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

796 pregnancies complicated by preeclampsia and 1,299 pregnancies without toxemia of the years 1981 to 1985 have been compared with regard to prematurity. Prematurity rates were 12.4 respectively 13.8 per cent, hypotrophy rates were 20 resp. 13 per cent, acidosis morbidity was 75 resp. 20 per cent and Apgar values below 8 were 63 resp. 24 per cent. Morbidity rate of respiratory distress syndrome was 8 resp. 12 per cent, of sepsis 2 resp. 7 per cent, intrauterine death rate 5 resp. 2 per cent, but survival rate overall was 93 resp. 90 per cent. Prematurity was influenced by severity of preeclampsia, time of onset and prenatal care. Prolongation of pregnancy by tocolysis is possible principally, but influenced in its effect by maternal and fetal symptoms and the necessity of termination of pregnancy by these factors.
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PMID:[Premature labor in gestosis]. 356 53

During approximately a 9-year period, 37 severe preeclamptic-eclamptic patients had pulmonary edema for an incidence of 2.9%. The incidence was significantly higher in older patients (p less than 0.0001) and in multigravid patients (p less than 0.05). Eleven (30%) had antepartum edema with 10 (90%) of the 11 having preexisting chronic hypertension. Twenty-six (70%) had postpartum edema with an average onset of 71 hours post partum. The majority of these patients had excessive colloid and crystalloid infusions for various medical, surgical, and obstetric complications. There were four maternal deaths and morbidity was significant. Eighteen patients had disseminated intravascular coagulopathy, 17 had sepsis, 12 had abruptio placentae, 10 had acute renal failure, six had hypertensive crisis, five had cardiopulmonary arrest, two had rupture of the liver, and two had ischemic cerebral damage. The overall perinatal mortality was 530/1000 and neonatal morbidity was significant. Pulmonary edema is infrequent in severe preeclampsia-eclampsia without associated medical, surgical and obstetric complications. The occurrence of pulmonary edema in such patients is associated with high maternal and perinatal mortality and morbidity.
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PMID:Pulmonary edema in severe preeclampsia-eclampsia: analysis of thirty-seven consecutive cases. 357 33

Characteristic features of expert evaluation of temporary disability during pregnancy and after abortion and labor adopted in the USSR are outlined. At the earliest stages of pregnancy, women should be assigned to the work not associated with potential exposure to hazardous factors. Women with pregnancy complications should undergo comprehensive examination, preferably in a hospital setting: average length of stay is 20 days for threatened abortion, 21 days for premature labor (28-37-week pregnancy), 16 days for hypertension, 14 days for vomiting or nephropathy, 17 days for anemia, and 14 days for Rhesus-incompatibility. After abortion on demand or abortion for medical indications, a woman should be given a sick leave. The length of sick leave depends upon the pregnancy term (56 days for pregnancy longer than 28 weeks). Women with normal pregnancy and labor can receive a leave for 112 calendar days (56 days during the prelabor period and 56 days for the postpartum period). In the case of labor complications or multiple pregnancy, duration of the postpartum leave should be increased to 70 days. Indications for a 70-day postpartum leave include preeclampsia or eclampsia; cesarean section or vacuum-extraction; profuse hemorrhage during labor requiring blood transfusions; tears of the cervix uteri; postpartum endometritis, thrombophlebitis, septicemia, and suppurative mastitis; history of heart valve disease or congenital heart defects; and premature labor.
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PMID:[Expert evaluation of temporary disability with regard to pregnancy, abortion and labor]. 368 64

Sixty-eight deaths during pregnancy, parturition and puerperium were recorded in Sweden during the years 1971-80, giving a maternal mortality of 6.6 per 100,000 live births. The figures for abdominal delivery and vaginal were 45.0 and 2.5 per 100,000 live births respectively. Amniotic fluid embolism, pulmonary embolism and hemorrhage were the main causes of death within 24 hours after delivery, while pre-eclampsia/eclampsia and sepsis were predominant during the rest of the puerperium. Age and parity are highly important risk factors. Presumed avoidable factors were identified in 19% of the cases. 9% of the deaths were related to unwanted pregnancy.
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PMID:Maternal deaths in Sweden, 1971-1980. 372 41

The lower limit of normal for the platelet count is considered to be 150,000/cu mm in both pregnant and nonpregnant normal adults. In the absence of preeclampsia, sepsis, drugs, or other apparent causes, the finding of asymptomatic mild thrombocytopenia in pregnant women is compatible with previously unrecognized immune thrombocytopenic purpura (ITP). Because of the risk of fetal/neonatal thrombocytopenia and the subsequent risk of neonatal intracranial hemorrhage in infants born of mothers with ITP, the optimal mode of delivery for an asymptomatic but thrombocytopenic mother is problematic. Conceivably, those gravidas with mild previously unrecognized thrombocytopenia may not have ITP and thus could be spared cesarean section. From the platelet counts of 730 antepartum patients, we found a mean value of 263,900/cu mm with a standard deviation of 66,000/cu mm, yielding 95% confidence limits of 134,500 to 393,300/cu mm. The distribution is statistically indistinguishable from a normal distribution. Of 26 asymptomatic thrombocytopenic patients with no hematologic history, none had infants with hemorrhage or platelet counts less than 100,000/cu mm. Only one patient subsequently had severe glucocorticoid-resistant thrombocytopenia requiring splenectomy several months after delivery. The remaining patients continue to be asymptomatic to date, with platelet counts greater than 100,000/cu mm. We suggest a plan for managing less than normal platelet counts in asymptomatic gravidas without a history of hematologic abnormality.
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PMID:Reacting appropriately to thrombocytopenia in pregnancy. 377 67

