1/14. Second trimester septic abortion and the Dalkon shield.The Dalkon shield was withdrawn from the market in the united states of America last year because of the reports of 11 maternal deaths and 209 cases of septic midtrimester abortions associated with the device in situ. Four cases of late midtrimester septic abortions resulting in neonatal deaths are presented. In one of these, the mother developed septicaemic shock and almost died. The true pregnancy rate with the Dalkon shield is much higher than was initially claimed, particularly if it is inserted in the puerperium. Surveys on the outcome of the pregnancy indicate that 50% end in spontaneous abortion and one in 20 pregnancies are ectopic. A high percentage of the abortions are septic. The Dalkon shield, therefore, has no advantages over other intrauterine contraceptive devices and it remains to be seen whether the recent modification of the device has overcome the disadvantages of the earlier version. If pregnancy is diagnosed with the device in situ, it should be removed if the string is visible. If pregnancy continues with the shield in place, the patient should be observed closely. Should septic abortion occur, active management is indicated and early evacuation of the uterus is recommended.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/14. Fatal clostridial sepsis after spontaneous abortion.BACKGROUND: Although obstetric mortality due to complications of clostridium perfringens infection is rare at present, we report a case of fatal clostridial sepsis secondary to a septic spontaneous abortion. CASE: A woman at 6-8 weeks' gestation presented with vaginal bleeding and abdominal pain. Although afebrile, the patient was hypotensive, tachycardic, and tachypneic. physical examination was remarkable for a 10-weeks'-gestation-size uterus, mild pelvic tenderness, a closed cervix without signs of trauma, and moderate vaginal bleeding. Laboratory studies were consistent with infection, hemolysis, and coagulopathy. Sonography demonstrated echolucencies consistent with gas formation in the endometrial cavity. Despite fluid resuscitation, transfusions, antibiotic therapy, and a dilation and curettage, persistent vaginal bleeding required an emergency hysterectomy. hypotension ensued, and despite aggressive resuscitation attempts, the patient died. CONCLUSION:Rare cases of fatal sepsis secondary to pelvic infection with clostridium perfringens continue to occur. hemolysis, anuria, coagulopathy, and characteristic sonographic findings should heighten suspicion of this potentially fatal infection.- - - - - - - - - - ranking = 0.12006204309514keywords = gestation (Clic here for more details about this article) |
3/14. Clostridium welchii infection following amniocentesis: a case report and review of the literature.We report a case of severe Clostridium welchii infection following amniocentesis with septicaemia, haemolysis, DIC, pulmonary oedema and renal failure. Full recovery occurred following aggressive conservative management using antibiotics, endometrial curettage and intensive monitoring. The patient retained her uterus and had a successful pregnancy two years later although caesarean section for uterine rupture was required. Conservative management with conservation of the uterus and ovaries may be a safe and effective option in the management of severe clostridium infections, using antibiotics, endometrial curettage and multidisciplinary team input.- - - - - - - - - - ranking = 0.25keywords = pregnancy (Clic here for more details about this article) |
4/14. Viable intrauterine pregnancy with acute salpingitis progressing to septic abortion. A case report.BACKGROUND: A viable intrauterine pregnancy with salpingitis has been reported rarely. CASE: A 27-year-old woman at 10 weeks' gestation developed abdominal pain, fever, leukocytosis, peritoneal signs, closed cervix and a viable pregnancy. Progression from acute salpingitis to septic abortion was documented. CONCLUSION: Acute salpingitis in the presence of a viable pregnancy warrants aggressive intervention.- - - - - - - - - - ranking = 1.8100310215476keywords = pregnancy, gestation (Clic here for more details about this article) |
5/14. haemophilus influenzae septic abortion.BACKGROUND: haemophilus influenzae septic abortion is typically caused by nontypeable strains of the organism. Furthermore, nontypeable species with a special affinity for the genital tract are the most frequent isolates encountered, and an ascending vaginal or cervical infection is often the suspected route of transmission. CASE: A 39-year-old woman at 8 weeks gestation who underwent dilation, evacuation, and curettage for embryonic demise had clinical evidence for sepsis and isolation of a nontypeable, ampicillin resistant H. influenzae from blood cultures. Although an ascending vaginal infection was suspected, the route of transmission was not determined. CONCLUSION: Nontypeable strains of. H. influenzae have demonstrated increased beta-lactamase activity, and ampicillin, formerly the treatment of choice, should be used only if isolate susceptibility is known.- - - - - - - - - - ranking = 0.060031021547568keywords = gestation (Clic here for more details about this article) |
