Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 42
Filtrar
Mais filtros

Base de dados
País/Região como assunto
Tipo de documento
Intervalo de ano de publicação
1.
Am J Perinatol ; 30(2): 187-92, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24915563

RESUMO

OBJECTIVE: The aim of the article is to evaluate and compare labor outcomes in obese patients undergoing induction of labor (IOL) with misoprostol and dinoprostone. STUDY DESIGN: This was a retrospective review of patients who delivered from February 1, 2008, to July 1, 2013 at our institution. All obese women who underwent IOL were identified. The rates of successful cervical ripening and cesarean delivery (CD) for patients who underwent IOL with misoprostol and dinoprostone were calculated and compared. RESULTS: A total of 564 women met inclusion criteria; 297 (52.7%) were induced with misoprostol, and 267 (47.3%) were induced with dinoprostone. The misoprostol group had a higher successful cervical ripening rate (78.1 vs. 66.7%; odds ratio [OR], 1.79; 95% confidence interval [CI], 1.23-2.6; p = 0.002) and a lower CD rate (39.1 vs. 51.3%; OR, 0.61; 95% CI, 0.44-0.85; p = 0.003) than the dinoprostone group. This significance persisted in a multivariate model adjusting for parity, gestational age, birth weight, and indication for IOL. The rates of tachysystole, terbutaline use, postpartum hemorrhage, and infectious morbidity were comparable in both groups, as were Apgar scores, rates of neonatal intensive care unit admission, and meconium passage. CONCLUSION: In obese women undergoing IOL, misoprostol leads to a higher successful cervical ripening rate and a lower CD rate than dinoprostone, with a similar rate of peripartum complications and neonatal outcomes.


Assuntos
Cesárea/estatística & dados numéricos , Dinoprostona , Trabalho de Parto Induzido/métodos , Misoprostol , Obesidade , Ocitócicos , Complicações na Gravidez , Adolescente , Adulto , Maturidade Cervical , Parto Obstétrico , Feminino , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Gravidez , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
2.
Am J Perinatol ; 29(8): 623-8, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22566112

RESUMO

OBJECTIVE: To evaluate the effect of comorbidities and induction of labor (IOL) on the cesarean delivery (CD) rate in an obese nulliparous cohort. STUDY DESIGN: This was a retrospective review of medical records of patients who delivered at our institution from January 1, 2010, to January 18, 2011. Nulliparous patients were identified with a body mass index of ≥ 30.0 kg/m2. The rates of IOL and CD for patients with a comorbidity were compared with those patients without a comorbidity. RESULTS: Among 1908 patients, 105 met inclusion criteria. The CD rate was significantly higher in the comorbid group (58.5%) than in the control group (34.6%) [odds ratio (OR) 2.66, 95% confidence interval (CI) 1.21 to 5.87, p = 0.019] [corrected].The IOL rate was significantly higher in the comorbid group (71.7% versus 15.4%; OR 13.93, 95% CI 5.33 to 36.46, p < 0.0001). Preeclampsia (44.7%) was the most common indication for IOL in the comorbid group, whereas postterm pregnancy (50%) was the most common indication in the control group. CONCLUSION: The CD rate in obese women with comorbidities is higher than that of obese women without comorbidity. These results suggest that the higher IOL rate and subsequent failed induction in obese women with comorbidities is a significant factor contributing to this association.


Assuntos
Cesárea/estatística & dados numéricos , Obesidade/epidemiologia , Índice de Massa Corporal , Comorbidade , Feminino , Humanos , Trabalho de Parto Induzido/estatística & dados numéricos , Obesidade/fisiopatologia , Gravidez , Estudos Retrospectivos
3.
J Matern Fetal Neonatal Med ; 35(8): 1527-1531, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32366141

