Cases reported "Chorioamnionitis"

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1/65. Placental candidiasis: report of four cases, one with villitis.

    Four cases of placental candidiasis, an uncommon complication of rupture of the membranes, are presented. In addition to chorioamnionitis, in one of these cases villitis was also observed. Villitis is a rare occurrence in Candida infection and this represents only the second case in the literature. The involvement of villi may be suggestive of blood-borne infection. However, since neither the mother nor the foetus presented any signs of systemic dissemination, the authors suggest a hypothesis of contamination of the villi from foci of chorioamnionitis.
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2/65. chorioamnionitis with intact membranes caused by capnocytophaga sputigena.

    We report a case of chorioamnionitis with intact membranes caused by capnocytophaga sputigena. The pregnant woman was hospitalised in preterm labor without fever, neither tenderness, just regular contractions. In spite of the tocolitic treatment the patient gave birth to a girl at 29 weeks' gestation, weighing 1220 g and transferred to intensive care. The newborn had clinical and biological signs of infections and was initially treated by ampicillin, cephalosporin and metronidazol. capnocytophaga sputigena was found on membranes, cord, amniotic fluid and placenta. It was also identified in maternal endocervix culture. Histologic findings showed a focal chorioamnionitis. This was the fourteenth reported case of infection due to capnocytophaga species occurring in pregnancy. All the cases are reviewed.
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3/65. Management of cervical cerclage after preterm premature rupture of membranes.

    The optimal management of preterm premature rupture of membranes (PPROM) in a patient with a cerclage is controversial. The issues are whether the latency period between rupture of membranes and delivery is decreased if the cerclage is removed and whether there is an increased rate of maternal or neonatal infection if the cerclage is kept in place. The data are sparse in directing management of women with prophylactic cerclages placed earlier in their pregnancies who rupture membranes. Latency seems to be increased if the cerclage is kept in place, but maternal and neonatal infectious morbidity is increased also. In women at early gestational ages, keeping the cerclage in place may be warranted until labor ensues. In more advanced gestations, it seems preferable to immediately remove the cerclage upon diagnosis of PPROM.
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4/65. Immature delivery after intrauterine candida albicans infection.

    The case is presented of a patient who delivered an immature infant after an intrauterine candidial infection in the presence of an intrauterine contraceptive device (IUD). 8 other cases of intrauterine Candida infection leading to immature deliveries were gathered from the literature. On the basis of the pathologic findings, the medium of infection is thought to be the amniotic fluid.
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ranking = 3.5
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5/65. Fatal early onset infection in an extremely low birth weight infant due to morganella morganii.

    OBJECTIVE: This paper reports a case of chorioamnionitis due to morganella morganii in a mother who presented with ruptured membranes at 24 weeks' gestation and was treated with dexamethasone and prophylactic ampicillin. Her premature infant developed severe early onset infection due to the same organism and expired. STUDY DESIGN: A clinical case report of M. morganii infection complicating preterm rupture of membranes is presented. Possible risk factors for maternal and neonatal infection with this organism as well as the therapy of neonatal M. morganii infection are discussed. RESULTS: risk factors in the mother included having a cervical cerclage in place and treatment with dexamethasone and prophylactic ampicillin. The major risk factors in the infant were maternal chorioamnionitis and extreme prematurity. The mother responded to treatment with ampicillin, metronidazole, and gentamicin following delivery and had an uncomplicated recovery. Her infant developed severe early onset M. morganii infection complicated by neutropenia, thrombocytopenia, and severe acidosis and expired. Postmortem cultures of pleural fluid, peritoneal fluid, and blood were positive despite treatment with gentamicin, an antibiotic to which the organism was sensitive. CONCLUSION: M. morganii may cause serious infection in pregnancy and in the neonatal period. The use of dexamethasone and prophylactic ampicillin may have increased the risk of infection with this ampicillin-resistant organism. The failure of gentamicin to sterilize the infant's blood and body fluids emphasizes the necessity of treating such infections with a combination of an aminoglycoside and a third-generation cephalosporin, such as cefotaxime.
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ranking = 6
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6/65. Does amniotomy influence the prognosis of babies in cases with severe chorioamnionitis? Report of a twin pregnancy with varying outcome.

