Is Maternal Blood Procalcitonin Level a Reliable Predictor for Early Onset Neonatal Sepsis in Preterm Premature Rupture of Membranes?

2016 ◽  
Vol 82 (2) ◽  
pp. 163-169 ◽  
Author(s):  
Orkun Cetin ◽  
Zuhal Dilek Aydın ◽  
Fatma Ferda Verit ◽  
Ali Galip Zebitay ◽  
Erbil Karaman ◽  
...  
Author(s):  
Lisnawati Yuyun ◽  
Ali Sungkar ◽  
Rinawati Rohsiswatno ◽  
Noroyono Wibowo ◽  
Denni Hermartin ◽  
...  

Abstract Objective: To identify the association between maternal and umbilical cord vitamin D levels with suspects of early-onset of neonatal sepsis (EONS) in newborns from mothers with preterm premature rupture of membranes (PPROM).Methods: This is a retrospective cohort study conducted from January 2017 to Augusts 2018. Data was taken consecutively from medical records and previous study data at Dr. Cipto Mangunkusumo and Persahabatan Hospital, Jakarta.Results: From total of 72 infants from mothers with PPROM, 22 infants (31%) were EONS-suspected and 50 infants (69%) were not EONS-suspected. There was a significant association between maternal and umbilical cord vitamin D levels with EONS.Conclusion: There was a significant association between maternal and umbilical cord vitamin D levels with EONS.Keywords: early-onset neonatal sepsis, preterm premature rupture of membrane, vitamin D,   Abstrak Tujuan: Untuk mengetahui hubungan antara kadar vitamin D maternal dan tali pusat dengan risiko tejadinya Sepsis Neonatal Awitan Dini (SNAD) pada bayi dari ibu dengan Ketuban Pecah Dini (KPD).Metode: Desain penelitian kohort retrospektif secara consecutive sampling. Data diambil dari rekam medis dan data penelitian sebelumnya di Rumah Sakit Umum Pusat Nasional (RSUPN) Dr. Cipto Mangunkusumo dan Rumah Sakit Umum Pusat (RSUP) Persahabatan, Jakarta. Hasil:  Dari 72 bayi yang dilahirkan dari ibu dengan KPD, 22 bayi (31%) diantaranya diduga mengalami SNAD, sedangkan 50 bayi lainnya tidak mengalami SNAD. Terdapat hubungan yang bermakna antara kadar vitamin D maternal dan tali pusat dengan kejadian SNAD. Kesimpulan:Terdapathubungan yang bermakna antara kadar vitamin D maternal dan tali pusat dengan kejadian SNAD.Kata kunci: ketuban pecah dini,  sepsis neonatal awitan dini, vitamin D


Placenta ◽  
2021 ◽  
Vol 112 ◽  
pp. e66
Author(s):  
Hiller G.G. Ruth ◽  
Zöllkau Janine ◽  
Pastuschek Jana ◽  
Heimann Yvonne ◽  
G.A. Borges Luiz ◽  
...  

1995 ◽  
Vol 3 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Michael J. Kupferminc ◽  
Elizabeth Wickstrom ◽  
Nam H. Cho ◽  
Patricia M. Garcia

Objective: This study was to determine the significance of meconium in the amniotic fluid of pregnancies complicated by preterm premature rupture of membranes (PPROM) without labor.Methods: A case-control study of 31 pregnancies complicated by PPROM at 27–36 weeks gestation with meconium present (study group) and 93 pregnancies complicated by PPROM but without meconium was performed. The patients were matched for year of delivery, gestational age, race, and parity. Pregnancy and neonatal outcome variables of the 2 groups were compared.Results: The incidence of early onset neonatal sepsis was significantly increased in the study group (16.1% vs. 1.1%; P < 0.001). Similarly, chorioamnionitis (48.3% vs. 22.5%; P < 0.01), cesarean delivery for a nonreassuring fetal heart rate pattern (19.4% vs. 3.2%; P < 0.01), a 5-min Apgar score < 7 (22.5% vs. 8.6%; P < 0.05), and fetal growth retardation (FGR) (12.9% vs. 2.2%; P < 0.05) were also more common in pregnancies complicated by PPROM with meconium. The mean umbilical cord arterial pH was significantly lower in these pregnancies (7.18 ± 0.07 vs. 7.28 ± 0.08; P < 0.001). After controlling for confounding variables with multiple logistic regression analysis, we found that meconium in the amniotic fluid remained associated with early onset neonatal sepsis.Conclusions: The presence of meconium in the amniotic fluid of pregnancies complicated by PPROM is associated with an increased incidence of early onset neonatal group B β-hemolytic streptococcus (GBBS) sepsis.


