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103 records · Page 6Linked to original sources
PubMed1989

[A cured case of adult respiratory distress syndrome caused by septicemia of Staphylococcus aureus].

A 33-year-old woman was admitted as an emergency case because of shock condition after delivery. Physical examination revealed fever, cyanosis and coarse crackles throughout the entire chest. Laboratory data showed leukocytosis and increase of CRP value. Adult respiratory distress syndrome (ARDS) was diagnosed based on progressive severe hypoxemia and bilateral diffuse alveolar shadows on chest X-ray film. The cause of ARDS was considered to be septicemia as staphylococcus aureus was cultured from lochia. The patient was intubated, then artificially ventilated employing PEEP. Chemotherapy using three different kinds of antibiotics was started, combined with the administration of corticosteroid and a protease inhibitor, Urinastatin. The patient finally recovered completely.

Adult↗
PubMed1986

[Experimental inoculation of bovine herpesvirus 4 (strain LVR 140) in pregnant and nonpregnant cows].

Ten cows (5 pregnant and 5 non pregnant) were inoculated with a BHV 4 (Bovine Herpes Virus 4) strain LVR 140. The infection caused metritis symptoms, but only after parturition and even if the calving occurred several weeks after the inoculation. The metritis was accompanied by leucopenia. The virus was reisolated from the lochia and the lymph nodes, in some cases several weeks after parturition. A number of unexplained mortalities was observed during the experiment. The evolution of antibodies detected by the indirect immunofluorescence test (IIF) showed two levels: the first after inoculation and the second after parturition.

Animals↗
PubMed1987

The use of reduced-dose Brucella abortus strain 19 vaccine in the control of bovine brucellosis.

Adult animals from a known negative and an infected herd were vaccinated with reduced-dose Brucella abortus strain 19 vaccine. Since some of these animals developed elevated post-vaccinal blood titres, it is suggested that, when adult vaccination is decided on, such herds should be bled and tested about 4 months after vaccination and thereafter at 2 month intervals. Reactions with complement fixation titres of 392 IU ml-1 or higher on the first test should be taken as positive. During the 2nd and 3rd tests, positive reactions should be taken as less than 98 IU ml-1 and 49 IU ml-1, respectively. After vaccination, an overkill of up to 5%, due to vaccination reactions could be expected. Positive cases might occur up to 9 months after vaccinating an infected herd. On farms selected for adult vaccination suitable calving facilities in isolation, largely facilitate eradication. Lochia samples for the early diagnosis of brucellosis should be collected. Adult vaccination with a reduced dose S 19 vaccine, should be practised on selected, problem herds only, where the owner is fully aware of the consequences of this procedure.

Animals↗
PubMed1981

[Endometrial bacteriology in puerperal infections (author's transl)].

From the third to the sixth day postpartum transcervical endometrial swabs were taken from 51 women with the clinical signs of endometritis, like fever over 38 degree C, uterine tenderness and purulent lochia using prereduced anaerobic transport-media. The specimens were cultured aerobically and anaerobically. 27 women had an endometritis following vaginal delivery, 24 following caesarian section. Following vaginal delivery aerobic bacteria were isolated in 85.2% of the cases and anaerobic bacteria in 62.9%, post caesarian section in 75.1% aerobic and in 83.3% anaerobic bacteria. A mixed aerobic/anaerobic infection was found in 48.1% following vaginal delivery and in 58.4% post caesarian section. The aerobes most frequently recovered were Staphylococcus epidermidis, E. coli, Enterocococci and Streptococci, the prevalent anaerobes were the grampositive anaerobic cocci, Peptostreptococcus and Peptococcus, and Bacteroides species. Our results suggest that anaerobic bacterial play an important role in the endometritis post partum and that frequently a polymicrobial aerobic/anaerobic infection is present. Therapeutically, anaerobes should be taken into consideration especially for the treatment of severer infections following caesarian section. In such cases the 5-Nitroimidazoles, such as Metronidazole or antibiotics effective against anaerobes as Clindamycin or Cefoxitin should be administered.

Anaerobiosis↗
PubMed1982

[A case of post partum gonococcal arthritis].

The authors report a case of gonorrhoea occurring immediately after delivery, characterized by acute inflammatory polyarthritis. The diagnosis was made from swabs taken from the lochia that were cultured on enriched media. The outcome of the disease treated with penicillin was good after 48 hours. The new-born's state of health after swabs take from the nostrils were positive was satisfactory all the time. A review of the literature shows how rare these conditions are, how serious they can sometimes be, and the management that should be undertaken in order to prevent complications occurring.

Adult↗
PubMed1980

Endometritis following vaginal delivery.

