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Biomedical subjects

M Mazor

Publications and source records attributed to M Mazor.

At least 181 records · Page 10Linked to original sources
PubMed1994

Premature delivery of small versus appropriate-for-gestational-age neonates. A comparative study of maternal characteristics.

Prematurity and growth retardation of the fetus are major factors affecting perinatal outcome. The purpose of this study was to compare maternal characteristics of 63 women who delivered a preterm, small-for-gestational-age (SGA) neonate with those of 63 women matched for parity and gestational age who delivered a preterm, appropriate-for-gestational-age (AGA) neonate. All women delivered at the Soroka Medical Center between January 1, 1985, and December 31, 1990. Mothers of SGA neonates were more likely than those of AGA neonates to be over the age of 35 years (P = .043), to have hypertensive disorders and oligohydramnios (P < .001), to have induced labor (P < .001) and to deliver by cesarean section (P < .001). In addition, they had a higher rate of morbidity in the puerperium (P = .015) and were more likely to have longer hospitalization (P = .002). In contrast, previous preterm deliveries were significantly more common in the AGA group than in the SGA group (P = .034). The results of this study indicate that women who deliver preterm SGA neonates belong to a special subgroup with unique characteristics in comparison to those who deliver preterm AGA neonates.

Adolescent↗
PubMed1993

[C-reactive protein as a marker of infection in women with preterm delivery].

There is a strong association between systemic and intrauterine infection and preterm delivery. C-reactive protein (CRP) is considered a nonspecific marker for intrauterine inflammation. We determined its blood level in 100 women who presented with preterm labor and intact membranes and delivered prematurely. CRP levels were used as a noninvasive marker for infection to compare clinical characteristics between women who delivered prematurely at 31-36 and 24-30 weeks of gestation. Women who delivered earlier than the 24th week of gestation had a higher rate of positive CRP levels than those who delivered later, 54% vs 24%, respectively (p < 0.0001). Moreover, women from the lower gestational age group with positive CRP levels had significantly different clinical characteristics than those in the same group but with negative CRP levels. There was a significant difference between Jewish and Bedouin women in cervical dilatation and time interval from hospitalization to delivery between those with positive CRP and those with negative CRP levels. We conclude that patients who delivered prematurely at 24-30 weeks had higher rates of an inflammatory etiology than women who also delivered prematurely, but at a more advanced gestational age.

Adult↗
PubMed1993

Maternal mortality in southern Israel.

Between 1969 and 1991 there were 166,410 births in Southern Israel with 13 maternal deaths (7.8/100,000). In the Jewish population there were 119,130 deliveries with 7 maternal deaths (5.9/100,000), and the Bedouins had 47,280 deliveries with 6 maternal deaths (12.7/100,000). Prenatal care was an important preventive factor. 7 maternal deaths occurred among 151,088 women who had received prenatal care (4.6/100,000), whereas 6 such deaths occurred among 15,322 without prenatal care (39.1/100,000) (P value 0.0005). Ten of the 13 women who died were over 24 years old. Eight of the 13 patients were multiparous. Live births occurred in 6 patients and stillbirths in 5 patients. Hemorrhage, preeclampsia-eclampsia and pulmonary embolism were the leading causes of maternal death.

Cross-Cultural Comparison↗
PubMed1993

Successful treatment of preterm labour by eradication of Ureaplasma urealyticum with erythromycin.

Ureaplasma urealyticum was detected in the amniotic cavity of a woman with premature contractions at 32 weeks of pregnancy. Treatment with Erythromycin base was instituted for a period of ten days. Amniotic fluid analysis performed 48 hours after discontinuation of antibiotic treatment revealed sterile amniotic fluid. The pregnancy continued uneventfully until 39 weeks.

Administration, Oral↗
PubMed1993

The diagnostic and prognostic value of amniotic fluid white blood cell count, glucose, interleukin-6, and gram stain in patients with preterm labor and intact membranes.

OBJECTIVE: Our goal was to compare the value of amniotic fluid tests in the detection of microbial invasion of the amniotic cavity and in the relationship with the amniocentesis-to-delivery interval and neonatal complications in patients with preterm labor and intact membranes. STUDY DESIGN: Amniotic fluid was retrieved by transabdominal amniocentesis from 120 patients with preterm labor and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria and for mycoplasmas. Amniotic fluid analysis included a Gram stain, white blood cell count, glucose and interleukin-6 determinations. Logistic regression and Cox's proportional hazards model were used for analysis. RESULTS: (1) The prevalence of positive amniotic fluid cultures was 9.2% (11/120); (2) patients with microbial invasion had a shorter amniocentesis-to-delivery interval and a higher neonatal complications rate than patients with a negative culture; (3) the most sensitive test for the detection of microbial invasion of the amniotic cavity was amniotic fluid interleukin-6 determinations (cutoff 11.3 ng/ml) (sensitivity; for interleukin-6 100%, for glucose 81.8%, for white blood cell count 63.6%, and for Gram stain 63.6%; p < 0.05 for all comparisons); (4) the most specific test was the Gram stain of amniotic fluid (specificity: for Gram stain 99.1%, for white blood cell count 94.5%, for interleukin-6 82.6%, and for glucose 81.6%; p < 0.01 for all); (5) of all amniotic fluid tests, interleukin-6 determinations were the only ones that had significant relationship with the amniocentesis-to-delivery interval and neonatal complications. CONCLUSION: Interleukin-6 concentrations in amniotic fluid are better indicators of microbial invasion of the amniotic cavity, amniocentesis-to-delivery interval, and neonatal complications than the amniotic fluid Gram stain, glucose concentration, or white blood cell count.