6/14. candida sepsis in pregnancy and the postpartum period.Colonization of the vagina by candida is common during pregnancy, while candida sepsis in pregnancy is rare. A case of candida sepsis complicating an abortion prompted us to review seven additional cases that occurred during pregnancy or the postpartum period. In four women candidemia developed during pregnancy or following abortion, while in the other four it developed postpartum. Seven women had an apparent predisposing factor, such as antibiotic treatment or an intrauterine device. The clinical course was difficult in four patients and ended in death in three instances. Both amphotericin b and 5-fluorocytosine proved effective for treatment.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
7/14. Chlamydia and incidental carcinoid tumor in spontaneous abortion.Maternal chlamydia trachomatis infections have been associated with premature rupture of the membranes, preterm labor, premature birth, and fetal wastage. women with acute infection may be at particular risk. We report the case of an unexplained second trimester spontaneous abortion with serologic evidence of recent infection with C. trachomatis. serum IgG antibody titer ultimately exceeded 1:10,240. This patient also had an incidental finding of appendiceal carcinoid tumor. While treatment of asymptomatic chlamydial infections in early pregnancy is controversial, we suggest that delaying treatment may result in fetal loss.- - - - - - - - - - ranking = 0.25keywords = pregnancy (Clic here for more details about this article) |
8/14. Combined intrauterine and extrauterine pregnancy in a consistent twin producer.A case is presented of a simultaneous intra- and extra-uterine pregnancy in a gravida five. The history of persistent twin deliveries assisted in establishing the correct diagnosis when the patient presented with signs of a septic incomplete abortion.- - - - - - - - - - ranking = 1.25keywords = pregnancy (Clic here for more details about this article) |
9/14. Human parvovirus infection in pregnancy and hydrops fetalis.Human parvovirus is the causative agent of erythema infectiosum, a mild epidemic illness. In a recent outbreak in northeast scotland, six women had serologic evidence of having contracted human parvovirus infection during pregnancy. Two of the women had midtrimester abortions, and both abortuses were grossly hydropic with anemia. They had similar microscopical histopathological features--a pronounced leukoerythroblastic reaction, hepatitis, excessive iron pigment in the liver, and eosinophilic changes in the hematopoietic cell nuclei. Dot hybridization with radiolabeled human parvovirus dna probes revealed viral DNA in several tissues from both fetuses, indicating that they had been infected by the virus in utero. The remaining four women had uncomplicated pregnancies and delivered apparently healthy babies, none of whom had human parvovirus-specific IgM antibody at delivery. We conclude that this common virus may pose a serious risk to the fetus after maternal infection.- - - - - - - - - - ranking = 1.25keywords = pregnancy (Clic here for more details about this article) |
10/14. listeriosis and recurrent abortion in a renal transplant recipient.A 29-year-old farmer's wife had received a kidney from her brother (of identical HLA type) at the age of 22 years. She was afterwards immunosuppressed with prednisolone and azathioprine. Her first pregnancy had been uneventful but the second and third had terminated spontaneously at 15 and 24 weeks gestation respectively. Following the third pregnancy, listeria monocytogenes (serotype 4) was grown from the fetus, the placenta and maternal blood. Over the next 18 months, antibody titres which were assessed by an IgG indirect immunofluorescent antibody assay remained high. When the patient became pregnant for a fourth time, 9 months after her second abortion, 250 mg ampicillin were administered three times daily for the remaining duration of the pregnancy. A second child was successfully delivered by Caesarean section at 39 weeks' gestation.- - - - - - - - - - ranking = 0.87006204309514keywords = pregnancy, gestation (Clic here for more details about this article) |
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