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

The number of cesarean births for dystocia has increased dramatically in the United States. Central to the management of dystocia is correction of ineffective labor by oxytocin administration, and contemporary obstetric practice is to stimulate labor with a low-dose oxytocin regimen. We prospectively compared a low-dose oxytocin regimen (1-mU/minute dosage increments) with a high-dose regimen (6-mU/minute dosage increments) in 2788 consecutive singleton cephalic pregnancies. The low-dose regimen was used first for 5 months in 1251 pregnancies, and the high-dose regimen in 1537 pregnancies during the subsequent 5 months. Indications for oxytocin stimulation were divided into augmentation (N = 1676) and induction (N = 1112). Labor stimulation was more than 3 hours shorter (P less than .0001) with the high-dose oxytocin regimen and associated with a reduction in neonatal sepsis (0.2 versus 1.3%; P less than .01). Uterine hyperstimulation was more common (55 versus 42%; P less than .0001) with the high-dose regimen, but no adverse fetal effects were observed. High-dose augmentation resulted in significantly fewer forceps deliveries (12 versus 16%; P = .03) and fewer cesareans for dystocia (9 versus 12%; P = .04). Similarly, failed induction was less frequent with high-dose compared with low-dose oxytocin (14 versus 19%; P = .05). Although the high-dose induction regimen was associated with a significantly increased cesarean incidence for fetal distress (6 versus 3%; P = .05), the incidence of umbilical artery cord blood acidemia was not increased in this subset. Induction of labor with high-dose oxytocin is problematic because of risk-benefit considerations. Although induction failed less frequently with the high-dose regimen, cesarean for fetal distress was performed more frequently. In contrast, high-dose oxytocin to augment ineffective spontaneous labor minimized the number of cesareans done for dystocia.
 ...
PMID:High- versus low-dose oxytocin for labor stimulation. 160 79

From 1980 to 1989, 8 cesarean sections were performed on an elective basis in 5 mares. Four mares had partially obstructed pelvic canals; 2 of these mares had previously lost foals because of dystocia. Cervical adhesions that might obstruct passage of the fetus through the pelvic canal was suspected in the fifth mare. Cesarean section was performed prior to mares entering the first stage of labor. Readiness for birth was estimated by development of the mare's mammary gland and the presence of colostrum in the udder. A ventral midline celiotomy provided excellent exposure and healed without complications in all instances. Eight viable foals were produced. One foal developed bacterial pneumonia and septicemia after surgery and died. Follow-up evaluation of the 7 foals discharged from the hospital failed to reveal complications associated with elective cesarean section. All mares survived the procedure. Fetal membranes were retained for up to 72 hours following surgery; however, systemic complications secondary to retained placenta did not develop. Three mares were bred subsequent to elective cesarean sections, with each mare conceiving the year following surgery. Three foals were produced by 1 mare and 2 foals have been produced by another mare by elective cesarean sections.
 ...
PMID:Elective cesarean section in mares: eight cases (1980-1989). 227 66

The periodicity of morbidity rate in heifers and dairy cows kept on pasture (278 animals) and in stables (187 animals) was studied in relation to macroclimatic conditions under the assumption of two peaks per annum. The following conditions were used as the parameters of morbidity: purulent inflammations of uterus, sterility, lesions of the female tract and sepsis, dystocia, retention of placenta, mastitis, foot diseases and lying down after parturition. No significant differences were found between the studied groups of animals. A statistically significant up to highly significant dependence was found between the health of the heifers and cows and macroclimatic conditions both in stables and on pasture; an increase in morbidity rate was recorded in spring and autumn.
 ...
PMID:[Health status of cattle in relation to the time of year]. 641 43

