Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This prospective study presents a protocol for the treatment of premature labor with beta sympathomimetics and the results when isoxsuprine was used. Seventy-two patients from 25 to 36 weeks' gestation were treated. All patients were placed at bed rest, hydrated, and given parenteral sedation prior to the intravenous use of isoxsuprine. Treatment was continued via the intramuscular and oral routes until the thirty-seventh week of gestation. Three patients (4.2%) were delivered of infants during the initial infusion, and 15 (20.2%) were delivered of infants within 2 weeks after the onset of therapy. Forty-nine (68%) were delivered of infants after 37 weeks' gestation, and their infants weighed more than 2,500 grams. Maternal side effects were common, but none necessitated termination of therapy. There were six neonatal deaths, the causes of which were respiratory distress syndrome in two infants, necrotizing enterocolitis in one, group B streptococcal sepsis in one, congenital anomalies with sepsis in one, and multiple congenital anomalies in one.
 ...
PMID:Treatment of premature labor with beta sympathomimetics: results with isoxsuprine. 610 25

Chorioamnionitis is a frequent cause of premature labour and delivery, as well as of maternal and neonatal mortality. Group B streptococcus (GBS) has emerged over the past decade as a common pathogen in the etiology of neonatal sepsis. The case of chorioamnionitis reported here is unusual for three reasons: the premature labour was associated with intact membrane and amniotic fluid infected with GBS; all 5 infants were contaminated with GBS and all infants survived. Chorioamniotitis with intact membranes raises some questions regarding the antepartum use of steroids (potent anti-inflammatory agents), etc. The likelihood of chorioamnionitis in spite of cervical mucus, intact membranes, and the bacteriostatic activity of the amniotic fluid should alert the obstetrician to take special precautions, such as weekly vaginal cultures and appropriate vaginal antimicrobial treatment, in cases of imminent premature delivery.
 ...
PMID:Group B streptococcus amnionitis with intact membranes associated with quintuplet delivery. 637 93

C-reactive protein (CRP) was determined serially in 31 patients with premature rupture of the membranes, 41 patients in premature labor, and 18 pregnant patients with a variety of high-risk conditions. Elevated levels of CRP were not predictive of clinical amnionitis, histologic chorioamnionitis, or neonatal sepsis. No discernible relationship was found between serum CRP and peripheral white blood cell count. CRP was not elevated (false negative) in two patients in the premature labor group with culture-proved bacterial amnionitis. Elevated CRP in the absence of infection (false positive) likewise occurred. The results suggest that CRP be used in conjunction with other signs and symptoms suggestive of chorioamnionitis, rather than as a pathognomonic test.
 ...
PMID:C-reactive protein with premature rupture of membranes and premature labor. 685 22

Human term labor is thought to be initiated by amniotic and chorionic phospholipase A2, an enzyme that liberates arachidonic acid esters from the phospholipids of these membranes, leading to the synthesis of prostaglandins by the placental membranes. The striking association of premature labor with intrauterine infection or contamination, urinary tract infection, and early neonatal sepsis led us to study the microorganisms present in these infections for phospholipase A2 activity. Activity was found in Bacteroides fragilis, Peptostreptococcus, Fusobacterium necrophorum, Streptococcus viridans, Streptococcus fecalis, Streptococcus A and B, Escherichia coli, Klebsiella, Staphylococcus epidermidis, Pneumococcus, Lactobacillus, and Mycoplasma hominis. Bacteroides fragilis, Peptostreptococcus, Fusobacterium, and S viridans had the highest activities. The specific activities of phospholipase A2 from these organisms were several times higher than that of the membrane phospholipase A2 of the amnion and chorion. We postulate that premature labor may be initiated by microorganisms with phospholipase A2 activity from endocervical and/or intrauterine contamination or infection, producing deacylation of arachidonic acid from amniotic phospholipids with increased concentrations of free arachidonic acid and increased prostaglandin synthesis, which triggers labor.
 ...
PMID:Premature labor. II. Bacterial sources of phospholipase. 701 16

Eight cases of materno-fetal listeriosis were discovered at the University Women's Hospital of Basel from May 1977 until June 1980. This represent an incidence of 0,15% of all births. This infectious disease has often a fatal course for the unborn child, therefore it is important to know the clinical manifestations occurring with it. Listeriosis during pregnancy has a typical-two-stage course: During the first phase we see commonly a flu-like illness abating rapidly, about two weeks later fever starts again and premature contractions ensue, but no therapy is successful in controlling the fever and the premature labour. The usual fate for the unborn child is stillbirth or premature delivery with subsequent neonatal death due to prematurity, RDS, sepsis and meningitis. The low fetal and neonatal survival rate can be improved by two relatively simple measures: 1) a high index of suspicion with early diagnosis, 2) an early treatment with ampicillin either in the antepartal or neonatal stage. We review the epidemiology, the bacteriology, the serology and the histo-pathology of this relatively rare but important disease during pregnancy.
 ...
PMID:[Listeriosis during pregnancy (author's transl)]. 720 Jun 83

