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

The intrauterine identification of fetuses at risk of developing intraventricular hemorrhage would be helpful to the perinatologist, in light of the recent results which suggest that indomethacin given to the infant reduces the risk of developing intraventricular hemorrhage. We hypothesized that fetuses undergoing brain sparing, as identified by a lowered pulsatility index (PI) in the middle cerebral artery, and delivered prior to 34 weeks may differ in terms of being at risk for intraventricular hemorrhage from those fetuses without the brain-sparing effect. The middle cerebral artery PI was studied in 43 fetuses between 25 and 33.6 weeks' gestation. The pregnancies were complicated by pre-eclampsia, intrauterine growth restriction (IUGR) and preterm labor. A cranial sonogram was performed during the first postnatal week in all the neonates. Intraventricular hemorrhage was present in 6/22 infants with a normal middle cerebral artery PI (group A) and 0/21 with an abnormal middle cerebral artery PI (group B) (p < 0.05). The mothers of the six fetuses who developed intraventricular hemorrhage underwent preterm labor. IUGR fetuses and pre-eclampsia were more common in group B. No difference was found between the two groups when the following variables were compared: (1) gestational age at the time of the Doppler study; (2) gestational age at delivery; (3) antenatal exposure to steroids; (4) antenatal exposure to magnesium; (5) Apgar score greater than 6 at 5 min; (6) respiratory distress syndrome in the newborn; (7) necrotizing enterocolitis; (8) Cesarean section; and (9) sepsis in the infant. Although the mean birth weight was significantly lower in group B than group A, no fetus in this group developed intraventricular hemorrhage. The fetal brain-sparing effect, pre-eclampsia and IUGR were associated with a lower risk of neonatal intraventricular hemorrhage than was preterm labor. Preterm labor appears to be a key factor in the development of intraventricular hemorrhage and must be included when testing associations with intraventricular hemorrhage.
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PMID:Is the fetal brain-sparing effect a risk factor for the development of intraventricular hemorrhage in the preterm infant? 923 32

In two pregnant women aged 39 and 35, who presented with fever and diarrhoea, Campylobacter was cultured from a blood sample. They were treated with antibiotics. One had a healthy neonate, in the other intrauterine foetal death had occurred. Campylobacter species have increasingly been recognized as possible causes of septic abortion, premature labour and neonatal sepsis. Early recognition and treatment of maternal Campylobacter infection may reduce the risk of serious foetal or neonatal complications.
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PMID:[Campylobacter infections in pregnancy]. 900 35

Preterm labor, cervical cerclage (especially when performed as an emergency procedure), and diabetes mellitus are all associated with an increased risk of chorioamnionitis. It might be expected that the combination of all 3 could lead to especially severe infection. We report such a case. A woman with a history of two spontaneous midtrimester abortions had had cervical cerclage performed at 13 weeks. She was referred at 24 weeks' gestation with preterm labor, and the cervix was found to be dilated. An emergency repeat cerclage was performed. The following day, ultrasonography revealed the presence of intra-amniotic gas. Infection was confirmed by the presence of a purulent cervical discharge, a neutrophilia with a left shift, and an elevated C-reactive protein level. The cervical stitch was removed and labor induced. The infant was liveborn, but succumbed to the complications of prematurity and sepsis. E. coli was isolated. In her subsequent pregnancy, severe gestational diabetes was diagnosed and following pregnancy, permanent diabetes mellitus was confirmed. The combination of infection, diabetes, and intact membranes may lead to a particularly severe form of chorioamnionitis, with the production of gas within the amniotic cavity. Infection should be excluded before emergency cervical cerclage, especially in the woman with diabetes mellitus.
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PMID:Emphysematous chorioamnionitis diagnosed by ultrasonography. 925 46

We report a case of maternal brain death at 25 weeks gestation in which aggressive maternal hemodynamic, respiratory, and metabolic support and tocolytic drug therapy resulted in prolongation of pregnancy for 25 days. The indication for delivery was torulopsis giabrata amnionitis, which may have occurred due to transmembrane or transplacental route. The baby was treated for fungal sepsis, and did well. Premature labor may occur spontaneously after maternal brain death, and may be precipitated by infection or by maternal drug therapy. The myriad of hemodynamic and endocrine issues associated with maternal brain death complicate the choice of tocolytic drugs, but this case illustrates that uterine activity can be successfully blocked, potentially diminishing risks to the newborn, following the tragedy of maternal brain death during pregnancy.
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PMID:Brain death during pregnancy: tocolytic therapy and aggressive maternal support on behalf of the fetus. 926 66