RESUMO

OBJECTIVE: The objective of this study was to determine the relationship between maternal antepartum antibiotic administration and antibiotic resistance patterns in preterm neonates admitted to the neonatal intensive care unit (NICU). METHODS: This was a retrospective cohort study of women and their preterm neonates delivered at a single tertiary care center over a 5-year period. Women and neonates were included if they delivered between 23 weeks 0 days and 28 weeks 6 days of gestation and neonates were admitted to the NICU. Subjects were excluded if there was incomplete antibiotic administration data or incomplete laboratory or bacterial culture data for either mothers or neonates. Data collected from maternal and neonatal charts included the type, duration, and total number of antibiotics administered to subjects, neonatal culture results within the first 7 days of life, and bacterial antibiotic resistance information. Women with neonates that cultured positive for bacteria demonstrating antibiotic resistance were compared to those whose neonates did not have antibiotic-resistant bacteria. RESULTS: 79 women with 90 neonates met inclusion criteria. Of the 79 women, 71 (89.9%) received at least 1 antibiotic antepartum. 14 neonatal bacterial isolates were resistant to at least 1 antibiotic. Antibiotic-resistant bacteria were present in 11 neonates; 3 neonates had more than 1 resistant bacteria cultured. The most common resistant bacteria cultured were Coagulase-negative Staphylococcus (6/14, 42.9%), S. aureus (3/14, 21.4%), and E. coli (2/14, 14.3%). Enterobacter spp (2) and Klebsiella pneumoniae (1) made up the remainder. Of the 11 neonates with resistant bacteria isolated, 10 of their mothers received antibiotics antepartum. Neonates with antibiotic-resistant bacterial isolates were more likely to be born at lower gestational ages (24.6 vs 25.9 weeks, p = .013) and have lower mean birth weights (679.5 vs 849.3 g, p = .009) than those without resistant bacteria. In 8 of 11 (73%) neonates with resistant bacteria, the mother received an antibiotic to which the bacteria cultured were resistant: 6 coagulase-negative Staphylococcus, 1 MRSA, and 1 S. aureus. CONCLUSIONS: Although preterm neonates are often treated for presumed sepsis, they infrequently have positive bacterial cultures. In this study, those that had positive bacterial cultures for resistant bacteria were born at earlier gestational ages and had lower birth weights. These bacteria cultured in neonates are likely to be resistant to antibiotics received by mothers in the antepartum period. Careful selection of maternal and neonatal antibiotics in the preterm setting with consideration for local antibiotic resistance patterns is suggested.


Assuntos
Infecções Bacterianas , Staphylococcus aureus , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Farmacorresistência Bacteriana , Escherichia coli , Feminino , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Estudos Retrospectivos
4.
Case Rep Womens Health ; 34: e00390, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35601507

RESUMO

Background: Ornithine transcarbamylase deficiency (OTCD) is a rare disorder of the urea cycle that obstetricians should be aware of in order to guide management for pregnant carriers of the X-linked gene that causes the condition. Cases: We present the pregnancy management and outcomes of two women with OTCD. The particular manifestations of the disease drive antenatal, intrapartum and postpartum management. Conclusion: Preconception counseling, early prenatal diagnostics and multidisciplinary intrapartum and postpartum management plans contribute to improved outcomes for patients.

5.
J Reprod Med ; 56(1-2): 78-80, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21366133

RESUMO

BACKGROUND: Bilateral dacryocystoceles develop as a result of obstruction of the nasolacrimal canal. The advances in obstetric sonography have led to increased diagnosis of this structural defect in the antenatal period as early as 24 weeks' gestation. CASE: We describe a case of bilateral dacryocystocele with clear visualization of this defect using 3-D/4-D sonography. CONCLUSION: Optimal visualization of this lesion using 3-D/4-D sonogram is helpful in providing better distinction of this lesion from other fetal facial lesions and can provide reassurance to anxious parents.


Assuntos
Aparelho Lacrimal/diagnóstico por imagem , Aparelho Lacrimal/embriologia , Mucocele/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Adulto , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Obstrução dos Ductos Lacrimais/complicações , Obstrução dos Ductos Lacrimais/embriologia , Masculino , Mucocele/embriologia , Mucocele/etiologia , Gravidez , Resultado da Gravidez
6.
J Matern Fetal Neonatal Med ; 34(21): 3629-3630, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31718373

RESUMO

Maternal mortality improvement depends on the proper classification used in defining maternal deaths. Since there are several definitions of maternal deaths depending upon the proximate cause of the death, if the death is related to the physiologic changes during pregnancy or not and the timing of the death, some opportunities for improvement may be missed to decrease the overall maternal mortality rate in the USA if the correct definition is not utilized appropriately.


