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

This study was conducted in a subdivisional hospital of eastern Himalayan region among 5,273 pregnant women over a period of 8 years. There were 29 deaths, the maternal mortality rate was 55 per 10,000. Septic abortion was encountered in 4 among them. Direct obstetric cause was responsible in 72.41% of cases and indirect cause in 27.59% cases. Sepsis, both puerperal and postabortal resulted in 24.14% followed by postpartum haemorrhage in 20.69%. Two of these cases were associated with inversion of the uterus. Preeclampsia caused 10.34% and eclampsia 6.9% of the deaths. Among the indirect causes severe anaemia and pulmonary tuberculosis accounted for 10.34% and 6.9% respectively. Infective hepatitis was the cause in 6.9% cases. Only 17% of the cases were booked and the rest were unbooked. Majority of the cases (62.07%) belonged to the age group of 20-30 years. Primigravida constituted 41.38% of the cases.
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PMID:Maternal mortality in a subdivisional hospital of eastern Himalayan region. 151 13

A retrospective analysis of 95 deaths due to abortion at the Kenyatta National Hospital between 1974 and 1983 showed that the average death rate over the 10-year period was high: nearly three deaths per 1000 abortion admissions. The mean hospital stay was 12 days. Of the 95 abortions 76 (80%) were induced or were likely to have been induced. Septic abortion with its complications accounted for 97.4% of the deaths from induced abortion. Among the deaths from spontaneous abortion, 52.6% were due to haemorrhagic shock compared to 47.4% due to sepsis. In this study 76.9% of the deaths occurred among women who were widowed, divorced or unmarried. Adolescents (age 19 or younger) accounted for 23 (24.2%) of the deaths. In this latter group there was evidence of interference in 22 (95.7%).
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PMID:Mortality due to abortion at Kenyatta National Hospital, 1974-1983. 387 61

Abortion-related deaths, which account for 47% of total maternal mortality in the world, result primarily from sepsis and are widespread in developing countries where abortion is illegal or inaccessible. Septic abortion offers opportunities for prevention on the primary, secondary, and tertiary level of medial care. Primary prevention of septic abortion encompasses the provision of effective contraception, provision of safe and legal abortion in cases of contraceptive failure, and appropriate medical management of abortion. Secondary prevention involves the prompt diagnosis of endometriosis and effective treatment to avert more serious infection. The diagnosis of septic abortion should be considered when women of reproductive age present to health facilities with vaginal bleeding, lower abdominal pain, and fever. Tertiary prevention is aimed at avoiding the serious complications of postabortal infection, including hysterectomy and death. Women with high fever, pelvic peritonitis, and tachycardia should undergo uterine evacuation and parental antibiotic therapy. Supportive care for cardiovascular system and other organs may be essential. The medical technology needed to avert serious complications and deaths from septic abortion is available. Lacking is a political commitment on the part of many governments and health care agencies to address this avoidable contributor to maternal morbidity and mortality.
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PMID:Septic abortion. 802 46

The causes and clinical course of 136 cases of acute renal failure (ARF) consecutively treated in the Renal Unit of Tikur Anbessa Hospital, Addis Abeba, Ethiopia, between January 1989 and December 1992 are described. There were 106 women and 30 men with mean age of 26.9 +/- 7.2 and 40.7 +/- 14.9 years respectively. Septic abortion is still the leading cause of ARF (71 patients) followed by falciparum malaria (29 patients) and nephrotoxic agents (12 patients). One-hundred-seventeen patients (86%) required dialysis. The overall case fatality rate was 33.8%, with similar mortality rates in septic abortion (36.6%) and falciparum malaria infection (37.9%), but a much lower rate (16.7%) in acute renal failure secondary to nephrotoxic agents. Septicaemia and pneumonia were leading causes of death. Derangement of liver function was associated with higher mortality rates in patients with septic abortion and malaria, whereas leukocytosis was found to be a poor prognostic finding in the latter. Non-oliguric ARF was seen in 33.8% of cases and was found commonly in patients with malaria (75.9%) or in nephrotoxin-induced ARF (83.8%). Mean duration of oliguria was 18.9 +/- 11 days. Compared to the previous report from the same centre, this larger series identified important clinical settings other than septic abortion which predispose to ARF. As renal function tests are not performed routinely in many Ethiopian hospitals and as many patients have non-oliguric ARF, cases may be being missed. Measures to prevent septic abortion and malaria, and the judicious use of nephrotoxic agents, may decrease the incidence of ARF.
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PMID:Acute renal failure in Addis Abeba, Ethiopia: a prospective study of 136 patients. 803 81

