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Indirect transmission of bovine viral diarrhoea virus at calving and during the postparturient period.

Two trials were designed to investigate whether bovine viral diarrhoea virus (BVDV) could be transmitted after the birth of persistently infected calves, even if they were removed immediately after birth. In trial 1, 11 calves were actively exposed to fetal fluids and uterine lochia collected from cows that had delivered calves persistently infected with type 1 BVDV. One calf that was exposed to a sample taken on the day of calving seroconverted. In trial 2, six calves were housed in stables where persistently infected calves were being born and then removed immediately from their dams and from the stable unit within two to three hours. One of four calves in close contact with the cows after delivery seroconverted and one of two calves housed within the same stable unit became infected.

Animals↗

Vesicouterine fistula--variable clinical presentation.

Vesicouterine and vesicocervical fistula are mostly caused by trauma during lower segment caesarian section. The clinical presentation and management of nine cases are described. Presentation was typical, i.e. cyclic haematuria (menouria) without urinary leakage, in three of the nine patients, and atypical--vaginal leakage of urine, urethral passage of lochia and/or regular vaginal menes--in six patients. The diagnosis was made clinically, radiologically and endoscopically. Surgical repair was successfully performed in eight cases and one was managed conservatively with satisfactory outcome. Atypical presentation of such fistulas may considerably delay the diagnosis. In contrast to vesicovaginal fistula, conservative management may be tried in selected cases.

Adult↗

[Antibiotic prophylaxis of infectious complications in cesarean section--prospective study].

OBJECTIVE: To verify the significance of Cefazolin administration to women who were indicated for caesarean section. SETTING: Department of Obstetrics and Gynecology, First Faculty of Medicine, Prague, Czech republic. METHODS: Cefazolin was administered to 30 women with a patient history risk in a dose of 1 mg i.v. after ligation of the umbilical cord. The control group consisted of 30 women. Observed parameters: weight gain during pregnancy, indications for caesarean section, culture from the cervix and vagina prior to the caesarean section, culture from the amniotic fluid, culture from the 4th day lochia, temperature curve, leucocyte count before and 4 days after the operation, complications after the surgery, administration of antibiotics, and length of hospitalisation. RESULTS: In the group with antibiotic prophylaxis, we observed a more favourable course of the temperature curve and a smaller leucocyte count the fourth day after the surgery (p < 0.01), in comparison with the women without prophylaxis. The duration of hospitalisation in women with antibiotic prophylaxis was one day shorter and there was no occurrence of febrile complications requiring further antibiotic treatment. CONCLUSION: Cafazolin is advantageous antibiotic for prophylaxis in caesarean section in patients with risk.

Antibiotic Prophylaxis↗

Early onset neonatal sepsis due to Neisseria meningitidis B.

The onset of meningococcal infection in the first 72 hours after birth has only been reported on a few occasions; The authors describe a case where it was confirmed that the bacteria responsible, Neisseria meningitidis group B, grew in the newborn's blood and in the mother's lochia. The transmission mechanisms are also reviewed.

Female↗

Early onset of neonatal sepsis due to group A streptococcus.

Neonatal infections by group A beta-hemolytic streptococcus are very rare in the antibiotic era. There are only a few cases in the first 72 hours after birth. The authors describe a case in which it was confirmed that the bacteria responsible, group A beta-hemolytic streptococcus, had grown in the newborn's blood and in the mother's lochia. The transmission mechanisms are also reviewed.

Humans↗

[Clinical observation on treatment of postpartum hemorrhage by xuesaitong soft capsule].

OBJECTIVE: To observe the effect of Xuesaitong (XST) soft capsule in treating postpartum hemorrhage. METHODS: Sixty pregnant women were randomly divided into the treated group (A) and the control group (B), 30 cases in each, they were treated with XST and placebo respectively for 7 days to observe the changes of hemorrhagic conditions. RESULTS: After delivery, the hemoglobin, RBC count, hematocrit and cardiac index were lower at 3rd day than those before delivery in both groups (P < 0.05 or P < 0.01), reticulocyte count lowered insignificantly as compared with that before delivery in group A but significantly in control group B; the bleeding time shortened significantly in group A (P < 0.05) but unchanged in group B; significant change of blood viscosity only found in group B (P < 0.05). The amount of bleeding 30 min, 1 hr, 2 hrs and 24 hrs after delivery in group A was all lower than that in group B respectively (P < 0.01 or P < 0.05). Involution of uterus in group A at 2nd, 4th and 7th day after delivery was all better than that in group B respectively (P < 0.05). CONCLUSION: XST has definite effect in decreasing postpartum hemorrhage, it also shows effects in promoting involution of uterus, reducing lochia and accelerating recovery of parturients.

Adult↗

Primary postpartum haemorrhage due to a large submucosal nonpedunculated uterine leiomyoma: a case report and review of the literature.