Assuntos
Morte Materna , Mortalidade Materna , Causas de Morte , Feminino , Humanos , New Jersey , Gravidez , Estados Unidos/epidemiologia
7.
Am J Perinatol ; 27(3): 231-4, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19834868

RESUMO

We sought to determine if gravidas with pregestational diabetes mellitus (DM) are at increased risk for asymptomatic bacteriuria (ASB) compared with nondiabetic gravidas. This is a retrospective case-control study of 150 pregnant patients with pregestational DM and 294 nondiabetic controls. Rates of ASB and any colony count of group B streptococcus (GBS) bacteriuria were reviewed. The incidence of ASB among pregestational diabetics was higher compared with nondiabetic gravidas (18% versus 8.2%, odds ratio [OR] 2.47, 95% confidence interval [CI] 1.37 to 4.45). GBS was the most common organism in diabetic gravidas (26%). There was no difference in incidence of ASB recurrence (OR 1.26, 95% CI 0.37 to 4.36), but antibiotic resistance was higher in the control group (OR 0.28, 95% CI 0.09 to 0.91). Diabetic gravidas with ASB or any level of GBS bacteriuria had higher hemoglobin A (1c) values compared with diabetics without ASB (8.31 +/- 1.89 versus 7.31 +/- 1.84, P = 0.0035). Our results demonstrate that gravidas with DM are at increased risk of ASB including GBS bacteriuria compared with non-diabetic gravidas.


Assuntos
Bacteriúria/epidemiologia , Complicações na Gravidez/epidemiologia , Gravidez em Diabéticas/epidemiologia , Infecções Estreptocócicas/epidemiologia , Streptococcus agalactiae/isolamento & purificação , Adulto , Bacteriúria/diagnóstico , Estudos de Casos e Controles , Comorbidade , Intervalos de Confiança , Feminino , Humanos , Incidência , Razão de Chances , Gravidez , Cuidado Pré-Natal/métodos , Estudos Retrospectivos , Fatores de Risco , Infecções Estreptocócicas/diagnóstico , Adulto Jovem
8.
J Reprod Med ; 55(3-4): 124-8, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20506672

RESUMO

OBJECTIVE: To compare the incidence of respiratory distress syndrome (RDS) in African American and Caucasian neonates after antenatal betamethasone or dexamethasone. STUDY DESIGN: This was a retrospective review of all deliveries occurring at < or = 32 weeks' gestation at Hackensack University Medical Center from 2001 to 2004. Only patients who received a complete course of antenatal steroids were included. The type (betamethasone or dexamethasone) was based on pharmacy supply. Statistical analysis was performed using Pearson's chi2 and Fisher's exact test. RESULTS: The African American (n = 32) and Caucasian (n = 86) groups were similar in terms of maternal age, gestational age and infant birth weight. African Americans receiving dexamethasone had a 1.65-fold increased risk of delivering infants with RDS as compared to those who received betamethasone (91.3% vs. 55.6%, respectively; p = 0.038). No difference was noted among Caucasians. CONCLUSION: Among African American neonates, the incidence of RDS was higher in those who received dexamethasone vs. betamethasone.


Assuntos
População Negra , Glucocorticoides/uso terapêutico , Cuidado Pré-Natal , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , População Branca , Adulto , Betametasona/uso terapêutico , Estudos de Coortes , Dexametasona/uso terapêutico , Feminino , Idade Gestacional , Humanos , Incidência , Recém-Nascido , Recém-Nascido Prematuro , Gravidez , Nascimento Prematuro , Síndrome do Desconforto Respiratório do Recém-Nascido/prevenção & controle , Estudos Retrospectivos
9.
Case Rep Obstet Gynecol ; 2020: 8703980, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32015919

RESUMO

Cardiac tamponade is an uncommon but life-threatening emergency that may occur in pregnant women. There is a plethora of causes, but prompt diagnosis and intervention is imperative to optimize both maternal and fetal outcomes. We report on a case of a large pericardial effusion leading to cardiac tamponade occurring in the 32nd week of gestation in a previously healthy woman. Rapid recognition and a multidisciplinary team meeting resulted in a therapeutic pericardial window and drainage and relief of symptoms. The woman underwent an uncomplicated repeat cesarean delivery at term with a positive neonatal outcome. This case highlights the importance of a rapid diagnosis and a team-based approach to managing a complex medical condition like cardiac tamponade in pregnancy.

