scholarly journals Treatment of mid-trimester preterm premature rupture of membranes (PPROM) with multi-resistant bacteria-colonized anhydramnion with continuous amnioinfusion and meropenem: a case report and literature review

2021 ◽  
Author(s):  
Michael Tchirikov ◽  
Ronja Ocker ◽  
Gregor Seliger ◽  
Katarina Chaoui ◽  
Stefan Moritz ◽  
...  
Keyword(s):  
Male Infant ◽  
Resistant Bacteria ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Amniotic Cavity ◽  
E Coli ◽  
Preterm Premature Rupture ◽  
Systemic Antibiotics

Abstract Purpose Treatment of mid-trimester classic preterm premature rupture of membranes (PPROM) with systemic antibiotics has limited success in the prevention of chorioamnionitis, funisitis and fetal inflammatory response syndrome because of very low transplacental passage. Methods Here we report a case of PPROM at 18 weeks gestation with anhydramnion colonized by multi-resistant Escherichia coli (E. coli). A catheter system was implanted at 23/2nd weeks gestation, enabling long-term continuous lavage of the amniotic cavity with Amnion Flush Solution (100 ml/h combined with intraamniotic meropenem application). Results The patient gave birth to a preterm male infant at 28/3rd without any signs of infection. In a follow-up examination at 24 months, there was no neurological disturbance or developmental delay. Conclusion The classic PPROM with multi-resistant E. coli colonization could be treated with continuous amnioinfusion and meropenem.

scholarly journals Changes in Umbilical and Cerebral Blood Flow in Pregnancies Diagnosed with Clinical Chorioamnionitis. Is Chorioamnionitis Predictable?

2019 ◽  
pp. 1
Author(s):  
Berfin Okmen Ozkan ◽  
Emre Ekmekci
Keyword(s):  
Umbilical Artery ◽  
Demographic Data ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Significant Difference ◽  
Umbilical Artery Doppler ◽  
Doppler Evaluation ◽  
Umbilical Arteries

<p><strong>Objective:</strong> To evaluate the predictability of clinical chorioamnionitis by Doppler changes in fetal middle cerebral and umbilical arteries, at hospitalized patients due to preterm premature rupture of membranes.</p><p><strong>Study Design:</strong> Patients who were admitted and hospitalized due to preterm premature rupture of membranes between 24 weeks and 33 weeks and 6 days pregnancies are included in the study. Demographic data of patients, gestational age at referring to hospitalization, fetal presentation at admission, delivery time, delivery indications and total follow-up time until delivery of each case were recorded.</p><p><strong>Results:</strong> A total of 108 patients were evaluated retrospectively. The rate of clinical chorioamnionitis was 5.55% (6/108). There was no significant difference between pregnancies terminated with the diagnosis of clinical chorioamnionitis and pregnancies terminated with other indications in terms of the maximum systolic velocity at middle cerebral artery and umbilical artery pulsatility indices.</p><p><strong>Conclusion:</strong> Clinical chorioamnionitis is a serious complication and is more common in patients being followed up after preterm premature rupture of membranes. Although it is crucial to be predicted due to neonatal worse prognosis, it cannot be predicted by middle cerebral and umbilical artery Doppler evaluation.</p>

A case of severe SARS-CoV-2 infection with negative nasopharyngeal PCR in pregnancy

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Anna Fuchs ◽  
Lauren Harris ◽  
Ashley Huber ◽  
Mia Heiligenstein ◽  
Cassandra Heiselman ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Status ◽  
Igg Antibodies ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Case Presentation ◽  
Preterm Premature Rupture ◽  
High Clinical Suspicion ◽  
Maternal Status

Abstract Objectives SARS-CoV-2 remains a pressing issue for our obstetric community during the current pandemic. We present a case of a 22-year-old nulliparous woman 31 weeks pregnant, with significant clinical SARS-CoV-2 disease, in the setting of negative nasopharyngeal PCR testing but positive IgG antibodies. Case presentation This was a 22-year-old patient 31 weeks pregnant who presented with fever, tachycardia, and subsequently preterm premature rupture of membranes (PPROM) and pulmonary emboli with multifocal pneumonia. The patient underwent three negative SARS-CoV-2 tests via nasopharyngeal PCR testing during her hospital stay as well as a negative workup for fever. After a cesarean section for worsening maternal status after 7 days of hospitalization, the patient was admitted for worsening clinical status to the SICU. At the time of SICU admission patient was found to have serum IgG positive antibodies and was managed with intubation, antibiotics, and anticoagulation. Patient eventually left hospital against medical advice on hospital day 16 on oral antibiotics but was found to be recovering well at later outpatient follow up. Conclusions Diagnosis of SARS-CoV-2 remains a complicated picture in the setting of testing limitations. This case highlights an antepartum clinical presentation of severe SARS-CoV-2 and recommends a high clinical suspicion for diagnosis of SARS-CoV-2 and initiation of treatment in the pregnant population, even in the presence of negative nasopharyngeal PCR testing.