The complications of leiomyomas during pregnancy are very rare and can be divided into those occurring during pregnancy, at delivery and in puerperium. We present an unusual complication of large submucosal nonpedunculated uterine leiomyoma in puerperium. The patient was a 32-year-old woman, gravida 2, para 1, who was admitted to our department from a private maternity clinic with a considerable drop in haemoglobin 23 hours after delivery of a healthy boy. The placenta had easily and spontaneously delivered. On admission to our department her haemoglobin was 6.3 g/dl. Pelvic examination disclosed the presence of fresh blood clots in the vaginal vault. A circular firm structure, 12 by 12 cm, was noted within the external cervical os. This mass was immovable. Total abdominal hysterectomy without salpingo-oophorectomy was immediately performed and the patient's postoperative course was uneventful. In conclusion, in this patient the uterine leiomyoma obstructed the cervical os and prevented the passage of lochia resulting in haematometra, uterine atony and subsequent serious uterine haemorrhage. In such cases ostetricians and gynaecologists should proceed immediately with surgical intervention to avoid a life-threatening situation.

Adult↗

Group B streptococci implicated in the etiology of acute pneumopathies in neonates.

111 neonates with acute respiratory insufficiency and/or severe pneumopathy (pneumonia, bronchopneumonia) occurring in the first 10 hours after birth were investigated during January 1990-September 1991 for the group B streptococci presence. 430 samples from these neonate cases: throat and nose exudates, necroptic material from died neonates (pulmonary, blood, bronchial secretion) and their mothers (lochia, vaginal and uterine secretion) were examined. 33% of the neonates and their mothers were positive with the same GBS. 65.30% from the GBS strains belonged to serotype Ia and 34.70% to Ib. 24.48% from the GBS strains were resistant to Penicillin G by diffusimetric method with a corresponding MIC of 0.1 UP/ml (22.12%) and 0.5 UP/ml (2.65%).

Acute Disease↗

[Experience with the management of endometritis in the Instituto Nacional de Perinatalogía].

Endometritis is the most frequent infectious complication of the puerperal period; with the objective to know the clinical characteristics, etiology and evolution of this disease we did a retrospective study of the endometritis cases among the patients of the Instituto Nacional de Perinatología (INPer) from January 1st, 1990 to May 31, 1991. During the revision period were diagnosed 120 cases, but we were able to examine only 90. In the 90% the resolution of the pregnancy was by means of caesarean. A 24.4% of the patients had premature rupture of the membranes. The 10% had diagnose of chorioamniotis. The latency period to develop postpartum endometritis was 120 +/- 66 hours, and post-caesarean 56 +/- 30 hours (p = 0.001). The symptom most frequent were fever (100), foul-smelling lochia (61.1%) and uterine tenderness (60%). The infection was polymicrobial, being the microorganisms most frequent isolated Staphylococcus coagulase negative, Escherichia coli and Peptostreptococcus. A 3.3% developed pelvi-peritonitis. One patient died.

Endometritis↗

[Submucosal isthmicocervical myoma--problems of diagnosis, labor and puerperium].

A case of submucosal isthmicocervical myoma, 85 mm in diameter, diagnosed for first time during CS. The neonate is with atrophy of left m. sternocleidomastoideus and facial asymmetry due to impression in the left temporoparietal region, without neurological impairment. Multiple ultrasound examinations were done but the fibroids vas not diagnosed. During one examination we presume that the fibroid was mistaken for the head because the BPD was in great discrepancy with other ultrasound parameters of the fetus. During the operation OICC was not found that is why the dilatation was made through the vagina. A myomectomy was not made during the operation. Because of the pressure and the deformation of the cervical canal from the myoma a drain was inserted through the canal to facilitate the evacuation of the lochia. The post operative period passed without any complications, the drainage was taken off on the 7th post operative day and the patient was discharged on the 8th day.

Adult↗

[Computer-assisted determination of the pharmacokinetic parameters of Solupront after intrauterine administration in cattle].

The drug "Solupront" a sulfonamide was clinical tested in healthy heifers and cows with endometritis, retentio secundinarum etc. The test-results were evaluated with the computer-program "Phakimo". The pharmacokinetic parameters show that there are similar relationships between the extravasal and the intravasal application of this osmochemotherapeutic. A retard of absorption is shown in dioestrus and in prooestrus. If there are pathological signs in uterus, the rate of absorption of the drug is higher and the excretion via urine is more quickly, too. The effect of the sulfonamide in the drug "Solupront" is impaired after application in the uterus in order of the quick absorption, of distribution and excretion and also in order of dilution by lochia and by interaction with p-aminobenzoic acid.

Administration, Intravaginal↗

[Current diagnostic methods and therapeutic principles in various forms of puerperal endometritis].