Listeria species are Gram-positive bacilli, present in food and in the environment (soil, water). Most of them are fortunately low-virulent, so there is no risk for healthy people. However, in special circumstances, they can be pathogenic, in immunocompromised individuals. Septicaemia in pregnancy is not dangerous for women, but for the foetus, so delayed diagnosis will lead to spontaneous abortion, intrauterine death or eventually to premature labour. We report in our paper case of Listeria septicaemia in a pregnant woman in the third trimester of the pregnancy. Thanks to early diagnosis and subsequent causal antibiotic treatment, we were able to prevent the development of congenital infection and a healthy baby was born.
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PMID:[Bacterial zoonoses: listeria infection of the mother in the 3rd trimester of pregnancy]. 1104 18

The authors have described the issues surrounding Listeria monocytogenes infection with reference to cases diagnosed and managed during the 5-year period (1995-2000) in the Clinical Department of Neonatal Pathology and Intensive Care of the National Institute of Mother and Child in Warsaw. Four cases of congenital listeriosis have been diagnosed. Some mothers presented with "flu-like" symptoms. All mothers delivered prematurely (29 hbd - 32 hbd). Among the 4 infants the most common clinical features were: perinatal asphyxia, respiratory distress, pathological icterus, haematologic abnormalities. Septicemia occurred in 50% of cases; pneumonia in 100%. Three of them presented skin manifestations; one of the neonates had mucosal abnormalities of the laryngopharynx. Cerebral sonography showed intracranial hemorrhage. One of the infants died within 7 days of birth. The other two neonates developed posthemorrhagic hydrocephalus. Only one infant has normal development. Although listeriosis appears to be not a frequent cause of perinatal infection, clinicians must be aware of Listeria, particularly in gravid patients who present with fever and "flu-like" illness and go into premature labour. Initial therapy implemented in our Department, with ampicillin and aminoglycosides seem to be the most appropriate.
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PMID:[Clinical and laboratory diagnosis of Listeria monocytogenes on the basis of own investigations]. 1132 73

Intrauterine infection is a major cause of premature labor with and without intact membranes. Intrauterine infection is present in approximately 25% of all preterm births and the earlier the gestational age at delivery, the higher the frequency of intra-amniotic infection. Microorganisms may also gain access to the fetus before delivery. A fetal inflammatory response syndrome elicited in response to microbial products is associated with the impending onset of preterm labor and also with multi-systemic organ involvement in the human fetus and a higher rate of perinatal morbidity. The most common microorganisms involved in intrauterine infections are Ureaplasma urealyticum, Fusobacterium species and Mycoplasma hominis. The role of Chlamydia trachomatis and viruses in preterm labor remain to be determined. Use of molecular microbiology techniques to diagnose intrauterine infection may uncover the role of fastidious microorganisms that have not yet been discovered. Antibiotic administration to patients with asymptomatic bacteriuria is associated with a significant reduction in the rate of preterm birth. However, such benefit has not been demonstrated for patients with bacterial vaginosis, or women who carry Streptococcus agalactia, Ureaplasma urealyticum or Trichomonas vaginalis. Antibiotic administration to patients with preterm premature rupture of membranes is associated with prolongation of pregnancy and a reduction in the rate of clinical chorioamnionitis and neonatal sepsis. The benefit has not been demonstrated in patients with preterm labor and intact membranes. Major efforts are required to determine why some women develop an ascending intrauterine infection and others do not and also what interventions may reduce the deleterious effect of systemic fetal inflammation.
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PMID:Intrauterine infection and prematurity. 1192 80