Eighty two hypertensive pregnant patients were treated with clonidine during the last trimester of pregnancy. Clonidine was effective hypotensive agent in all groups treated; in essential hypertension (N 31), in mild pre-eclampsia (N 7), in severe pre-eclampsia (N 19) and in superimposed pre-eclampsia (N 24). The drug was well tolerated by the mothers. One fetus died in utero in severe pre-eclampsia group for hypoxia and another infant died at the age of 1 day for sepsis. If antihypertensive treatment is needed during pregnancy, clonidine is one choice.
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PMID:Clonidine in the treatment of hypertension during pregnancy. 386 31

The authors undertook a case-control study of 113 cases of neonatal sepsis and 347 randomly selected controls. All cases and controls were selected from the 1980 and 1981 Washington State birth certificates. The increased risk for males (odds ratio (OR) = 1.75, p = 0.012) and the large risk associated with low birth weight (OR = 99.1, p less than 0.001 if less than 1,500 g and OR = 5.17, p less than 0.001 if 1,500-2,500 g) are consistent with past studies. The relationship of maternal age (OR = 2.00, p = 0.01 if less than or equal to 20 years and OR = 1.74, p = 0.05 if greater than 30) parallels the overall risk of many pregnancy-related complications in these age groups. Interpretation of the elevated risk associated with amniocentesis is hampered by small numbers but is provocative. The strong association of an Apgar score of 6 or less at five minutes (OR = 36.25, p less than 0.001) with neonatal sepsis suggests the possibility of routine sepsis evaluation in such neonates born in areas with high incidence rates of early neonatal sepsis. We found no previous reports associating either abruptio placentae (OR = 12.70, p = 0.028) or preeclampsia (OR = 6.43, p = 0.017) with neonatal sepsis.
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PMID:Risk factors for early neonatal sepsis. 401 63

Triplet pregnancy of over 20 weeks gestation occurred 20 times during 75,506 deliveries at a referral hospital. Commonly occurring maternal complications included premature delivery (75%), antepartum anemia (35%), postpartum hemorrhage (35%), preeclampsia (20%), and premature spontaneous rupture of the membranes (20%). Malpresentation was common. Neonatal complications were also common and included respiratory distress syndrome (45%), presumptive sepsis (36.6%), hyperbilirubinemia (33%), and neonatal death (21.6%). These high complication rates emphasize the importance of early identification and referral center care for these vulnerable pregnancies.
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PMID:Triplet gestation: maternal and neonatal implications. 405 Feb 99

The causes of the high maternal mortality rate (21.6/1000) at the Goroka Base Hospital in Papua New Guinea are reviewed for the 1964-1973 period. This study covers deaths directly due to pregnancy and childbirth and deaths due to other causes occurring in association with pregnancy and childbirth (referred to as associated deaths). The definition of parity in this study is the number of previous pregnancies that have lasted 28 weeks or more. During the 10-year period, 6031 public patients were admitted for confinement and 542 public patients were admitted following delivery elsewhere. For the purpose of deriving the maternal mortality rate (MMR), only direct maternal deaths are considered. The MMR was much higher (97.8) for patients admitted after delivery than for those admitted before delivery. The parity of 74 of the patients who died from direct obstetric causes was recorded: para 0, 52.7%; para 1-4, 40.5%; and para 5 or more, 6.8%. Autopsy confirmed the cause of death in 33 (23.2%) of the 142 maternal deaths. In most patients, sufficient clinical data was available to establish the diagnosis. Sepsis was the predominant cause of death, accounting directly for 44 (38.3%) of the deaths. Obstructed labor accounted for 29 deaths (25.2%) with the uterus intact. Of patients whose parity was recorded, 15 (60%) were primigravida, 8 (32%) were multigravida, and 2 (8%) were multigravida. Of 45 patients admitted to Goroka Base Hospital with the diagnosis of ruptured uterus, the mortality was 28.9%. The incidence of ruptured uterus declined from 1.4% to 0.4% over the 10-year review period. Abortion was the cause of 14 deaths. Criminal interference was admitted in 9 patients and may have occurred in the others. The cause of death of 4 women was toxemia of pregnancy; 2 of these patients were referred from other hospitals, each after treatment for pre-eclampsia. Pulmonary embolism was responsible for 1 death as was extrauterine pregnancy. There were 29 deaths in patients delivered by caesarean section. Additionally, 3 women died after referral following caesarean section at other hospitals. The average duration of hospitalization for patients with peritonitis at or developing after caesarean section was 17.7 days. 27 deaths were associated with pregnancy, and the conditions responsible are listed in a table. Continuing education is necessary to reduce maternal morbidity and mortality. Simple proposals for health education purposes are identified.
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PMID:Maternal mortality at Goroka Base Hospital. 453 53

A prospective pair-controlled study of maternal, cord blood, and neonatal hematologic findings was done in 50 severely preeclamptic/eclamptic and 50 well-matched normotensive pregnancies. There were no neonatal complications in mature infants. Neonatal complications were similar in premature infants of both study and control group; however, neonatal deaths were higher in the study group. In the study group, there was a poor correlation between maternal and cord blood hematocrit (r = .07), platelet count (r = .11), and fibrinogen (r = .05). In addition, there was no correlation (r = .06) between maternal and cord blood thrombocytopenia. Within each subgroup, abnormal neonatal hematologic findings were usually associated with fetal growth retardation, perinatal asphyxia, acidosis, sepsis, or intracranial hemorrhage. The present findings suggest that abnormal hematologic findings described in neonates of severely preeclamptic/eclamptic pregnancies are the result of associated neonatal complications, rather than a direct consequence of preeclampsia.
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PMID:Maternal-fetal correlations in patients with severe preeclampsia/eclampsia. 663 1


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