A total of 55 puerperants+ with endometritis followed by spontaneous labours (26 females) and cesarean operation (29 females) were studied. A comprehensive study involved echography, hysteroscopy, bacteriological analysis of the uterine content, and histological examination of mucosal curettage of the corpus uteri. Three types of the clinical course of endometritis were identified: 1) in the presence of placental tissue residues; 2) with necrosis of delayed decidual tissue and lochia- or hematometra; and 3) a "pure" type of endometritis without abnormal tissues in the uterus. Uterine curettage was performed in the first type of endometritis, vacuum aspiration of its content was carried out in Type 2. The patients from Group 3 who had the most severe inflammatory process of the uterus underwent its cavity washing with large volumes of cold antiseptic solutions, took detoxifying, ++rheo-vasoactive and protein agents, received immunomodulating and uterotonic therapy. The algorithm developed for management of puerperants+ with postpartum endometritis substantially enhanced the efficiency of therapy and prevented severe septic events in time.

Adult↗

Postpartum bleeding.

The nurse caring for the postpartum woman must be able to distinguish normal from abnormal blood loss. Characteristics that identify normal lochia are reviewed, as are important nursing assessment parameters. Guidelines for managing impending shock are provided. Problems with blood volume estimations are explored. Information on resumption of menses and patient teaching approaches related to late postpartum hemorrhage are included.

Bandages↗

[Puerperal deciduometritis. Importance of mechanical cervical dilatation].

A prospective, longitudinal, comparative, experimental design, was carried out at CMN T HGZ No. 16, from Dec 5, 1988 to July 5, 1989, in order to evaluate the importance of cervical dilatation in puerperal endometritis management. Two groups of thirty patients each, were formed at random. Cervical dilatation was performed in Group A, and it was not done in Group B. Signs and symptoms as uterine pain, uterine sub-involution, fever, fetid and/or purulent lochia remitted in two to three days average, and hospital stay was six days for both groups. During the study two patients of each group showed complications (6.66%). Therefore, these results show that cervical dilatation, performed as a part of puerperal deciduometritis management, has little or none therapeutic value.

Adult↗

[Evaluation of various culture media for use in isolating group B streptococci from clinical specimens].

The author compares the potentialities of several nutrient media for the isolation of Group B streptococci. The media used have been as follows: agar, manufactured by the Daghestan Research Institute for Nutrient Media, with 5% of human defibrinated blood (HBA), and blood agar containing 5% of sheep red blood cells (BAS). Gentamicin (8 micrograms/ml) and nalidixic acid (15 micrograms/ml) have been added into the media selectively, and the media have been then labeled as SHBA or SBAS. Liquid nutrient medium: placental broth with the same selective agents in the same concentrations (PBS), prepared by the author, has also been employed. 213 lochia samples and 196 urine samples from pregnant women have been examined. Urine cultivation in PBS has yielded a 4-fold increase (p less than 0.01) of the isolation rate of streptococci vs. other media. The difference in the isolation rates of streptococci cultivated in HBA and SHBA has been insignificant. Addition of donor or sheep red cells to solid nutrient media has provided similar isolation rates of streptococci. The best results have been achieved when liquid selective medium and blood agar have been simultaneously employed.

Culture Media↗

[Toxic shock. Presentation of an obstetrical case].

The case of a 22 years old patient, primigravida, who underwent cesarean for acute fetal distress, and who presented with, at the second day of puerperium, puerperal infection, with clinical picture of shock at the third day, is presented. The clinical picture was preceded by skin rash which became a pyoderma, and ended up as desquamation; there were several alterations: hepatic, renal, hematological (disseminated intravascular coagulation) and digestive (gastroenteritis); and Staphylococcus aureus (coagulase positive) was isolated from the skin, lochia, coproculture; and they were negative to this microorganism the ones from blood, urine and pharynx. The patient received general care for her shock, steroids, blood and fresh plasma and antimicrobial agents (dicloxacillin, cefoperazone and netilmicin). Evolution was favourable, and was discharged at the eleventh day of puerperium in good conditions. A brief summary of the bibliography about this condition, and its very low incidence in our country, is pointed out, as this report is the second one in Latin American literature.

Adult↗

Lochiauria: a new entity--(a case report).

Passage of menstrual blood only in the urine is termed as menouria, which is due to a supraisthmic utero-vesical fistula. Passage of lochia in the urine, instead of through the cervix has not been described in the literature. A case is described, and has been labelled lochiauria.

Adult↗

[A case of immediate fertility restoration following childbirth].

We report an unwanted pregnancy following immediately after fulltime childbirth. We could not find previous reports of this nature in international literature. Women who give bottle-feeding are even more liable to early return of ovulatory cycles than women who give breastfeeding. If a puerpera has vaginal bleeding (not lochia), there is an increased risk of ovulation as well as of endometritis. It is no longer acceptable to take impossibility to conceive immediately after delivery for granted: there is need for contraception from the puerperium on.

Adult↗