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

The hospital of Attat in central Ethiopia serves 300,000 people. In 1987 there were 777 deliveries in the hospital, maternal mortality was 21.2/1000 live births, and the rate of stillbirths was 212/1000 total births. In 1976 a residence or tokul with 15 beds was inaugurated for pregnant women with obstetrical problems to mitigate obstetrical emergencies because of the difficulty of transportation to the hospital. Average stay was 15 days with prenatal care by a hospital nurse visiting the tokul once a day. There were 15 villages around the hospital with 15,000 inhabitants, and a 5-member development committee met with a public health matters. In 1987 a total of 151 pregnant women were admitted, most with a history of obstetrical problems. 34 had caesareans (19 of 25 with previous caesareans), 7 had assisted delivery, and 30 had spontaneous delivery. Only 7 of 15 with previous uterine rupture gave birth via the abdominal route, the others delivered vaginally. There were 635 deliveries of women who entered the hospital directly. Only 142 out of 151 women who stayed at the tokul gave birth in the hospital: 9 of them went home. Many of the direct hospital cases had severe problems: 45 suffered uterine rupture and 23 had craniotomy of the stillborn fetus. 88 (25%) of 348 abnormal deliveries required caesarean section, while there were 44 (72%) caesareans in 61 abnormal deliveries in the tokul group. 13 women died in the direct admission group vs. none in the tokul cases. The maternal mortality rate was 21.2/1000 live births. Rupture of the uterus caused 5 deaths, eclampsia 3, hepatic coma 2, grave sepsis 2, and placenta previa 1. There were 161 fetal deaths in 635 pregnancies of the direct referral group. The stillborn rate was 253.5 vs. 28.2/1000 births in the tokul group.
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PMID:[Residences for pregnant women reduce the risk of obstetrical catastrophies]. 1217 50

Vasectomy is usually done under local anesthesia. After isolating the vas by blunt and sharp dissection, a length of 1/2-1 inch is excised between clamps. Cut ends are then ligated with silk or chromic catgut. After ligating bleeders, if any, the wound is closed,y The patient may leave immediately. Skin sutures are removed after 7 days. Hamartoma and sepsis are the only complications. The patient should use other contraceptive measures for 3 months. Ideally, repeated semen examinations should be carried out until they are negative for spermatozoa. For women, the best time for sterilization is during the early puerperal period before the uterus has involuted back into the pelvis, usually the 4th-7th day. The operation can be done under local anesthesia, or, if the patient prefers, general anesthesia. A midline incision 3-4 inches is made. Tubes are identified and 1/2-1 inch of each tube is excised. The cut ends are ligated with chromic catgut or silk. The wound is then closed in layers. Complications are rare.
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PMID:The techniques of vasectomy and puerperal sterilization. 1225 24

During calender 1968, the septic abortion incidence at a New Dehli hospital was 3.7%. Of these 107 women, 4 patients were under 20 and 7 over 40. 69.1% were classed as Type I, with infection confined to the uterus. These women generally responded to early treatment. When curettage was done during the febrile period, 93% remained afebrile. If curettage was performed during the febrile period, 94% continued febrile. 18% were classed as Type II, which included parametritis, pelvic peritonitis, pelvic abscess or spread to the adnexae. These patients responded better to curettage after 24-48 hours of antibiotic therapy. 11% of the women were Type III, with widespread sepsis. The death rate was 8.4% of the septic abortions. Treatment with antibiotics before curettage seems to be a more effective means of managing spetic abortion.
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PMID:Septic abortions and their management. 1225 93