During 15 years (1965 through 1979), 9,718 cesarean sections were performed at Hutzel Hospital. This report concerns the indications, incidence, morbidity, and mortality. Dystocia, fetal distress, and breech presentations were the most common indications for primary cesarean section. The incidence rose from 9.8% to 16.8% during this study. Forceps deliveries dropped from 47.5% to 12.0% and vaginal breech deliveries decreased from 86% to 35%. Spinal anesthesia was used in 90%. Caesarean section hysterectomies were performed in 128. The most common indications were carcinoma in situ of the cervix, uterine leiomyoma, and hemorrhage. Puerperal sepsis and urinary tract and wound infections were the major causes of morbidity. Perinatal mortality decreased from 40% to 29%. There were 10 maternal deaths. Sepsis was the major cause of death. At least four deaths could have been avoided if ultra-high-risk patients had not been pregnant in the first place.
 ...
PMID:Caesarean section: a 15-year review of changing incidence, indications, and risks. 722 16

A one-year retrospective study of cesarean section (CS) at Women and Infants Hospital of Rhode Island is reported. There were 5,467 women delivered, including 1,011 who delivered by CS, yielding a total CS rate of 18.5% and a primary rate of 13.4%. The four leading indications for primary CS were: dystocia (38.8%), breech presentation (14.9%), malposition (11.9%) and fetal distress (11.3%). Sepsis was responsible for 75% of the complications. The incidence of low-birth-weight infants was 14.2% for primary CS and 6.7% for repeat CS. The perinatal death rate was 21.2% per 1,000. The relationship of these findings to changing obstetric practice is discussed.
 ...
PMID:Cesarean section: a contemporary assessment. 737 98

In settings where most births occur at home, collection of data on complications experienced around the time of delivery is often dependent on self-reported data, collected through individual interviews. This paper describes a study designed to validate interview data on obstetric complications by comparing women's responses with data extracted from their medical records. The major complications of hemorrhage, dystocia, sepsis, and eclampsia were the main focus of the study. The sample was drawn from women hospitalized for delivery in a Manila hospital within the past 4 years. The main goal of the study was to assist in development of a survey instrument to be used in a national sample survey of women in the Philippines. The best sensitivity and specificity, respectively, for combinations of questions on these four conditions were: for hemorrhage, 0.70 and 0.78; for dystocia, 0.69 and 0.97; for sepsis, 0.89 and 0.83; and for eclampsia, 0.44 and 0.96. There were no significant differences in the duration of the recall periods according to diagnosis.
 ...
PMID:Validation study of women's reporting and recall of major obstetric complications treated at the Philippine General Hospital. 767 75

The purpose of this study was to determine the incidence of neonatal mortality in a large, extensively managed mare herd and what risk factors were involved in foal mortality. For a 6 wk period between April 18, 1994, and May 31, 1994, 334 foals were born, of which 74 died before reaching 10 d of age, giving an overall mortality of 22% for this period. Seventy four percent of the foal deaths occurred within 48 h of parturition. The major causes of foal mortality included starvation/exposure 27%, septicemia 26%, and dystocia 20%. Weekly incidences varied significantly, ranging from 67% for week 1 to 14% for week 5 (P < 0.01). Other risk factors that were associated with foal death included failure of passive transfer (P < 0.0001), poor mothering ability (P < 0.0001), the presence of dystocia (P < 0.0001), low birth weight (p < 0.05), lack of rainfall (P < 0.01), and low temperatures (P < 0.1). The effect of sire, mare age, mare body condition, and foal sex were not significant risk factors for foal survival (P > 0.1). Further studies are required to determine if changing management procedures will be effective in reducing the incidence of neonatal foal mortality in this extensively managed herd.
 ...
PMID:Risk factors associated with the incidence of foal mortality in an extensively managed mare herd. 864 Jun 55