10.
Am J Obstet Gynecol MFM ; 2(3): 100125, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-33345871

RESUMO

BACKGROUND: Previous research has focused mainly on neonatal outcomes associated with preterm and periviable delivery, but maternal outcomes with preterm delivery are less well described. OBJECTIVE: This study aimed to determine if early preterm delivery results in an increase in maternal morbidity. STUDY DESIGN: This is a retrospective cohort study conducted at a tertiary care center over a 5-year time period. Subjects were women identified by review of neonatal intensive care unit admission logs. Women were included if they delivered between 23 0/7 and 28 6/7 weeks' gestation and their neonate was admitted to the neonatal intensive care unit. The prevalence of maternal morbidities was assessed, including blood transfusion, maternal infection, placental abruption, postpartum depression or positive depression screen, hemorrhage, and prolonged maternal postpartum hospitalization. A composite outcome comprising blood transfusion, maternal infectious morbidity, placental abruption, and postpartum depression was developed. Outcomes for women who delivered between 23 0/7 and 25 6/7 weeks' gestation (early group) and 26 0/7 and 28 6/7 weeks' gestation (late group) were compared. Multivariate logistic regression analysis was performed to evaluate contributors to the composite morbidity, controlling for confounding. RESULTS: A total of 82 women met the inclusion criteria: 38 in the early group and 44 in the late group. Maternal demographics were similar between the groups. The early group was significantly more likely to experience composite maternal morbidity (60.5% vs 27.3%; P=.004) and infection (42.1% vs 13.6%; P=.006). Regression analysis determined that delivery at a later gestational age was associated with lower rates of composite morbidity (odds ratio, 0.6; 95% confidence interval, 0.41-0.83). CONCLUSION: In this study, data suggest that maternal morbidity is higher with delivery at periviable gestational ages. Composite morbidity and maternal infection were more frequent in women who delivered at less than 26 weeks' gestation. The management of women at risk for delivery at early gestational ages should include a discussion of increased maternal complications.


Assuntos
Nascimento Prematuro , Cesárea , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Placenta , Gravidez , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos
11.
Pregnancy Hypertens ; 22: 216-219, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33239217

RESUMO

OBJECTIVES: Women with hypertensive disorders of pregnancy should have a blood pressure evaluation no later than 7-10 days after delivery. The objective of this study was to identify the factors associated with patient attendance at the postpartum blood pressure follow-up visit. STUDY DESIGN: This was a retrospective cohort study of postpartum women who had a hypertensive disorder of pregnancy. Postpartum follow-up rates were recorded, and characteristics of women who attended a postpartum visit for blood pressure evaluation were compared to women who did not return for the visit. Multiple logistic regression was performed. MAIN OUTCOME MEASURES: Characteristics of women who returned for a blood pressure visit. RESULTS: There were 378 women who met inclusion criteria; 193(51.1%) attended the blood pressure visit. Women who returned were older and more likely to have preeclampsia, severe features, magnesium sulfate use, or severe hypertension during hospitalization. They were less likely to have gestational hypertension. Adjusted analysis demonstrated that black/non-Hispanic women (OR 0.53, 95% CI 0.34-0.83), the presence of any preeclampsia diagnosis (OR 2.19, 95% CI 1.03-4.81), and whether the woman underwent a cesarean delivery (OR 3.06, 95% CI 1.85-5.14) remained significant factors in predicting adherence. CONCLUSIONS: Women who returned for a blood pressure visit were more likely to have had significant hypertensive disease or a cesarean delivery. Non-Hispanic black women had the lowest rate of follow-up. Given black women have the highest rates of maternal morbidity and mortality nationwide, effective interventions to increase follow-up for them are needed.


Assuntos
Determinação da Pressão Arterial , Hipertensão Induzida pela Gravidez/terapia , Cooperação do Paciente/estatística & dados numéricos , Cuidado Pós-Natal/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Período Pós-Parto , Gravidez , Estudos Retrospectivos
12.
Obstet Gynecol ; 111(2 Pt 2): 522-4, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18239007

RESUMO

BACKGROUND: Glutaric aciduria type II is a rare disorder affecting the metabolism of fatty acid oxidation and several mitochondrial dehydrogenase enzymes. Narcolepsy and cataplexy is a disorder affecting sleep cycles and rapid eye movement activity. There is little information on outcome or management for either disorder in pregnancy. CASE: This is a case of a 16-year-old with glutaric aciduria type II and narcolepsy with cataplexy, treated with L-carnitine, riboflavin, fluoxetine, and modafinil during pregnancy. Intrapartum management included intravenous carnitine administration, and the patient underwent cesarean delivery at term without complication. CONCLUSION: This inborn error of metabolism and sleep disorder can be effectively treated during pregnancy with nutritional supplementation and stimulants. Because of the risk of cataplexy during labor, cesarean delivery is recommended to minimize the patient's risk.