Pregnancy after the fifth delivery is viewed with anxiety, especially by obstetricians in developing countries working with inadequate facilities. High parity is still common with serious consequences to the fetus, the mother, the family and society. In the last 40 years, non-governmental, national and international efforts have been made to reduce fertility rates. We therefore intended to determine the trend in the grandmultiparity rates from 1 January 1987 to 31 December 1994 in the South Western part of Nigeria. The obstetric performance of these grandmultiparae in two different settings were to be compared. This was a retrospective, case-note analysis of all the grandmultiparae delivered at the University College Hospital (UCH) (Group A) and the Oluyoro Catholic Hospital (OCH) (Group B), both in Ibadan city. The former is a tertiary health care centre while the latter is a secondary centre. The socio-clinico-demographic characteristics of these patients were collated and analysis and comparison performed using EPI-INFO software. In Group A, 828 grandmultiparae were seen among 9215 deliveries, a rate of 8.99% (10.90% in 1987 to 3.36% in 1994). In Group B, there were 1940 cases among 22 587 deliveries, i.e. 8.59% (12.75% to 6.07%), respectively. The modal age group was 31-35 years, and women above 35 years formed one-third of cases. The parity group 5-7 was the most frequent in both groups (91.6% vs. 94.9%). Only two mothers (both in group B) had parity above 10. Booked patients formed a larger percentage in Group B than in Group A (85.8% vs. 69.7%, respectively). In Group B 85.9% had spontaneous vertex delivery as opposed to 66.3% in Group A. Caesarean section was the mode of delivery in 9.0% and 24.2% in Groups B and A, respectively. Equal percentages had breech delivery. The modal birth weight was 2.51-3.00 kg in both groups. Macrosomic babies formed 3.7% in Group A and 2.4% in Group B, while low birth weight babies formed 17.7% and 11.7% in Groups A and B, respectively. The crude perinatal death ratio was 123/1000 in Group A and 68/1000 in Group B. Antepartum haemorrhage, anaemia and premature rupture of membranes in Group A and anaemia, hypertension and antepartum haemorrhage in Group B were the most common pregnancy complications noted. In labour, abnormal lie/presentation, prolonged labour and premature labour in Group A and abnormal lie/presentation, antepartum haemorrhage and birth asphyxia in Group B formed the majority of the complications. The most common puerperal complications were primary postpartum haemorrhage, wound/genital sepsis in Group A and anaemia and primary postpartum haemorrhage in Group B, respectively. Maternal death ratio was 10.85/100 000 total deliveries in Group A and 35.42/100 000 in Group B. High parity is still common in developing countries, although the incidence is declining, with rates of 3.4% and 6.1% of total deliveries in Groups A and B, respectively. More patients are delivered per abdomen at UCH compared to OCH. The perinatal mortality rate is higher at UCH than OCH but the maternal mortality rates follow the reverse. Recommendations are made concerning the reduction in high parity rates and its associated complications.
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PMID:Grandmultiparity--trends and complications: a study in two hospital settings. 1252 27

Infection due to Campylobacter fetus subsp. fetus during pregnancy is uncommon in humans. We report a case of a pregnant woman who experienced premature labor. The infant was diagnosed with neonatal sepsis due to C. fetus subsp. fetus, and was successfully treated with carbapenem. Maternal clinical symptoms and severe villitis suggested that the route of fetal infection was hematogenous spread. We also review previous reports in the literature that describe this infection during pregnancy.
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PMID:A case of perinatal sepsis by Campylobacter fetus subsp. fetus infection successfully treated with carbapenem--case report and literature review. 1654 30

Listeria monocytogenes can cause a placental-foetal infection that results in spontaneous abortion, premature labour, stillbirth, or neonatal sepsis and meningitis. Bacteria cross the maternofoetal barrier at the villous syncytiotrophoblast level and subsequently spread from the placenta to the fetus. L. monocytogenes is able to induce different kinds of death in a variety of cells. Murine hepatocytes, murine T and human B lymphocytes, and murine dendritic cells die by apoptosis, whereas bacterial infection of murine and human macrophages leads mainly to necrotic cell death. As we previously described the efficient infection and growth of L. monocytogenes in a human amniotic cell line, we investigated the fate of these cells in order to analyse the mode of cell death. Our results provide biochemical and morphological evidence of necrotic death induced by L. monocytogenes infection.
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PMID:Necrotic cell death in human amniotic cells infected by Listeria monocytogenes. 1930 62


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