The authors reviewed 158 cases of endometritis complicating vaginal delivery. The diagnostic criteria included fever over 100F with uterine tenderness and/or foul lochia. The mean temperature at diagnosis was 102.2F, and only 21 (13%) had temperature less than 100.9F. The majority of patients did not have traditional risk factors. Endometritis was characterized as generally early in onset (84% within 7 days) and usually mild in course (5.0% had bacteremia, 93.7% responded to initial antibiotics). Yet a small group (1.9%) developed documented pelvic abscess, fulminant peritonitis, or suspected septic pelvic thrombophlebitis.

Adult↗
PubMed1995

[Puerperal endometritis: study of 52 clinically and microbiologically diagnosed cases].

BACKGROUND: To know the epidemiologic features, clinical manifestations and etiology of puerperal endometritis in our environment in addition to the use of endometrial cultures in the microbiologic diagnosis of this infection. METHODS: A retrospective study of 52 cases of puerperal endometritis, clinically and microbiologically diagnosed over a 4-year period. RESULTS: Fifty percent of patients had undergone a cesarean, 36.5% presented puerperal anemia and 23% presented upper amniorrhexis at 12 hours. All the patients presented puerperal fever greater than 38 degrees C, 46% uterine subinvolution and 24% fetid lochia. The most frequently isolated microorganisms in the endometrial aspirate were Escherichia coli, Streptococcus agalactiae and Bacteroides spp. The association of ampicillin plus cefoxitine and clindamycin plus tobramycin presented in vitro efficacy in more than 85% of the isolates. CONCLUSIONS: The practice of endometrial aspirate and blood cultures in patients suspected of having puerperal endometritis effectively contributes to the diagnosis and treatment of this infection.

Adult↗
PubMed1994

[Treatment of puerperal endometritis. Evaluation of the efficacy and safety of clindamycin + gentamycin vs. penicillin + chloramphenicol + gentamycin].

This was a prospective, single-blind, comparative study in patients with diagnosis of puerperal endometritis, carried out at the Loayza Hospital in Lima, Peru. The objective of this study was to evaluate the efficacy and safety of clindamycin and gentamicin in the management of endometritis vs. penicillin, chloramphenicol and gentamicin for 10 days. Sixty-five patients were enrolled and 62 were evaluable for efficacy. Both treatment groups were comparable in the pre-treatment period in terms of age, history of pregnancies, controls by gynecologist, days of disease and fever, clinical symptoms like fever, pelvic pain, pulse, uterine size and in laboratory, in hematocrit and leukocytes count. In the culture of endometrium tissue, 27/32 patients (84.4%) in Group A (penicillin + CAF + gentamicin) and 27/30 patients (90%) in Group B (clindamycin + gentamicin) had positive cultures at baseline; 18 and 22 patients showed anaerobes; 8 and 4 patients showed anaerobes plus aerobes and, one patient in each treatment group showed aerobes only. Peptostreptococcus and Bacteroides fragilis were the most frequently isolated pathogens. Improvement in lochia fetidity was more rapid in Group B, it turned transparent and not fetid since day 3. Complete cure was significantly better in Group B 24/30 (80%) in comparison with Group A 16/32 (50%) (p = 0.02). Partial response was found in 15 patients (43.3%) in Group A and 5 patients (16.6%) in Group B. Only one case was considered as bacteriological failure in Group A and only one patient in Group B was considered as failure and required an additional operation due to residual abscess.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Antibiotic prophylaxis in cesarean section].

Childbirth by Caesarean section is associated with 7-10x more complications than spontaneous childbirth [28] whereby the second place is held by infection. One of the possible ways how to prevent these infectious complications is antibiotic prophylaxis. Views on the latter still differ as regards selection of the antibiotic, its effectiveness, onset of administration, dosage, period of administration etc. Prophylaxis should meet the following demands; it should be aimed, of short-term character, bactericide and non-toxic-these demands are met by cephalosporins of the second generation [11]. The objective of the present work was to evaluate the contribution of the prophylactic administration of antibiotics, i.e. a cephalosporin of the second generation-Zinacef (Cefuroxime). The group was formed by 23 women to whom a dose of Zinacef was administered after childbirth by Caesarean section and subsequently twice after 8-hour intervals (1.5-0.75-0.75 i.m.). The control group (23 women) did not have this prophylaxis. In both groups the authors compared the indication of s.c., time of loss of amniotic fluid before s.c., results of cultivations from the cervix, vagina, amniotic fluid, lochiae and sutures. The authors evaluated the postoperative course where they were interested in infectious complications, the temperature curve, period of hospitalization, the necessity to administer another antibiotic or to proceed with the antibiotic therapy after the prophylactic dose. The results are clearly in favour of the prophylactic administration of antibiotics to the risk group of patients delivering by Caesarean section.

Adult↗
PubMed1994

[Characteristics of the course of pregnancy and labor, fetal and neonatal outcome in group B Streptococcus carriers].

