocytogenes increases, progress can be made in the prevention and control of human infection.
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PMID:Listeria monocytogenes, a food-borne pathogen. 194 98

Even though the isolation rate of Candida species in the vagina stands at 30% during pregnancy, only 8 cases of candida sepsis connected with pregnancy were documented as of early 1991. Effective antifungal treatment began in 1956 and the 1st reported case was in 1954. She and the next 2 cases (1962 and 1971) did not recover. Possible predisposing factors in the 8 cases included antibiotic treatment, especially those in the beta lactam group; and IUD in situ; and intravenous (IV) line; or a urinary catheter. (Presumably antibiotics encourage C. albicans growth and pathogenicity. Foreign objects provide a portal of entry or a foothold for Candida.) In fact, a combination of these factors probably fostered candida sepsis in 4 cases. The 4 mildest cases experienced fever and impaired liver functions or reduced vision. 1 case had a hysterectomy. 2 had generalized convulsions. The 4 more severe cases experienced pneumonia, acute renal failure, osteomyelitis, or shock. In Haifa, Israel, physicians admitted a 24 year old woman with a fever to the Bnai Zion Medical Center for a presumed septic abortion at 15 weeks gestation. They performed a dilation and curettage (D&C) which included removal of an IUD. Laboratory personnel cultured the contents and later blood since her temperature rose .7 degrees. They started IV antibiotic treatment to no avail. Later her temperature hit 40 degrees Celsius and on day 5 she had convulsions. 1 blood sample and D&C materials grew C. albicans. They also observed multiple chorioretinal cotton wool lesions typical of Candida. They changed her medication to the antifungal medication, amphotericin B. Before discharge, they also prescribed 5-fluorocytosine. She had decreased hearing in the right ear, many hot spots over the iliac crests and thoracic vertebrae, and almost complete destruction of the body of D7 in the spine. She completely recovered.
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PMID:Candida sepsis in pregnancy and the postpartum period. 201 14


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