Adult↗
PubMed1993

A comparative study of the diagnostic performance of amniotic fluid glucose, white blood cell count, interleukin-6, and gram stain in the detection of microbial invasion in patients with preterm premature rupture of membranes.

OBJECTIVE: Our aim was to compare the value of amniotic fluid tests for the detection of microbial invasion of the amniotic cavity and in the prediction of the amniocentesis-to-delivery interval and neonatal complications in patients with preterm premature rupture of membranes. STUDY DESIGN: Amniotic fluid was obtained by transabdominal amniocentesis from 110 consecutive patients with preterm premature rupture of membranes. Fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. Amniotic fluid analysis included a Gram stain examination, white blood cell count, and glucose and interleukin-6 determinations. Logistic regression and survival techniques (proportional hazards model) were used for statistical analysis. RESULTS: (1) The prevalence of positive amniotic fluid cultures in patients with preterm premature rupture of membranes was 38% (42/110); (2) patients with microbial invasion had a shorter amniocentesis-to-delivery interval and a higher neonatal complication rate than patients with negative cultures; (3) the most sensitive test for the detection of microbial invasion of the amniotic cavity was amniotic fluid interleukin-6 determinations (cutoff 7.9 ng/ml) (sensitivity: for IL-6 80.9%; for white blood cell count 57.1%; for glucose 57.1%; for Gram stain 23.8%; p < 0.05 for all comparisons); (4) the most specific test for the detection of microbial invasion was the Gram stain of amniotic fluid (specificity: for Gram stain 98.5%; for white blood cell count 77.9%; for interleukin-6 75%; for glucose 73.5%; p < 0.01 for all); (5) of all amniotic fluid tests, interleukin-6 determination was the only test that had significant clinical value in the prediction of the amniocentesis-to-delivery interval and neonatal complications. CONCLUSION: Interleukin-6 concentrations in amniotic fluid are a better predictor of microbial invasion of the amniotic cavity, amniocentesis-to-delivery interval and neonatal complications than the amniotic fluid Gram stain, glucose, or white blood cell count in patients with preterm premature rupture of membranes.

Amniocentesis↗
PubMed1993

Meconium stained amniotic fluid is associated with maternal infectious morbidity in pre term delivery.

The purpose of the study was to determine if intra partum meconium stained amniotic fluid (MSAF) is associated with infectious morbidity in women with pre term delivery. The study group was composed of 89 women with pre term delivery and MSAF. The control group comprised 89 women with pre term delivery and clear amniotic fluid, matched for maternal age, gravidity, parity, gestational age, rate of premature rupture of membranes, breech presentation and mode of delivery. The parameters of maternal infectious morbidity were compared between the two groups during pregnancy, delivery and puerperium. The prevalence of recurrent urinary tract infections was significantly higher in the study group than those in the control group, 7.8% (7/89) vs. 0% (0/89), respectively (p = 0.02). During delivery women with MSAF had a significantly higher rate of clinical chorioamnionitis than women without MSAF, 6% (6/89) vs. 0% (0/89), respectively (p = 0.03). Histological chorioamnionitis was also significantly higher in patients with intra partum MSAF, as compared to those the clear amniotic fluid, 11.2% (10/89) vs. 0% (0/89), respectively (p = 0.03). In addition, women in the study group had a significantly higher post partum infectious morbidity rate and endometritis than women in the control group [52.8% (47/89) vs. 37.1% (33/89) (p = 0.05); 18% (16/89) vs. 7.8% (7/89) (p = 0.03), respectively]. We conclude that intra partum MSAF should be considered as a potential marker for infectious morbidity in women with pre term labor and delivery.

Adult↗
PubMed1993

Relationship between C-reactive protein levels and intraamniotic infection in women with preterm labor.

The purpose of this study was to determine the relationship between C-reactive protein (CRP) levels and intraamniotic infection in 48 women presenting with preterm labor and intact membranes. Blood samples for CRP tests were obtained immediately before the performance of transabdominal amniocentesis. The prevalence of amniotic fluid cultures positive for organisms was 14.6%. In 16 women (33.3%) positive CRP levels were obtained. There were no significant differences in the prematurity rate or the prevalence of microbial invasion of the amniotic cavity between women with positive CRP levels and women with negative levels. The sensitivity, specificity, and positive and negative predictive values for the detection of amniotic infection were 71.5%, 73.2%, 31.3% and 93.8%, respectively. Based on these results, we suggest that in women with preterm labor and negative CRP levels, routine amniocentesis may not be essential to the initial workup.