scholarly journals Treatment of Preterm Premature Rupture of Membranes with Oligo-/Anhydramnion Colonized by Multiresistant Bacteria with Continuous Amnioinfusion and Antibiotic Administrations through a Subcutaneously Implanted Intrauterine Port System: A Case Report

2015 ◽  
Vol 42 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Michael Tchirikov ◽  
Zhaxybay Zhumadilov ◽  
Andreas Suhartoyo Winarno ◽  
Roland Haase ◽  
Jörg Buchmann
Keyword(s):  
Good Condition ◽  
Expectant Management ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Antenatal Corticosteroids ◽  
Amniotic Cavity ◽  
Preterm Premature Rupture ◽  
System A ◽  
Multiresistant Bacteria ◽  
Port System

Bacterial infection is one of the main causes of preterm premature rupture of membranes (PPROM) leading to preterm delivery, pulmonary hypoplasia, sepsis and joint deformities. Expectant management, broad-spectrum antibiotics and antenatal corticosteroids are routinely used in this condition with very limited success to prevent bacteremia, chorioamnionitis, funisitis and intra-amniotic infection syndrome. Here, we report a case in which we attempted to treat PPROM at 26+3 weeks of gestation with anhydramnion colonized by multiresistant Klebsiella. A perinatal port system was implanted subcutaneously at 28+0 weeks of gestation, enabling long-term continuous lavage of the amniotic cavity with a hypotonic aqueous composition similar to human amniotic fluid combined with intra-amniotic antibiotic application. The patient gave birth to a preterm female infant at 31+1 weeks without any signs of infection. The girl was discharged with a weight of 2,730 g in very good condition. In the follow-up examinations at 5 months and 1 year of age, there was no apparent neurological disturbance, developmental delay or Klebsiella colonization.

scholarly journals Neonatal Outcome After Hexoprenaline Compared with Atosiban After Preterm Premature Rupture of Membranes

2019 ◽  
Vol 6 (4) ◽  
pp. 171-176
Author(s):  
Daniela Ulrich ◽  
Verena Schneider ◽  
Gerhard Pichler ◽  
Josef Haas ◽  
Valeriu Culea ◽  
...  
Keyword(s):  
Neonatal Outcome ◽  
Categorical Variables ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Outcome Parameters ◽  
Preterm Premature Rupture

AbstractPreterm premature rupture of membranes (PPROM) occurs in up to 3% of all pregnancies. Only few comparative studies have investigated potential risks and benefits between different tocolytic substances in women with PPROM. The aim of this study was to compare the neonatal short term outcome after tocolysis with Atosiban or Hexoprenaline in women with PPROM. This is a retrospective observational cohort study of women with PPROM between 24 and 32 weeks of gestation comparing neonatal and maternal outcome after tocolysis with atosiban or hexoprenaline. Outcome parameters were short term neonatal outcome, maternal tocolytic efficacy, effectiveness and tolerability and neonatal neurodevelopmental long-term outcome. Continuous variables were compared using t-Test or Mann–Whitney U test, as appropriate. For categorical variables Chi-square after Pearson and Fisher exact-test were used to compare the two groups. 93 women were included into this study with 42 women receiving hexoprenaline and 51 women receiving atosiban as primary tocolytic treatment. Mean gestational age was 29 weeks in both groups at the time PPROM. No differences were found for any short term neonatal outcome parameters, tocolytic efficacy, effectiveness and tolerability and neonatal neurodevelopmental long-term outcome. Both hexoprenaline and atosiban do not affect the short and long term neonatal outcome in women with PPROM for the time of lung maturation.

Excellent Outcome of Bacteroides Meningitis in a Newborn Treated with Metronidazole

PEDIATRICS ◽  
1980 ◽  
Vol 66 (3) ◽  
pp. 463-465
Author(s):  
Barbara J. Law ◽  
Melvin I. Marks
Keyword(s):  
Case Report ◽  
Clinical Cure ◽  
White Male ◽  
Bacteroides Fragilis ◽  
Male Infant ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Excellent Outcome

Hydrocephalus has developed in all three reported cases of Bacteroides fragilis meningitis in newborns.1-3 One author suggested this complication was related to the documented persistence of Bacteroides in the CSF despite chloramphenicol therapy.3 In two of the cases metronidazole was tried late in the course, followed by prompt clinical and bacteriologic resolution.1,3 We report a newborn with B fragilis meningitis in whom metronidazole was used early, with rapid sterilization of the CSF, clinical cure, and no sequelae after 12 months of follow-up. CASE REPORT A 2,020-gm white male infant was delivered vaginally at 32 weeks gestation to a healthy primigravida, 52 hours after premature rupture of membranes.

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