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At least 379 records · Page 21Linked to original sources
PubMed1988

Histologic chorioamnionitis in pregnancies of various gestational ages. II: Implications in preterm labor.

A retrospective review of placental materials (membranes, chorionic plate, umbilical cord) derived from preterm birth is reported. All those studied had intact membranes on admission and did not have spontaneous rupture. Those with preterm labor unresponsive to tocolysis, including those with brief and more prolonged labors, were compared with those delivered preterm because of maternal or fetal indications without labor. Those with labor had inflammatory changes in all three sites of greater frequency than those without labor. Those with longer labors had significantly higher rates of inflammation than those without labor. In this population, removing the influence of spontaneous rupture and labor over 6 hours long greatly diminished the likelihood of inferring that inflammation of the choriamniotic environment is a cause of preterm labor unresponsive to tocolysis.

Chorioamnionitis↗
PubMed1994

Overwhelming maternal sepsis due to a gas-forming Escherichia coli chorioamnionitis.

We report a case of a patient who developed fulminant sepsis and respiratory distress caused by a gas-forming Escherichia coli intrauterine infection following premature rupture of the membranes and fetal death. Such gas-forming infections are rare, and, when they occur, they are usually caused by Clostridium welchii. This patient was treated with antibiotics, ventilator support, and hysterectomy, and at follow-up was in good health.

Adult↗
PubMed1993

Chorioamnionitis and intraamniotic infection.

Intraamniotic infection is a common (2-4%) event in labor. The predictors of IAI include preterm labor or rupture of membranes, abnormal vaginal flora (e.g., GBS, sexually transmitted disease, bacterial vaginosis), obstetric manipulations (e.g., vaginal exams, internal fetal monitoring) in the presence of ruptured membranes, and diminished host response (due to smoking, drug abuse, obesity, immunodeficiency states, etc.). Group B Streptococcus and Enterobacteriaceae are the most important organisms associated with the polymicrobial infection. Anaerobes predict post-cesarean section complications. Neonatal pneumonia (2-5%) and early neonatal sepsis (1-4%) are the outcomes of the greatest concern and are caused by group B streptococcal or aerobic gram-negative rod infections. These outcomes are kept to a minimum if maternal antibiotic chemotherapy is started interpartum with agents that are safe, cross the placenta, and are active against GBS and Escherichia coli (e.g., ampicillin plus gentamicin). Anaerobic coverage should be added (clindamycin) if a cesarean section is performed. Antipyretics such as acetaminophen will reduce the hyperthermic stress on the fetus, and persistent fetal tachycardia after antipyretics may indicate fetal infection. Continuous electronic fetal monitoring is appropriate in cases of IAI, and providers should be prepared for neonatal resuscitation, early neonatal intravenous antibiotics, and respiratory support at delivery.

Anti-Bacterial Agents↗
PubMed1985

Chorioamnionitis and funiculitis in the placentas of 200 births weighing less than 2.5 kg.

A retrospective histopathological study of the placental and non-placental membranes and umbilical cords of 200 live and stillborn babies weighing less than 2.5 kg is reported. The pathological studies were specifically concerned with the presence of infection as evidenced by a polymorphonuclear leucocytic infiltrate at these sites. Inflammatory lesions were demonstrated in 48.5% of specimens. The incidence of inflammatory lesions was highest in those with prolonged rupture of the membranes, and in the placentas of the smallest and least mature infants of a size appropriate to their gestational age. Puerperal pyrexia, neonatal sepsis and perinatal mortality were also more common in the infected group but none of the perinatal deaths was directly attributable to infection. The role of infection as a cause of premature rupture of the membranes, premature labour and subsequent perinatal outcome is still unclear though our data would suggest it is not unimportant.

Amnion↗
PubMed1991

Prediction of lethal pulmonary hypoplasia and chorioamnionitis by assessment of fetal breathing.

Twenty-three pregnancies with fetuses at risk for pulmonary hypoplasia were studied weekly until delivery. The amount of time spent in fetal breathing activity was recorded under controlled conditions during 1 h using real-time ultrasound. An amniotic fluid index was determined. The clinicians and the pathologist were unaware of the ultrasound findings. Eight of 23 fetuses did not breathe at the last ultrasound examination. Three babies died of pulmonary hypoplasia and two of these showed fetal breathing before birth. The three deaths were associated with rupture of the membranes at less than or equal to 20 weeks gestation and of greater than or equal to 44 days duration. One infant developed bronchopulmonary dysplasia. The amniotic fluid index in these four pregnancies was low and the newborn infants had limb contractures. Chorioamnionitis/funisitis was noted in 13 placentas. Eight fetuses were assessed for fetal breathing within 2 days of birth. The lack of fetal breathing had sensitivity, specificity, positive and negative predictive values of 0.75 for chorioamnionitis/funisitis. In this pilot study the absence of fetal breathing was of no value in predicting lethal pulmonary hypoplasia, but was related to chorioamnionitis/funisitis. We recommend further studies of fetal breathing in relation to fetal/neonatal infections.

Chorioamnionitis↗