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At least 91 records · Page 5Linked to original sources
PubMed1997

International Multicentre Term Prelabor Rupture of Membranes Study: evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term.

OBJECTIVES: Our purpose was to determine significant predictors for the development of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term. STUDY DESIGN: Logistic regression analysis with odds ratios and 95% confidence intervals was used to determine the significant predictors of clinical chorioamnionitis and postpartum fever in women with prelabor rupture of membranes at term enrolled in this study. The study recently compared in a randomized controlled trial four strategies of management: induction with oxytocin, induction with prostaglandin, expectant management, and, if failed, induction with oxytocin or prostaglandin. RESULTS: The following variables were significantly associated with clinical chorioamnionitis: (1) number of digital vaginal examinations: > 8, 7 to 8, 5 to 6, 3 to 4 (vs 0 to 2) (odds ratio 5.07, 3.80, 2.62, 2.06); (2) duration of active labor: > or = 12, 9 to < 12, 6 to < 9 hours (vs < 3 hours) (odds ratio 4.12, 2.94, 1.97); (3) meconium-stained amniotic fluid (odds ratio 2.28); (4) parity of 0 (odds ratio 1.80); (5) time from membrane rupture to active labor: > or = 48, 24 to < 48 hours (vs < 12 hours) (odds ratio 1.76, 1.77); and (6) group B streptococcal colonization (odds ratio 1.71). Variables significantly associated with postpartum fever were (1) clinical chorioamnionitis (odds ratio 5.37), (2) duration of active labor: > or = 12, 9 to < 12, 6 to < 9, 2 to < 6 hours (vs < 3 hours) (odds ratio 4.86, 3.53, 3.46, 3.04), (3) cesarean section, operative vaginal delivery (odds ratio 3.97, 1.86), (4) group B streptococcal colonization (odds ratio 1.88), and (5) maternal antibiotics before delivery (odds ratio 1.94). CONCLUSIONS: Increasing numbers of digital vaginal examinations, longer duration of active labor, and meconium staining of the amniotic fluid were the most important risk factors for the development of clinical chorioamnionitis in women with prelabor rupture of membranes at term. The most important risk factors for the development of postpartum fever were clinical chorioamnionitis, increasing duration of active labor, and cesarean section delivery.

Adult↗
PubMed1988

[Amniocentesis following premature rupture of fetal membranes and suspected premature rupture of fetal membranes in late pregnancy].

Amniocentesis during the third pregnancy trimenon in case of suspected premature rupture is performed for two reasons: on the one hand, the maturity parameters can be determined as usual from the amniotic fluid, and on the other hand it serves to determine the presence of germs that may have caused the premature rupture. At the same time, it is possible to confirm the suspicion of premature hydrorrhoea gravidarum by instillation of dyestuff into the amniotic cavity. Premature rupture was confirmed in 21 of 65 cases where clinical findings had not supplied safe evidence; in the remaining 44 cases this method permitted the exclusion of premature hydrorrhoea. An evaluation was performed by means of a retrospective study of parturitions between 1975 and 1985 with regard to late amniocenteses in cases of suspected premature rupture, the investigated parameters being the course of pregnancy and of birth, postpartal state of well-being, bacteriological findings in the amniotic fluid, and results of instillation of blue dyestuff.

Amniocentesis↗
PubMed1996

Simultaneous rupture of the quadriceps tendon with contralateral rupture of the patellar tendon in an otherwise healthy athlete.

A case of a healthy athlete with simultaneous rupture of quadriceps tendon and rupture of the contralateral patella tendon is reported. Both tendons rupturing in the same patient is rare and this is the first reported case in a previously healthy person. Different mechanisms are implicated in the different ruptures. The rarity is because the simultaneous presence of contributory factors for either injury in the same person is uncommon.

Athletic Injuries↗
PubMed1987

Is the fibrinolytic activity involved in the mechanism of fetal membrane rupture? A clinical study of term and prematurely ruptured membranes.

The fibrinolytic activity (FA) was determined in fetal membrane specimens obtained in 15 cases of premature rupture of the membranes (PROM) and from 15 control women who gave birth spontaneously at term. In each case two membrane specimens were obtained, one from the rupture margin and the other from the membranes close to the placental margin. No significant difference in FA was demonstrated between the two groups of patients. Nor could any significant difference be found on comparing the FA within the paired membrane specimens of each group. Furthermore, no obvious change in FA was demonstrated in relation to clinical signs of chorioamnionitis or microbiological findings. However, although the FAs observed in prematurely ruptured membranes were comparable to those found in term specimens, this does not exclude the possibility of an involvement of FA in the mechanism of membrane rupture.

Adolescent↗
PubMed1980

Acquired functional asplenia. Association with spontaneous rupture of the spleen and fatal spontaneous rupture of the liver in amyloidosis.

