1/7. perinatal mortality and maternal mortality at the Provincial Hospital, Quang Ngai, South vietnam, 1967-1970.The perinatal mortality, maternal mortality, infant mortality rates, and the complications of delivery at the Provincial Hospital of Quang Ngai, South vietnam are described. The perinatal mortality is the only valid statistic available as the infant usually leaves the hospital within three days of delivery. knowledge pertaining to the 4th to 28th day after birth is scanty and there is insufficient knowledge about the first year of life. infant mortality is estimated at 277 per 1,000 live births. The perinatal mortality 64.6 per 1,000 live births, and maternal mortality, 106 per 10,000 live births are extremely high in contrast to Western countries. The high perinatal mortality is attributable to deaths during birth, the neonatal and immediate postnatal period. The high maternal mortality is primarily due to caesarean section, anemia, uterine rupture, toxemia, post-partum hemorrhage and puerperal infection.- - - - - - - - - - ranking = 1keywords = puerperal infection (Clic here for more details about this article) |
2/7. Group A streptococcal sepsis and ovarian vein thrombosis after an uncomplicated vaginal delivery.BACKGROUND: Group A streptococcal puerperal sepsis is an uncommon peripartum infection that can quickly progress to a fulminant, multisystemic infection and life-threatening toxin-mediated shock. This infection can be asymptomatic during a short hospital stay after a routine delivery. Early treatment with antibiotics might not alter the course of tissue destruction caused by the exotoxin A. methods: literature searches were performed using the key words "puerperal infections," "streptococcal infections," "septic sacroiliitis," "postpartum septic arthritis," and "postpartum ovarian vein thrombosis." After patient consent was obtained, a report was prepared documenting the disease course, diagnosis, and treatment of a case of puerperal sepsis with multiple serious complications. RESULTS AND CONCLUSION: Puerperal sepsis occurs when streptococci colonizing the genital tract or acquired nosocomially invade the endometrium, adjacent structures, lymphatics, and bloodstream. A lack of symptoms early in the course of infection is common; later, minor somatic complaints can quickly progress to septic shock as effects of the exotoxin A are manifest. women who complain of fever, pelvic pain, or unexplained systemic symptoms in the early postpartum period should have a detailed history and physical examination. All sites of suspected infection should be cultured. If sepsis is suspected, diagnostic imaging includes chest radiographs, contrast-enhanced computed tomographic scans, or magnetic resonance imaging to rule out ovarian vein thrombosis, pelvic abscess, or sacroiliac septic arthritis. Broad-spectrum antibiotic coverage must be initiated immediately after collection of cultures. clindamycin plus a beta-lactam antibiotic is preferred for streptococcal toxic shock syndrome.- - - - - - - - - - ranking = 1keywords = puerperal infection (Clic here for more details about this article) |
3/7. The diagnosis and treatment of a patient with puerperal infection and subdural hygromas.We describe a patient readmitted after developing a persistent postural headache resulting from an accidental lumbar puncture during labor 10 days earlier. magnetic resonance imaging demonstrated bifrontal subdural hygromas and diffuse pachymeningeal enhancement. The patient had signs of a puerperal infection, and an epidural patch was performed with dextran 40 instead of blood, after which gradual improvement was noted. The patient was discharged totally asymptomatic 3 days later.- - - - - - - - - - ranking = 5keywords = puerperal infection (Clic here for more details about this article) |
4/7. life-threatening puerperal infection due to group A streptococci.We describe two patients with life-threatening puerperal infection due to group A beta-hemolytic streptococcus. Each patient had bacteremia, shock, and multi-organ involvement. Both cases were compatible with a recently described streptococcal toxic shock-like illness. Both women failed to improve despite vigorous medical and antibiotic therapies, and each required hysterectomy. Obstetricians should be alert to the importance of early diagnosis and treatment of this potentially lethal infection.- - - - - - - - - - ranking = 5keywords = puerperal infection (Clic here for more details about this article) |
5/7. Puerperal group A streptococcus infection: a case report.BACKGROUND: Group A streptococcus (GAS) sepsis is a rare event but carries a high risk of maternal mortality. CASE: A case of puerperal infection occurred with GAS. This patient had had an uneventful prenatal and intrapartum course. She was noted to have high, spiking fevers immediately postpartum, with minimal clinical symptoms. Her blood cultures were positive for GAS, most likely from a urinary tract infection. She was started on broad-coverage antibiotics and defervesced on postpartum day 4. She remained afebrile and was discharged on postpartum day 8. CONCLUSION: patients with puerperal GAS sepsis commonly appear well clinically, with minor somatic complaints. GAS bacteremia should be suspected and promptly treated in women with high, spiking fevers early in the postpartum period. There are currently no guidelines on preventing vertical transmission. It is unclear how a patient with a previous history of GAS should be managed. Prophylactic use of penicillin during future labor may be warranted.- - - - - - - - - - ranking = 1keywords = puerperal infection (Clic here for more details about this article) |
6/7. Maternal deaths associated with clostridium sordellii infection.clostridium sordellii is a common soil and enteric bacterium that is infrequently recovered from the vagina. We describe three women in which C. sordellii caused puerperal infection and a distinctive and lethal toxic shock-like syndrome. patients were less than 1 week post partum and each had a single, limited focus of infection including infection associated with a retained vaginal sponge, a cesarean section operative site, and endometritis. Each patient had a distinctive course characterized by sudden onset of clinical shock marked by severe and unrelenting hypotension associated with marked, generalized tissue edema and "third spacing" with increased hematocrit, presence of marked leukemoid reaction with total neutrophil counts of 84,000/mm3, 66,000/mm3, and 93,600/mm3, absence of rash or fever, limited or no myonecrosis, and a rapid and uniformly lethal course. hypoalbuminemia was also noted. Similar findings were noted in prior isolated reports of C. sordellii-mediated postpartum or surgical infection. Treatment of animals with C. sordellii or closely related C. difficile toxins produces similar findings. We suggest that localized infection with toxin-producing strains of C. sordellii can produce a rapidly lethal toxic shock-like syndrome. Further study and earlier recognition of this syndrome may be life-saving in other patients.- - - - - - - - - - ranking = 1keywords = puerperal infection (Clic here for more details about this article) |
7/7. haemophilus influenzae implicated in puerperal infection.We have described two cases of haemophilus influenzae isolation, one from a patient with chorioamnionitis and one from a patient with bacteremia and endomyometritis. The first patient responded to cefoxitin and delivery, while the second patient failed to improve satisfactorily with clindamycin and tobramycin therapy, but responded to ampicillin.- - - - - - - - - - ranking = 4keywords = puerperal infection (Clic here for more details about this article) |