Adult↗
PubMed1993

Microbial invasion of the amniotic cavity during term labor. Prevalence and clinical significance.

The purpose of this study was to determine the prevalence and clinical significance of microbial invasion of the amniotic cavity during spontaneous parturition at term. Amniotic fluid was retrieved by transabdominal amniocentesis from 90 women in spontaneous term labor with intact membranes. Fluid was cultured for aerobic and anaerobic bacteria, including Mycoplasma. The prevalence of positive amniotic fluid cultures was 18.8% (17/90). The most common microbial isolates were Ureaplasma urealyticum, Streptococcus agalactiae, Lactobacillus species and Mycoplasma hominis. Clinical signs of chorioamnionitis were present in three patients, and only one of them had a positive amniotic fluid culture. Five patients (5.5%) had puerperal endometritis; three of them had an amniotic fluid culture positive for microorganisms. All neonates were free of clinical signs of infection. The data indicate that microbial invasion of the amniotic cavity occurs frequently during spontaneous labor at term, and it may be both the cause and the consequence of labor.

Adolescent↗
PubMed1992

[Limulus amebocyte lysate assay for diagnosing intraamniotic infection].

The value of the Limulus amebocyte lysate assay (LAL) in the diagnosis of intraamniotic infection was determined in amniotic fluid from transabdominal amniocenteses in 51 women in preterm labor with intact membranes. The prevalence of positive amniotic fluid cultures was 21.5% (11/51) in detecting intraamniotic infection. The LAL was positive in 19.6% (10/51), its sensitivity 81.8% (9/11), specificity 97.5% (39/40), positive predictive value 90.0% (9/10), and negative predictive value 95.1% (39/41). Similarly, in detecting women who would fail tocolysis and deliver prematurely, its sensitivity was 27.6% (8/29), specificity 90.9% (20/22), positive predictive value 80% (8/10), and negative predictive value 48.8% (20/41). We conclude that LAL is a simple, rapid and sensitive test for detecting intraamniotic infection in women in preterm labor.

Amniotic Fluid↗
PubMed1992

Pregnancy with an intrauterine device in situ and preterm delivery.

We determined the prevalence of preterm delivery in a population of women who conceived with an IUD in situ and compared the results with those in a group of women without any contraceptive method. The study group consisted of 16 women who conceived with a copper IUD in situ. The control group comprised 48 women matched for age, gravidity and parity. The prevalence of preterm delivery was significantly higher in the study group than in the control group (18.7% (3/16) vs 2% (1/48)), respectively. (P = 0.045, Fisher's exact test.)

Adult↗
PubMed1992

Listeria monocytogenes. The role of transabdominal amniocentesis in febrile patients with preterm labor.

Two women with preterm labor and intraamniotic infection with Listeria Monocytogenes are presented. In both patients, the prenatal diagnosis of Listeriosis was made by transabdominal amniocentesis. The immediate prominent observation was meconium staining of the amniotic fluid. We propose that an amniocentesis should be performed in women with premature labor and fever. If the amniotic fluid is meconium stained and the Gram stain examination reveals Gram positive rods, Listeria Monocytogenes should be suspected and the patient should be treated accordingly until the culture results are obtained.

Adult↗
PubMed1992

Intraamniotic infection with fusobacteria.

A literature search produced ten studies in which Fusobacterium was cultured from amniotic fluid in women with preterm labor and intact membranes or with preterm premature rupture of membranes (PROM). Fusobacterium was isolated in 9.9% (9/91) of positive amniotic fluid cultures in women with preterm PROM and in 28.3% (17/60) of positive amniotic fluid cultures in women presenting with preterm labor and intact membranes. Fusobacterium plays a previously unrecognized role in the pathogenesis of premature labor and delivery. Amniotic fluid culture for anaerobes, specifically Fusobacterium, is suggested for all women who present with premature labor and intact membranes and do not respond to tocolytic drugs.

Amniotic Fluid↗
PubMed1992

The prevalence and clinical significance of intraamniotic infection with Candida species in women with preterm labor.

Intraamniotic infection is considered a major etiologic factor of preterm birth. Positive amniotic fluid cultures are rarely contaminated with Candida species. The presence of this microorganism is associated with a poor pregnancy outcome. Out of 773 transabdominal amniocenteses performed in women presenting with preterm labor and intact membranes, 77 patients (9.9%) had positive amniotic fluid cultures and in 5 women (6.5%) Candida species were identified. On the other hand, 625 amniocenteses were performed in women with preterm premature rupture of membranes and 178 (28%) had positive cultures. Only in 4 patients was Candida isolated (2.2%) (P = 0.13 Fisher's exact test). The importance of early and accurate diagnosis of intraamniotic infection with Candida is pointed out. A transabdominal amniocentesis for microbiological examination is suggested for every woman presenting with preterm labor or preterm premature rupture of membranes and especially for those who conceived with a retained IUD or cervical cerclage.

Amniotic Fluid↗