Author(s):  
Ashima Arora ◽  
Ratna Biswas ◽  
Bhawna Dubey ◽  
Binita Goswami ◽  
Sonal Saxena

Background: The aim is to study the effect of antibiotics on inflammatory marker (IL-6) and perinatal outcomes in women with preterm premature rupture of membranes (PPROM).Methods: 60 women with PPROM at 28–34 weeks of gestation were enrolled in the study. All the women were given antibiotics as per hospital protocol and were subjected to blood sampling for Interleukin -6(IL-6) at admission, delivery and umbilical cord blood. IL-6 levels were assessed for associations with adverse perinatal outcomes and the effect of antibiotic treatment on IL-6 and perinatal outcomes were studied. The data were analyzed using t test and χ2 test.Results: Increased level of IL-6 was associated with chorioamnionitis and neonatal sepsis (p<0.001). High level of IL-6 led to early delivery and complete course of antibiotics suppressed IL-6 (p<0.001) and clinical chorioamnionitis in women with PROM. Full course of antibiotics also decreased the admission rate of babies to neonatal intensive care unit and suppressed respiratory distress syndrome, neonatal sepsis.Conclusions: Increased level of IL-6 is seen in women with chorioamnionitis and neonatal sepsis. Antibiotics suppress the IL-6 levels, chorioamnionitis and neonatal sepsis.


2015 ◽  
Vol 21 (4) ◽  
pp. 161-170
Author(s):  
Ieva Daunoravičienė ◽  
Rūta Lenkutienė ◽  
Audrė Musteikytė ◽  
Diana Ramašauskaitė

Background. The study investigates the influence of the length of membrane rupture period among pregnant women with preterm premature rupture of membranes (PPROM) between the 32nd and 34th weeks of gestation on the development of chorioamnionitis and the congenital infection of a newborn. It seeks to ascertain the values of indicators in mother’s blood that enable to predict chorioamnionitis and funisitis for mothers, and congenital infection for newborns. Materials and methods. A retrospective study of case records of women with PPROM at 32 (32 w. + 0 d)–34 (33 w. + 6 d) weeks of gestation and their newborns was performed. Two comparative groups were made: 1) of women who had funisitis and / or chorioamnionitis with or without deciduitis and 2) of women having no proved inflammation (according to the results of histological examination of placentae). Analogically, comparative groups were made of their newborns: those who had diagnosis of congenital infection and those who had no infection. The duration of membrane rupture period and the blood markers were investigated in all the groups. Results. The study included 135 women. Duration of the membrane rupture period lasted 85.17 ± 84.72 hrs in the group of women who had histological inflammation, and 40.06 ± 56.57 hrs in the group with no inflammation, P = 0.01, AUC = 0.735; the critical membrane rupture period value for developing intrauterine infection by the Youden index was 43.7 hrs. The corresponding maternal CRP values (mg/l) were 25.85 ± 40.27 vs. 5.23 ± 7.88 (P = 0.01, AUC = 0.6), the Youden index 4.6 mg/l. For the mothers of the newborns diagnosed with infection, the duration of the membrane rupture period was 55.95 ± 65.04 hrs, for the mothers of the newborns without congenital infection it was 40.25 ± 73.71 hours. Respectively, CRP values for the mothers of newborns averaged 12.25  ±  22.14  mg/l vs. 4.8 ± 4.82 mg/l (P = 0.005). Conclusions. Longer membrane rupture period and higher maternal CRP are correlated with inflammatory changes in the placenta and umbilical cord, thus they can be used as the prognostic indicators of intrauterine infection. When the duration of the membrane rupture period lasts ≥44 hrs, the risk of chorioamnionitis and funisitis increases five times; when the maternal serum CRP is higher than 5 mg/l, funisitis / chorioamnionitis is twice more frequent than at lower than 5 mg/l CRP values.


2018 ◽  
Vol 32 (20) ◽  
pp. 3473-3479 ◽  
Author(s):  
Stefania Ronzoni ◽  
Rohan D’Souza ◽  
Oksana Shynlova ◽  
Stephen Lye ◽  
Kellie E. Murphy

2021 ◽  
Vol 9 (1) ◽  
pp. 96
Author(s):  
Maria Paola Bonasoni ◽  
Andrea Palicelli ◽  
Giulia Dalla Dea ◽  
Giuseppina Comitini ◽  
Paola Nardini ◽  
...  

Klebsiella pneumoniae is a Gram-negative, rod-shaped bacterium, responsible for hospital and community acquired pneumonia, urinary tract and wound infections, and bloodstream dissemination. K. pneumoniae infection in pregnancy, leading to acute chorioamnionitis (AC), preterm premature rupture of membranes (PPROM) and early pregnancy loss in the second trimester, has been rarely reported. Herein, we present a case of K. pneumoniae AC that caused intrauterine fetal demise (IUFD) at 19 weeks + 5 days. The 36-year-old mother was admitted at 18 weeks + 1 day of gestation for threatened abortion. IUFD occurred 11 days after. Fetal postmortem showed severe AC and funisitis, neutrophils within alveoli and intestinal lumen, associated with rod-like bacteria. Fetal blood and lung cultures grew K. pneumoniae, β-lactamase-non-producing strain. Antibiogram revealed sensitivity for piperacillin/tazobactam. Three days after IUFD, the mother presented with fever (37.8 °C) which persisted for one week. Maternal blood and urine cultures were negative. According to fetal microbiological results, available 6 days after IUFD, initial treatment with amoxicillin/clavulanic acid was replaced with piperacillin/tazobactam with full patient recovery. Therefore, in the event of PPROM and IUFD, fetal microbiological investigations should always be performed to isolate the proper etiologic agent and start the correct medical treatment.


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