We present 2 cases of maternal mortality after transabdominal amniocentesis performed during the 2nd trimester of pregnancy. In both these cases, blood cultures revealed Escherichia coli. Broad-spectrum intravenous antibiotic treatment started immediately after admission to the hospital did not change the rapid progression of the disease. Despite evacuation of the uterus within <10 h from the diagnosis of septic abortion and transfer to the intensive care units to treat multiorgan failure, these patients died. Septic abortion and septic shock following transabdominal amniocentesis are very rare; however, they carry a serious risk to the patients' life. The combination of fever and leukopenia several days after amniocentesis should alert the physician to the evolution of sepsis. Because of the risk involved, information given to the patient prior to amniocentesis should refer to possible fetal complications and to the remote possibility of maternal risks as well.
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PMID:Maternal mortality following diagnostic 2nd-trimester amniocentesis. 1476 70

The present study was undertaken at a rural medical institute in India to analyse the trends in maternal mortality due to sepsis and the factors associated with change, if any. During the study period of 20 years, a total of 37,155 women delivered, 192 deaths occurred and forty deaths (20.83%) were due to sepsis and it's sequlae. It was revealed that there is a definite decrease in the proportion of deaths due to sepsis, to 10% in the last five years from 35% in earlier years. The change seems to be due to the advocacy of clean deliveries and reduction in case fatality because of alterations in medication and earlier surgical intervention. However the percentage contribution of septic abortion has remained the same. Septic abortion continues to exist inspite of all the current laws and discussion about the availability of a liberal law, which permits abortion almost on request. Most of the women who had died due to septic abortion were married (65%). Deaths due to septic abortion, are persisting even in married women and it is a matter of concern for health providers, policy makers and governments.
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PMID:Reduction in maternal mortality due to sepsis. 1581 92

Septic abortion represents the main causes of abortion-induced maternal death. Hysterectomy may represent a beneficial therapeutic solution for septic abortion, nevertheless with irreversible effects on a woman's reproductive condition. The study analyzes the anatomopathological damage found in ninety-one patients hospitalized for septic abortion. The patients were admitted to the "Dr. D. Popescu" Clinical Hospital, Timisoara, between 1980-1989 and 1999-2008; hysterectomy was performed in all the cases to eliminate uterine sepsis responsible for the emerging complications.
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PMID:Utero-adnexal damage in septic abortion. Histopathological study on 91 cases. 1994 62

The spectrum of kidney disease occurring during pregnancy includes preeclampsia, hypertensive disorders of pregnancy, urinary tract infection, acute kidney injury, and renal cortical necrosis (RCN). Preeclampsia affects approximately 3-5% of pregnancies. We observed preeclampsia in 5.8% of pregnancies, and 2.38% of our preeclamptic women developed eclampsia. Severe preeclampsia and the eclampsia or hemolysis, elevated liver enzymes levels, and low platelets count (HELLP) syndrome accounted for about 40% of cases of acute kidney injury (AKI) in pregnancy. Preeclampsia/eclampsia was the cause of acute renal failure (ARF) in 38.3% of the cases. Preeclampsia was the most common (91.7%) cause of hypertension during pregnancy, and chronic hypertension was present in 8.3% of patients. We observed urinary tract infection (UTI) in 9% of pregnancies. Sepsis resulting from pyelonephritis can progress to endotoxic shock, disseminated intravascular coagulation, and AKI. The incidence of premature delivery and low birth weight is higher in women with UTI. The incidence of AKI in pregnancy with respect to total ARF cases has decreased over the last 30 years from 25% in 1980s to 5% in 2000s. Septic abortion-related ARF decreased from 9% to 3%. Prevention of unwanted pregnancy and avoidance of septic abortion are key to eliminate abortion-associated ARF in early pregnancy. The two most common causes of ARF in third trimester and postpartum periods were puerperal sepsis and preeclampsia/HELLP syndrome. Pregnancy-associated thrombotic thrombocytopenic purpura/hemolytic uremic syndrome and acute fatty liver of pregnancy were rare causes of ARF. Despite decreasing incidence, AKI remains a serious complication during pregnancy.
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PMID:The kidney in pregnancy: A journey of three decades. 2308 48