This is an historical survey of the abortion practices in Australia in the early 20th century. The evidence presented in the article is gathered from reports and documents, articles in medical journals, and information obtained at interviews. The estimated figures for induced abortion are 1/8 live births in 1904, 1/5 live birth in 1937, and 1/4 live births in 1970. Drugs inducing abortion were easily available by the 1890s; they usually were euphemistically advertised to correct irregularities, that is, to bring on a late period, thus enabling vendors to escape prosecution by law. Many of the prescriptions were simple purgatives, such as oil of savin, croton oil, aloe, or they caused contractions of the blood vessels or of the uterus, as did ergot of rye. The contents of the abortion inducing drugs were rarely stated and often misrepresented. In many cases abortion was a secondary effect of the woman poisoning her body with large quantities of drugs; women were also instructed to take hot mustard baths, to jump off tables, and to conduct other physical violence against themselves. Many women tried mechnical methods when chemical methods failed; they included insertion into the uterus of knitting needles, crochet hooks, laminaria and sponge tents. Women who could find the money went to an abortionist; in the 1890s there were an estimated 100-300 abortionists in the city of Sydney. The methods employed went from the use of laminaria tents, to insertion of a catheter, or forcing of fluids into the uterus. Septic infection, peritonitis, blood poisoning, and also uterine perforation were common complications noted in women being admitted to hospitals following abortion. Retention of the placenta was another common complication. After 1904 more restrictive laws reduced the availability of abortifacient drugs and also of contraceptives such as condoms and pessaries; the cost of an illegal abortion skyrocketed to 25 pounds. The result was that more women attempted to procure an abortion by themselves, and that morbidity and mortality rates increased. As recently as 1960 women were procuring abortions by the same means as in the 1890s with the same results and complications; the only advantage being the fact that they could be properly treated once they reached the hospital after attempting the abortion. There are still many restrictions placed on the availability of abortion in Australia; some abortion services, such as those in South Wales, interpret the law very freely. A survey conducted by the Preterm Foundation in 1976 found that 7.6% of its clients had attempted abortion before presenting at the clinic.
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PMID:Abortion techniques in Australia: a history. 1226 59

Maternal mortality in Madras state declined from 4.97/1000 in 1956 to 2.87/1000 in 1967. Prolonged labors, ruptured uterus and hemorrhages accounted for 60-75% of the deaths and toxemias and sepsis for 15-30%. 826 maternal deaths in Madurai were due to obstetric trauma (ruptured uterus). 78-85% of the deaths were considered preventable.
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PMID:Maternal mortality in Tamilnadu (Madras) state. 1227 54

185 deaths out of 83,135 outpatient cases, 19,027 admissions, 8121 deliveries, and 808 abortions are presented from a hospital in North India. 35 deaths occurred associated with abortion, which was an increase, vs. a declining over-all maternal death rate. Hemorrhage, sepsis and ruptured uterus were first, second and third causes of death, respectively.
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PMID:Abortion as a cause of maternal death. 1227 56

Abortion is called the invisible plague of all countries and cultures in the twentieth century. It is by far the most important method of birth control in the world today. For every 200 babies born there are at least 100 abortions. In the rich world, a woman who wants to end her pregnancy goes to an abortionist, but for millions of poor women, abortion happens spontaneously in their own homes induced by poor nutrition, sheer physical weakness, and too many pregnancies too close together. In countries where abortion is illegal, millions of women die each year as a result of severe illness or the botched handiwork of backyard operators. The most common complications are massive hemorrhaging, perforation of the uterus, laceration, sepsis, and renal failure. The experience of a great many countries shows that simply legalizing abortion can lead to a dramatic drop in death and illness. Relaxation of abortion laws can save lives, money, and misery for mothers and children. Illegal abortion has become a major problem in Africa there are 3 main types of women who enter hospitals with complications after abortions: 1) the teenager who is away from home; 2) the young woman, often educated, working, and with financial responsibilities, who is ambitious for herself, her husband, or her family; and 3) the woman in her thirties, illiterate, a rural worker, married most of her reproductive life, and pregnant most years. The third type of woman may abort because her system is utterly depleted. Such women must be shown that there is a good chance of survival for her children so that she will not have so many.
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PMID:Abortion: the hidden plague. 1230 49