A retrospective analysis of the course of pregnancy, labor and its outcome for the fetus and newborn in 103 women in whose lochia group B Streptococcus was found showed a high incidence of pregnancy complications (threatened abortions in 36.9%, late gestosis in 40.7%; high incidence (21.3%) of acute respiratory viral infections during pregnancy; 27.5% of women suffered from chronic pyelonephritis. Preterm labor occurred in 21.7% of cases. Preterm escape of amniotic fluid and rapid parturition took place in 43.7% of women. Perinatal mortality was 12.6%. Pathomorphologic examination of newborns who died in labor or later revealed intrauterine pneumonia in all the cases. Coincidence of the agent serotypes in the mother and child confirmed the fact of intrauterine infection.

Adult↗
PubMed1995

[The sensitivity to antibacterial preparations of enterococcal strains isolated from gynecological patients, pregnant women, puerperae and newborn infants].

The sensitivity to a given number of antibiotics of 205 strains of enterococci, isolated for a period of one year was studied. The enterococci were isolated from materials, sent for microbiological examination in different clinical settings 55 strains of enterococci from the lower genital tract were tested (vaginal and cervical secretions), 36 strains from the upper genital tract (lochia, peritoneal aspirates, IUD), 8 strains from wounds (perineal and abdominal), 37 strains from urine and 69 strains from the newborns. There was a high sensitivity towards carbenicillin--92.7% towards azlocillin 91.2% and towards ampicillin--83.9% The strains, isolated from gynecologic patients showed increased resistance towards aminoglucosides--49.5% towards gentamycin and 46.5% towards amicacin. The resistance towards gentamicin in the newborns was 68.1%. The strains from urine were resistant to cyprofloxacine in 29.7%. All the enterococci tested were practically resistant to cefamandole and oxacilline. The author suggests that for initial therapy in proven or suspected enterococcal infection carbenicilline, azlocillin and ampicillin. They are suitable both for gynecologic patients and newborns. The aminoglucosides have to be administrated after testing because of the significant resistance found for the different strains. The same is true for erythromycin and cyprofloxacine

Anti-Bacterial Agents↗
PubMed1997

[Protracted labor ending with a cesarean section--a high-risk factor for puerperal infection].

The author undertakes a study to investigate the protracted delivery with different duration of prematurely ruptured membranes, to investigate and to compare the morbidity and structure of patients. To investigate the lochia secretions and to compare the microflora of the patients with ruptured membranes at different times with a view to their influence by antibiotic prophylaxis. At the end author makes appropriate conclusions.

Bulgaria↗
PubMedDate not supplied

Double-blind, randomized comparison of the effect of carbetocin and oxytocin on intraoperative blood loss and uterine tone of patients undergoing cesarean section.

OBJECTIVES: A double-blind randomized study involving pregnant women undergoing cesarean section was conducted to compare the effectiveness of a single 100 micrograms intravenous injection of the long-acting oxytocin analog, carbetocin, with that of a standard infusion of oxytocin with respect to intraoperative blood loss. The two treatments also were compared for safety and ability to maintain adequate uterine tone. STUDY DESIGN: The study drug was administered to 57 women during elective cesarean section after placental delivery; blood was collected until abdominal closure. Intraoperative blood loss was calculated with a sensitive colorimetric method. Position, tone of the fundus, and vital signs were assessed up to 24 hours after the operation. The need for additional uterotonic agents was recorded. RESULTS: A single 100 micrograms intravenous injection of carbetocin was as effective as a continuous 16 hour infusion of oxytocin in controlling intraoperative blood loss after placental delivery. Mean blood loss after carbetocin administration was 29 ml less than after oxytocin administration (p = 0.3). Subset analysis deleting two patients who received oxytocic intervention in the operating room and one extreme outlier revealed a mean blood loss of 41 ml less in the carbetocin group (p = 0.14) with lower variances (p = 0.02). The percentage of patients with blood loss of 200 ml or less was greater with carbetocin (79% vs 53%; p = 0.041). Carbetocin enhanced early postpartum uterine involution. The fundus was below the umbilicus in more patients who received carbetocin at 0, 2, 3, and 24 hours on the ward (p < 0.05). There were no significant differences in uterine tone or type or amount of lochia. Additional oxytocin was used to treat three patients for postpartum hemorrhage or persistent uterine atony. All interventions were in the oxytocin group. Vital signs and hematologic values were comparable in each group, confirming similar safety profiles. CONCLUSIONS: A single 100 micrograms intravenous injection of carbetocin is as effective and more reliable than a standard continuous infusion of oxytocin in maintaining adequate uterine tone and preventing excessive intraoperative blood loss during cesarean section after delivery of the placenta. Patients receiving carbetocin required less intervention. Carbetocin was well tolerated.

Adult↗