    We report our experience in a woman with a twin pregnancy. The patient suffered severe escherichia coli chorioamnionitis and the outcomes were different between the two babies after birth. The first baby had only a mild infection, but the second suffered sepsis and subsequent perinatal death. These differences in outcome appeared to be due to amniotomy performed for the first baby after late labor stage I to augment uterus contractions. Removal of infectious amniotic fluid from the amniotic cavity might thus have prevented the spread of the chorioamnionitis. E. coli sometimes causes severe infection during pregnancy and the perinatal period. In this case, a large number of enteropathogenic E. coli (serotype O-6) was cultured from blood, stool, pharyngeal swab, gastric juice and puncture fluid from the thoracic cavity of the second baby. O-6 is classified an enterotoxigenic strain mainly causing diarrhea because of endotoxin released from bacteria. O-6 has not hitherto been reported as a cause of severe infection in chorioamnionitis and perinatal sepsis.
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ranking = 1.5
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7/65. candida albicans chorioamnionitis associated with preterm labor and sudden intrauterine demise of one twin. A case report.

    BACKGROUND: Although cervicovaginal Candida infections occur in 20-25% of pregnancies, the incidence of ascending infection in these cases is only 0.8%, and such infection rarely causes chorioamnionitis. CASE: Sudden intrauterine fetal demise (IUFD) of twin A occurred in a diabetic primigravida presenting with a twin pregnancy and preterm labor at 33 weeks of gestation. Placental pathology and autopsy of the stillborn twin revealed extensive chorioamnionitis and fetal sepsis in the presence of candida albicans. Twin B was unaffected. CONCLUSION: In this case, C albicans chorioamnionitis seemed to be associated with sudden IUFD.
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ranking = 1.5
keywords = infection
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8/65. Missed abortion complicated by Candida infection in a woman with rested IUD.

    Although Candida species are frequent saprophytes of the female genital tract, chorioamnionitis or intrauterine fetal infections are rarely caused by these fungi. The present report describes a 34-year-old woman G2, P2, presenting with vaginal bleeding in the 11.6 weeks of gestation. Clinical and sonographic examination revealed a missed abortion and rested IUD. Histopathologically, a fungal chorioamnionitis due to Candida spp. was found at the curetting material, confirmed by detection of C. albicans infection on mycological culture. Foreign intrauterine bodies, like IUD's and cerclage sutures predispose to fungal chorioamnitis or fetal infections. This conditions urge repetetive search for Candida spp. to establish early anti-fungal therapy which may be therapeutic for this hithero rare intrauterine infection.
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ranking = 4
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9/65. Absence of connections between spinal nerves and the spinal cord in a twin fetus: a very rare malformation occasionally evidenced at autopsy.

    We describe a rare case of spinal cord malformation in a dichorionic diamniotic twin fetus aborted at 20 weeks' gestation due to acute chorioamnionitis with placental dysmaturity probably caused by a maternal viral infection. At autopsy, there were no connections between the spinal nerves and the spinal cord. The spinal cord lacked the posterior median fissure and gray matter; only a few neurons were present in the anterior and lateral gray columns. No chromosome anomalies were found. Although we cannot reconstruct the pathogenetic chain of events leading to this malformation, we believe that it is correlated with a maternal viral infection. We hypothesize that this viral infection altered the delicate balance between the factors inducing and those inhibiting fetal spinal neural differentiation.
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ranking = 1.5
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10/65. campylobacter fetus subspecies fetus bacteremia associated with chorioamnionitis and intact fetal membranes.

    campylobacter fetus subspecies fetus was isolated from the blood of a patient with chorioamnionitis and intact fetal membranes. The mother improved after appropriate antibiotic treatment, but the infant died of neonatal infection a few minutes after delivery. This is a very unusual etiology of intra-amniotic infection.
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