A 45-year-old woman who had lower extremity ecchymoses and vague abdominal and back complaints was found to have acquired functional asplenia manifested by Howell-Jolly bodies and poikilocytosis on peripheral blood smear. On spleen scan there was inability to take up radioactive colloid. Shortly thereafter, she was found to have a spontaneous rupture of the spleen. At operation, the spleen, liver, and periaortic lymph nodes were found to be diffusely involved with amyloidosis. Five months later, an acute, serious, intra-abdominal condition developed secondary to spontaneous rupture of the liver, and the patient died. To our knowledge, neither acquired functional asplenia nor spontaneous rupture of the liver has been reported previously in association with amyloidosis.

Amyloidosis↗
PubMed2002

Sudden and unexpected death resulting from splenic artery aneurysm rupture: two case reports of pregnancy-related fatal rupture of splenic artery aneurysm.

Rupture of a splenic artery aneurysm is a rare and usually catastrophic event, most commonly associated with pregnancy. In spite of increasingly common reliance on abdominal angiography, magnetic resonance imaging, and computerized tomography during the past quarter century, clinicians uncommonly recognize any of the various splanchnic arterial aneurysms absent premonitory signs or symptoms. Accordingly, rupture of a visceral aneurysm, including splenic artery aneurysm, typically presents as sudden, unexpected obtundation or death. As a consequence, the initial recognition and diagnosis of splenic artery aneurysm rupture take place only at autopsy. This report presents two such cases of sudden death resulting from splenic artery aneurysm in a pregnant woman and a postpartum woman, respectively.

Adult↗
PubMed2000

Surgical repair of an impending rupture of left ventricular (LV) aneurysm with septal perforation and rupture of papillary muscle after acute myocarial infarction.

Acute cardiac rupture following acute myocardial infarction (AMI) carries a high mortality. The progression and rapid hemodinamic deterioration is the usual clinical course, with 50-80% mortality within the first week. The combination of septal perforation, impending cardiac rupture of left ventricular (LV) aneurysm and rupture of papillary muscle after AMI has rarely been reported. This article describes a case of successful surgical repair of this condition in a 52 years old man. The important clinical features were as follows: 1) a sick looking patient in gross congestion heart failure, 2) persistent pulmonary oedema, 3) hepatomegali, 4) arrhythmias, 5) cardiogenic shock. The respirator was removed on the first postoperative day. An echocardiography evaluation on the 3rd postoperative day showed normal LV dimension, normal LV systolic function. There were no VSD and mitral regurgitation, but apical wall and septal still hipokinesia-akinesia. The ejection fraction showed improvement from 44% to 71%. The patient was discharged from hospital on the 30th post-operative day and returned to work after 60th post-operative day. Seven months later today his condition is still good.

Aneurysm, Ruptured↗
PubMed2006

[Acute myocardial infarction with left ventricular free wall rupture and papillary muscle rupture caused by infectious endocarditis].

Infectious endocarditis sometimes causes coronary embolism which induces acute myocardial infarction. A 59-year-old man was admitted to our hospital with a diagnosis of acute myocardial infarction accompanied by left ventricular free wall rupture and papillary muscle rupture. We perfomed mitral valve replacement combined with repair of left ventricular free wall rupture. The anterior mitral leaflet had perforation and vegetation, which suggested that acute myocardial infarction was caused by septic embolus originated from infectious endocarditis in this case.

Endocarditis, Bacterial↗
PubMed1989

[Simultaneous bilateral spontaneous rupture of the quadriceps tendons compared with unilateral traumatic rupture].

A rare case of simultaneous, bilateral and spontaneous rupture of the quadriceps tendons is described in a 59-year-old man without systemic disease or traumatic lesions. For comparison, we report the case of a young woman with complete traumatic, unilateral rupture of the quadriceps tendon. The more or less normal degenerative changes of the ligament structure were considered to be the additional etiological reasons for both ruptures. A review of the literature is given.

Accidental Falls↗
PubMed1982

[Subdural hematoma from arterial rupture -mechanism of arterial rupture in minor head injury].

Five cases of subdural hematoma from arterial rupture (SDH-AR) are described and other 39 reported cases are reviewed. The average age of the patient is 59 and male to female ratio is 2:1. Fifty two percent of the patients have history of recent head injuries most of which are trivial. A very few patient have initial loss of consciousness. Approximately half of the patients with history of head trauma have long lucid interval (average of 7 days). Those patients without history of head trauma have spontaneous onset of the symptoms and some of the have acute onset of headache and loss of consciousness, simulating cerebrovascular accident. Natural history of the SDH-AR is progressing deterioration of the symptoms, resulting in coma and death. Skull fracture is seldom demonstrated in the patients with SDH-AR. Angiography shows and extracerebral avascular mass over the cerebral convexity with marked midline shift. In 3 cases including our 2 cases, extravasation of the contrast medium from the cortical artery is observed and this is a useful finding for making diagnosis of this disease. Computerized tomography reveals high density extracerebral mass with remarkable mass effect. Craniotomy discloses subdural clot and spurting arterial rupture from a branch of the cortical artery around the Sylvian fissure. In some cases, subarachnoid hemorrhage is observed but in none of the cases, cerebral contusion or laceration is present. It is presumed that the mechanism of the arterial rupture is gliding movement of the brain within the skull upon injury, tearing an arterial twig with dural attachment. Hypertension, arteriosclerosis and brain atrophy may be important contributing factors to this mechanism. Pseudoaneurysm of the cortical artery caused by closed head injury is also associated with this mechanism and may explain delayed sudden onset of the symptoms in some patients with SDH-AR.