Early-onset group B streptococci (GBS-EOS) sepsis may be prevented by intrapartum antibiotics administered for GBS maternal colonization, premature labor, or prolonged rupture of membranes. We sought to identify cases of neonatal GBS sepsis after apparent failure of intrapartum chemotherapy and to determine the factors associated with failure of intrapartum antibiotics in these cases. We identified 96 GBS blood culture-positive infants at five military medical centers from 1987 to 1990. Eighteen (18.7%) of these infants had mothers who had received intrapartum antibiotics; 16 of 18 cases were early-onset disease, 15 of which initially had symptoms at less than 1 hour of age. Two infants had late-onset disease develop at 3 weeks of age. At least one perinatal risk factor (prematurity, prolonged rupture of membranes > 12 hours, maternal fever) was present in each of the 16 cases. Indications for intrapartum antibiotics were suspected chorioamnionitis (13 cases), GBS colonization and prolonged rupture of membranes or prematurity (3), and GBS colonization alone (2). Maternal antibiotics included ampicillin (14 cases), cephadyl (1), vancomycin (1), clindamycin (1), and gentamicin alone (1). The median number of doses of ampicillin before delivery was 1 (range, 1 to 21), which was administered at a median of 4 hours (range, 1 to 84) before birth. The mean dose of ampicillin was 1.8 gm/dose (range, 1 to 2 gm/dose). Two of 16 (12.5%) infants with GBS-EOS died as a result of GBS sepsis. In our population of neonates with GBS-EOS, 18.4% (16 of 87) of the infants had positive blood cultures despite intrapartum antibiotics. Intrapartum antibiotics may fail to prevent GBS sepsis in a number of infants born to mothers colonized with GBS or to those with acute chorioamnionitis.
 ...
PMID:Failure of intrapartum antibiotics to prevent culture-proved neonatal group B streptococcal sepsis. 816 86

Urinary tract calculi presenting during pregnancy are rare, with less than 0.1% of pregnancies being associated with stones, the vast majority being asymptomatic and a chance finding. We outline six cases treated over an 8-year period. They presented with combinations of pain, sepsis and obstruction. Intervention was required in four cases: insertion of antegrade nephrostomy, double-J stent, Dormia basket stone extraction, open pyelolithotomy and induction of labour. In each case the pregnancy had a successful outcome. Renal colic can precipitate premature labour. Delayed diagnosis and intervention can result in permanent renal impairment. Ionising radiation and anaesthetic agents may be harmful during pregnancy. The problem is rarely encountered and we therefore present information on the relative risks in each trimester of exposure to the mother and fetus and present a clinical algorithm for the management of these patients.
 ...
PMID:Problematic renal calculi presenting during pregnancy. 871 72

Listeria monocytogenes has been increasingly recognized as a cause of intrauterine sepsis with associated perinatal wastage. The condition is mostly acquired through dietary intake and appropriate advice should be given to all pregnant women. The most common presentations in pregnancy include premature labour, an influenza-like illness and reduced fetal movements. In this report, we present a series of 24 cases of perinatal listeria infection presenting to either our obstetric or neonatal units and confirmed by the microbiology department of the hospital. In particular, we wish to highlight 3 cases in which antenatal diagnosis and aggressive therapy was associated with a successful outcome. Amongst the remaining 21 cases in which an antenatal diagnosis was not made, there were 5 perinatal deaths and 1 mid-trimester loss at 18 weeks. Clinicians must maintain a high index of suspicion for listeria, particularly in gravid patients who present with fever in the setting of a persistent 'flu-like' illness and premature labour. Once suspected, appropriate specimens for listeria culture should include blood, cervical swabs and midstream urine. Empirical antibiotic therapy with amoxicillin should be instituted while waiting for culture results in patients with possible Listeria monocytogenes sepsis.
 ...
PMID:Perinatal infection with Listeria monocytogenes. 888 52

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.
 ...
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.
 ...
PMID:[Campylobacter infections in pregnancy]. 900 35


<< Previous 1 2 3 Next >>