Premature amniorrhexis.
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Biomedical subjects
Publications and source records attributed to J W Larsen.
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Group B streptococci (GBS) are responsible for serious infections of newborn infants. An experimental model for GBS infection was developed in the newborn rhesus monkey in order to obtain more information concerning the pathogenesis of such infections. A series of 29 newborn monkeys were inoculated with either type Ic or type III GBS or sterile broth. Fatal neonatal meningitis without associated pneumonia was produced consistently following intracerebral inoculation with either type Ic or type III; intracerebral inoculation with sterile broth produced no apparent disease. Variable disease production followed intravenous or intra-amniotic GBS inoculation, and clinical manifestations ranged from no apparent disease to fatal meningitis and pneumonia. This monkey model may be useful for further investigation of treatment and prevention of neonatal GBS infection.
Amniotic fluid specimens from 110 patients in labor were examined for neutrophils and bacteria. Patients with neutrophils in their amniotic fluid had significantly higher fever indices than patients with clear amniotic fluid. The highest fever indices were found in those patients who delivered by cesarean section after neutrophils were present in their amniotic fluid. Febrile morbidity was significantly reduced in a group of 24 such patients by giving prophylactic antibiotics.
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Fetal cervical teratoma is a cause of polyhydramnios, premature labor, and newborn airway obstruction. Formation of a multispecialty team and use of the EXIT procedure is essential for survival of the neonate. Without a team, there is little hope for fetal survival; mortality will be 80-100%. Early diagnosis and planning are essential. Cervical teratomas can contribute to pulmonary insufficiency and chondromalacia because of a mass effect in utero and underdevelopment of the fetal lungs.
Toxicity to amniotic fluid from many brands of syringes has been reported in the past few years. Thirty amniocentesis samples were exposed to Becton-Dickinson syringes for varying lengths of time and evaluated for growth rate. Six amniocentesis samples were exposed to the syringes for prolonged periods at varying temperatures and also evaluated for growth rate. No evidence of syringe toxicity was found for exposure periods up to 24 h, regardless of storage temperature.
A multicenter, prospective, open-label, randomized trial compared imipenem-cilastatin (I-C) monotherapy with the combination of clindamycin+gentamicin (C+G). Efficacy and tolerability in the treatment of serious pelvic infections were evaluated in 94 female patients with acute salpingitis, pelvic abscess, or postoperative pelvic cellulitis. Duration of therapy averaged 5.4 days for treatment successes and ten days for treatment failures. The overall treatment success rate was 98% (43 of 44 patients) in the I-C group, compared with 92% (46 of 50 patients) in the C+G group (P = NS). Adjunct therapy for two treatment successes in the I-C group included laparoscopy and surgical removal of a pelvic abscess without change in antibiotics. Both I-C and C+G were highly effective and generally well tolerated for the treatment of salpingitis, pelvic abscess, and postoperative pelvic cellulitis.