Aged↗
PubMed1997

[Conservative surgical treatment of a spontaneous splenic rupture during infectious mononucleosis. Report of a case and review of the [Conservative surgical treatment of a spontaneous splenic rupture during infectious mononucleosis. Case report and literature review].

A spontaneous splenic rupture occurred in a 31 year old patient suffering from infectious mononucleosis. An echography and an abdominal CT Scan revealed a rupture of the inferior pole of the spleen with a hemoperitoneum. A conservative surgical treatment was performed. Postoperative course was uneventful. This case-report draws the attention to the possibility of a conservative surgical treatment of a splenic rupture in the course of infectious mononucleosis. This attitude avoids the complications of splenectomy.

Adult↗
PubMed1991

Rupture of the left ventricular free wall following mitral valve replacement for mitral stenosis: a cause of complete (fatal) or contained (false aneurysm) cardiac rupture.

Complete or incomplete left ventricular free wall rupture is a known complication of mitral valve replacement. Complete free wall rupture may result in fatal bleeding, whereas incomplete rupture may result in the formation of a pseudoaneurysm with survival possible. Two necropsy patients are described illustrating both of these complications. Proposed mechanisms for injury to the left ventricular free wall are reviewed.

Aged↗
PubMedDate not supplied

Cholesterol crystals rupture biological membranes and human plaques during acute cardiovascular events--a novel insight into plaque rupture by scanning electron microscopy.

Plaque rupture and/or erosion are considered the leading cause of cardiovascular events. To elucidate this process, we demonstrated that during cholesterol crystallization the occupied volume increases rapidly and sharp-tipped crystals cut through thin biological membranes in their path. The amount of cholesterol correlated directly with both peak level and rate of crystal growth (r = 0.98; r = 0.99; p < 0.01, respectively). These observations suggest that crystallization of cholesterol in atherosclerotic plaques can induce cap rupture and/or erosion. Observations by scanning electron microscopy confirmed similar findings of cholesterol crystals perforating the lumen surface in human coronary artery segments with ruptured plaque.

Acute Disease↗
PubMed1994

A ruptured thymic branch aneurysm mimicking a ruptured aortic aneurysm, with associated bronchial artery aneurysms: report of a case.

A 57-year-old woman who went into shock following an acute left hemothorax was operated on after stabilization under the diagnosis of a ruptured aortic aneurysm. A left fifth intercostal thoracotomy was done which revealed approximately 500 ml of bloody effusion in the extrapleural space and 2,000 g of clotted blood in the pleural cavity. While the aneurysm was initially thought to have originated in the isthmic or descending aorta, intraoperative findings revealed a swollen hematomatous thymus adherent to the aorta. A ruptured thymic branch aneurysm, 3 cm in diameter, was subsequently found in the resected hematomatous thymus. Histological examination also revealed several small aneurysms in the tortured bronchial arteries. Postoperative angiography showed a saccular aneurysm, 1.5 cm in diameter, and several smaller aneurysms in the bronchial artery of the left lung. The aneurysm was successfully treated by a transcatheter arterial embolization, and the patient has had no further symptoms since then. To our knowledge, there has been no other case of a ruptured thymic artery aneurysm reported in the literature, and only a few cases of bronchial artery aneurysms have been documented.

Aneurysm↗
PubMedDate not supplied

Fatal spontaneous rupture of a gravid uterus: case report and literature review of uterine rupture.

Spontaneous uterine rupture is a life-threatening obstetrical emergency encountered infrequently in the emergency department. The diagnosis of spontaneous uterine rupture is often missed or delayed, leading to maternal and fetal mortality. Emergency physicians must consider this diagnosis when presented with a pregnant patient in shock with abdominal pain. We present the case of a 38-year-old gravid female who presented to the emergency department in cardiac arrest 24 hours after an initial complaint of abdominal pain. We review the uterine rupture literature with specific focus on risk factors, signs and symptoms, diagnosis, treatment, and outcome.

Adult↗
PubMed1989

Subacute rupture of a pseudoaneurysm formed by late rupture of a true left ventricular aneurysm.

A man aged 34 in whom rupture of a true aneurysm at least four weeks after acute myocardial infarction led to the development of a pseudoaneurysm is described. Because the pseudoaneurysm ruptured subacutely and the haemodynamic, clinical, and echocardiographic signs were not consistent, diagnosis of the cardiac rupture was delayed. Operative repair was successful, but the patient died.

Adult↗