A prospective analysis was made of the 85 hysterosalpingographies performed at the University Hospital in Kuala Lumpur in a 1-year period in 1985-86. 51 of these procedures were performed through use of the Leech-Wilkinson cannula method; the Foley catheter technique was used in the remaining 34 cases. Secondary infertility was the most common indication for the hysterosalpingography. Comparable results were obtained with both methods in terms of visualization of the uterine cavity and tubal morphology. The Foley catheter technique was superior in the assessment of the cervical canal and the diagnosis of cervical incompetence. Complications recorded in this series included pain, significant bleeding from cervical trauma, and extravasation of dye into the pelvic veins; however, the majority of these complications involved the Leech-Wilkinson cannula technique. These complications caused the procedure to fail or be abandoned in 10 (20%) of the women in the Leech-Wilkinson method group and in 2 (6%) of subjects in the Foley catheter group. There were 2 cases of pelvic sepsis in this series, underscoring the risk of introducing pelvic infection associated with hysterosalpingography. Overall, however, these results indicate that hysterosalpingography has a role to play in the assessment of the functional and mechanical impairment of the fallopian tubes and the uterus.
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PMID:Hysterosalpingography -- a Malaysian experience. 1231 86

During 1981-1986, 86 maternal deaths transpired at the obstetrics department of the Jawaharlal Institute of Postgraduate Medical Education and Research in Pondicherry, India. The maternal mortality rate stood at 5.8/1000 births. 31.4% were primigravidae. The percentage of maternal deaths characterized as gravidae 2-4, 5, and multigravidae was 42.9%, 9.3%, and 16.4%, respectively. The leading causes of death were sepsis (41.9%), especially septic abortion (30.2%); eclampsia-severe preeclampsia (10.5%); ruptured uterus (9.3%); and hemorrhage and prolonged labor (8.1% each). Direct obstetric causes of death accounted for 81.4% of all maternal deaths. Indirect obstetric causes of death were hepatitis (5.8%), heart disease (4.7%), and severe anemia (2.3%). Most of the women who died were illiterate (97.6%), poor (98.8%), and had received no prenatal care (94.2%). 47.7% traveled more than 60 km to the hospital. Quacks or untrained traditional birth attendants had excessively interfered with about 33% before they reached the hospital, especially the septic induced abortion, obstructed labor, and ruptured uterus cases. Among the 48 women who delivered before dying, there were 24 live births (5 of whom died during the early neonatal period) and 24 still births. These findings indicate a need for a cooperative effort to improve and expand maternal and child health care in the community.
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PMID:Determinants of maternal mortality: a hospital based study from south India. 1231 6

This special feature focuses on the care of mothers and infants during the postpartum period. Postpartum care should include prevention, early detection and treatment of complications and disease, and provision of advice. Most maternal mortality is due to postpartum hemorrhage within 4 hours of delivery, especially among anemic women. The uterus should be well contracted, and blood loss should be minimal. Sepsis, as indicated by fever, should be treated with antibiotics, but preventive measures include cleanliness and hygiene at delivery. Infections are more likely after cesarean section, prolonged labor, and early rupture of membranes. Handwashing prevents infection. Women should be encouraged to pass urine in the first 12 hours after delivery. Bathing frequently relieves painful episiotomy. 85% of neonatal deaths are due to preterm birth and low birth weight. Keeping the baby warm helps prevent low body temperature and infections. Parents need social support in adjusting to congenital defects. Infants with infections should be recognized on time, managed correctly, and referred to a district hospital. Breast feeding should start immediately or within the first hour of birth. Mothers need adequate rest and a nutritious diet. Breast tenderness is common during the first 4 days after delivery. Breast feeding on demand and proper hygiene helps to prevent infections and breast tenderness. Postpartum depression requires support from families and expert advice. Exclusive breast feeding inhibits ovulation until menstruation returns. Family planning may begin during lactation with a progestin-only pill, IUD, or diaphragm. HIV-positive mothers should discontinue breast feeding and take extreme care to mix formula with clean water. Mothers should be immunized with two doses of tetanus toxoid. Pregnant mothers need iodized oil and vitamin A supplements. Reproductive tract infections should be treated.
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PMID:Postpartum care -- what's best for mother and baby. 1232 60


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