This study examines the impact of the Maternal-Child Health and Family Planning (MCH-FP) program in the Matlab, Bangladesh. Data were obtained from the Matlab surveillance system for treatment and comparison areas. This study reports the trends in maternal mortality since 1976. The MCH-FP area received extensive services in health and family planning since 1977. Services included trained traditional birth attendants and essential obstetric care from government district hospitals and a large number of private clinics. Geographic ease of access to essential obstetric care varied across the study area. Access was most difficult in the northern sector of the MCH-FP area. Contraception was made available through family welfare centers. Tetanus immunization was introduced in 1979. Door-to-door contraceptive services were provided by 80 female community health workers on a twice-monthly basis. In 1987, a community-based maternity care program was added to existing MCH-FP services in the northern treatment area. The demographic surveillance system began collecting data in 1966. During 1976-93 there were 624 maternal deaths among women aged 15-44 years in Matlab (510/100,000 live births). 72.8% of deaths were due to direct obstetric causes: postpartum hemorrhage, induced abortion, eclampsia, dystocia, and postpartum sepsis. Maternal mortality declined in a fluctuating fashion in both treatment and comparison areas. Direct obstetric mortality declined at about 3% per year. After 1987, direct obstetric mortality declined in the north by almost 50%. After the 1990 program expansion in the south, maternal mortality declined, though not significantly, in the south. Maternal mortality declined in the south comparison area during 1987-89 and stabilized. The comparison area of the north showed no decline.
 ...
PMID:Decline in maternal mortality in Matlab, Bangladesh: a cautionary tale. 973 75

The incidence of dystocia from ewes in nine lambing periods (1992-2000) was recorded at an obstetrical clinic. First we analysed parturition difficulties in normal pregnant sheep (group 1, n = 229). In the second group parturitions of ewes with vaginal prolapse ante partum were investigated (n = 129). In group 1 maternal causes of dystocia occurred more often than fetal ones (50% maternal, 45% fetal). In maternal parturition difficulties ringwomb was the dominating reason (64%), while abnormal presentations, position and/or posture of the lambs occurred most frequently in fetal dystocia (67%). But there was no statistical influence of age and number of parturitions in both groups. The average of the first notice of prolapsed vaginal tissue was 11 days before lambing. There was a predominance in the affection of sheep at first and second pregnancy (52%). Only 26% of the group 2 sheep had a spontaneous delivery. In 58% of the cases a dystocia was diagnosed. A preterm caesarean section had carried out in 12%, five ewes died before parturition because of septicemia (4%). Sheep suffering from vaginal prolapse ante partum showed maternal caused dystocia significant more frequently than members of group 1 (p < 0.001), with ringwomb as dominating reason (70%). The number of born lambs was significant higher in group 2 than in group 1 (p = 0.019).
 ...
PMID:[Investigations about kind and frequency of mechanical dystocia in ewes with special regard to the vaginal prolapse ante partum]. 1217 20

In India, physicians analyzed data on 56 women (18-20 weeks gestation) at the Marie Stopes Clinic in Jodhpur who underwent pregnancy termination to evaluate the efficacy and safety of ethacriding lactate which has antiseptic properties. They injected 150 cc 0.1% ethacriding lactate into the intrauterine, extra-amniotic space. They used iv infusion of oxytocin to expedite the delivery of the abortus. 59% of cases were unmarried teenagers. Ethacridine lactate induced successful abortion in 92.8% (52) of cases which was much higher than that found in the literature (about 82%). Abortion failure occurred in the other 4 cases because of transverse lie of fetus (2), cervical dystocia (1), and uterine inertia (1). The transverse lie and cervical dystocia cases would have experienced failure regardless of the uterotonic abortifacient used. 3 of the failure cases underwent evacuation while the other underwent hysterotomy. Most women (73.2%) experienced the abortion 12-24 hours after induction. The mean interval was 20.1 house which was shorter than that of previous reports (29.5-38 hours). The shortest induction-abortion interval was 10.5 hours and the longest was more than 36 hours. Complications occurred in 6 (14.4%) cases. 3 (5.4%) women suffered from cervical tear. 3 (5.4%) women experienced incomplete expulsion which was much lower than that reported in the literature (16-30%). On the other hand, the 5.4% incomplete expulsion rate was higher than that for prostaglandin and hypertonic saline. There was 1 case each of severe bleeding and vaginal laceration. The antiseptic properties of ethacridine lactate likely accounted for the complete absence of sepsis in these women. In conclusion, ethacridine lactate performs better than other instillation abortion methods and it is a safe and effective method.
 ...
PMID:Ethacridine lactate -- a safe and effective drug for termination of pregnancy. 1231 89


1 2 Next >>