Assuntos
Deficiência Múltipla de Acil Coenzima A Desidrogenase/complicações , Deficiência Múltipla de Acil Coenzima A Desidrogenase/terapia , Narcolepsia/complicações , Narcolepsia/terapia , Complicações na Gravidez/terapia , Adolescente , Feminino , Humanos , Deficiência Múltipla de Acil Coenzima A Desidrogenase/diagnóstico , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/etiologia
13.
Eur J Obstet Gynecol Reprod Biol ; 136(1): 53-60, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17408846

RESUMO

OBJECTIVE: To examine birth weight related risks of fetal injury in connection with shoulder dystocia. STUDY DESIGN: The investigation was based on a retrospective analysis of 316 fetal neurological injuries associated with deliveries complicated by arrest of the shoulders that occurred across the United States. RESULTS: The study revealed that the distribution of birthweights for the high risk shoulder dystocia population differs from the standard birthweight distribution. The relative difference per birthweight interval is used to adjust an assumed 1:1000 baseline risk of injury due to shoulder dystocia following vaginal deliveries. These adjusted risks show a need to consider new thresholds for elective cesarean delivery. CONCLUSIONS: Current North American and British guidelines, that set 5000 g as minimum estimated fetal weight limit for elective cesarean section in non-diabetic and 4500 g for diabetic gravidas, may expose some macrosomic fetuses to a high risk of permanent neurological damage. The authors present the opinion that the mother, having been informed of the risks of vaginal versus abdominal delivery, should be allowed to play an active role in the critical management decisions.


Assuntos
Traumatismos do Nascimento/etiologia , Distocia , Macrossomia Fetal , Adolescente , Adulto , Traumatismos do Nascimento/epidemiologia , Traumatismos do Nascimento/mortalidade , Peso ao Nascer , Criança , Distocia/epidemiologia , Feminino , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Participação do Paciente , Gravidez , Estudos Retrospectivos , Risco , Ombro , Estados Unidos/epidemiologia
14.
J Matern Fetal Neonatal Med ; 31(20): 2705-2708, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28691546

RESUMO

PURPOSE: Procalcitonin (PCT) is an acute-phase protein that has been infrequently studied in amniotic fluid. We sought to determine if PCT levels measured in amniotic fluid samples at the time of genetic amniocentesis are predictive of preterm delivery. MATERIALS AND METHODS: A retrospective cohort study was performed on all women presenting for genetic amniocentesis between 15-23 weeks of pregnancy at our institution from 2011 to 2013 with stored amniotic fluid samples. PCT protein levels were measured in the samples by enzyme-linked immunosorbent assay (ELISA). PCT levels in women who delivered less than 37 weeks versus those who delivered at or after 37 week were compared. Mann-Whitney test was used. RESULTS: Eighty-seven samples were available for analysis and of these eight (9.2%) were from patients who delivered preterm. Sixty-two (70%) had PCT levels below the lower limit of quantification, which was 25 pg/mL. Median PCT levels did not differ between the preterm and term group [20.4 pg/mL (range 0-82.8) and 20.2 pg/mL (range 0-198.4), respectively, p = .95]. CONCLUSION: In asymptomatic women undergoing genetic amniocentesis in this cohort, procalcitonin levels were low to undetectable and did not correlate with risk of subsequent preterm birth.


Assuntos
Líquido Amniótico/metabolismo , Calcitonina/metabolismo , Nascimento Prematuro/metabolismo , Amniocentese , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Gravidez , Estudos Retrospectivos
15.
J Matern Fetal Neonatal Med ; 31(19): 2624-2627, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28715920

RESUMO

INTRODUCTION: Histologic chorioamnionitis (HC) is a common finding in the placenta from patients with preterm premature rupture of membranes (PPROM). The purpose of this study is to determine if HC differs based on the Group B streptococcus (GBS) status in patients managed expectantly with PPROM <34 weeks gestation. METHODS: A retrospective study was performed of patients admitted with PPROM between 23 0/7 and 33 6/7 weeks from 2003 to 2014 at one institution. Patients were excluded if in labor, evidence of clinical chorioamnionitis, nonreassuring fetal status, multifetal gestation, HIV positive, or if GBS specimens or placental histology were not available. Placental pathology results were compared using Fisher's exact test. RESULTS: One hundred eighty-one patients met inclusion criteria and 55 (30.3%) were GBS positive. The prevalence of HC did not differ between the GBS positive and GBS negative groups (69 versus 64.2%, respectively; p = .62). Clinical chorioamnionitis, endomyometritis, wound infection, maternal and neonatal sepsis did not differ between the two groups. CONCLUSIONS: Vaginal-rectal colonization with GBS on admission does not appear to affect the rate of HC nor neonatal outcome in patients managed conservatively with PPROM <34 weeks gestation.


Assuntos
Corioamnionite/microbiologia , Ruptura Prematura de Membranas Fetais/microbiologia , Infecções Estreptocócicas/complicações , Adolescente , Adulto , Corioamnionite/epidemiologia , Corioamnionite/patologia , Feminino , Ruptura Prematura de Membranas Fetais/epidemiologia , Humanos , Recém-Nascido , New Jersey/epidemiologia , Placenta/patologia , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Adulto Jovem
17.
Am J Obstet Gynecol ; 197(4): 390.e1-4, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17904972

RESUMO

OBJECTIVE: The purpose of this study was to determine the duration of the time that is needed to eradicate group B Streptococcus (GBS) in pregnant women with preterm premature rupture of membranes (PPROM). STUDY DESIGN: A retrospective cohort study was performed of pregnant women with PPROM from January 1, 2000, through December 31, 2005. Vaginal/rectal cultures were performed on admission and repeated daily. Patients received antibiotics until cultures were negative for 3 consecutive days. RESULTS: Two hundred fourteen women were identified with PPROM; 169 of the women met the inclusion criteria. Thirty-three patients were GBS positive on admission and had negative cultures by day 3. Neonatal sepsis occurred in 19 neonates (11.2%); 3 neonates (16%) were from mothers who tested positive for GBS on admission, and 16 neonates (84%) were from mothers who tested negative on admission. There were no cases of neonatal sepsis because of GBS. CONCLUSION: A 3-day regimen of antibiotic prophylaxis appears to be adequate to eradicate GBS from the genital tract of patients with PPROM.


Assuntos
Antibacterianos/uso terapêutico , Ruptura Prematura de Membranas Fetais/microbiologia , Complicações Infecciosas na Gravidez/tratamento farmacológico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus agalactiae/isolamento & purificação , Adolescente , Adulto , Antibioticoprofilaxia/métodos , Clindamicina/uso terapêutico , Estudos de Coortes , Feminino , Ruptura Prematura de Membranas Fetais/tratamento farmacológico , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , New Jersey , Penicilinas/uso terapêutico , Gravidez , Complicações Infecciosas na Gravidez/microbiologia , Estudos Retrospectivos , Infecções Estreptocócicas/microbiologia
19.
Case Rep Obstet Gynecol ; 2017: 4018096, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28203469

RESUMO

Background. Salmonella enterica serotype Typhi (S. Typhi) is an anaerobic gram-negative enteric rod that causes infection when contaminated food or water is ingested and may cause illness in pregnancy. Case. This is a patient who presented at 31 weeks' gestation with abdominal pain and fever and was diagnosed with S. Typhi bacteremia. Conclusion. S. Typhi should be considered in febrile patients with recent travel presenting with abdominal discomfort with or without elevated liver enzymes.

20.
Infect Dis Obstet Gynecol ; 2006: 15614, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17485796

RESUMO

Septic pelvic thrombophlebitis (SPT) was initially diagnosed and described in the late 1800's. The entity had a high incidence and mortality during this period of time, and a surgical therapeutic approach was the treatment of choice. Since then, the diagnosis, incidence, and management of the entity evolved. This evolution followed the development of newer diagnostic tools such as computed tomography (CT), magnetic resonance imaging (MRI), and a better understanding of the pathophysiology of the disease. The treatment of SPT has had significant changes as well, from a surgical approach at the end of the 19th century to a medical approach after the 1960's. By using an adequate broad-spectrum antibiotic therapy, mortality has decreased. However, controversy in the management of this entity remains even till today.


Assuntos
Pelve , Sepse , Tromboflebite , Adulto , Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Feminino , Humanos , Imageamento por Ressonância Magnética , Pelve/irrigação sanguínea , Pelve/diagnóstico por imagem , Sepse/diagnóstico , Sepse/diagnóstico por imagem , Sepse/tratamento farmacológico , Sepse/microbiologia , Tromboflebite/diagnóstico , Tromboflebite/diagnóstico por imagem , Tromboflebite/tratamento farmacológico , Tromboflebite/terapia , Tomografia Computadorizada por Raios X
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA