Congenital syphilis as a cause of death in a newborn in 31st week of pregnancy – significance of testing for syphilis during pregnancy

2021 ◽  
Vol 86 (4) ◽  
pp. 242-245
Author(s):  
Lukáš Čapek ◽  
◽  
Aleš Toman
Keyword(s):  
Caesarean Section ◽  
Cause Of Death ◽  
Umbilical Cord ◽  
Preterm Labor ◽  
Congenital Syphilis ◽  
Severe Pneumonia ◽  
Blood Samples ◽  
Primigravid Woman ◽  
Objective Description ◽  
Level Hospital

Summary: Objective: Description of a case of newborn death after acute caesarean section in 31st week of pregnancy because of mother’s syphilitic infection. Results: Fifteen-years-old primigravid woman in 31st week of pregnancy was admitted to a secondary level hospital due to a high risk of preterm labor. The pregnancy was terminated with an acute caesarean section because of pathological cardiotocograph record. The newborn died after 35 min of resuscitation. Blood samples from the umbilical cord and mother’s blood taken by her gynecologist were positive for syphilis. In cooperation with a dermatologist, the treatment has been provided and reported to the National Referential Laboratory. The autopsy of the newborn had found severe pneumonia, necrotic lymphadenitis and pyocele. Conclusion: The diagnosis of congenital syphilis had been determined after the death of a preterm delivered newborn. Resuscitation had no chance to success because of syphilitic damage of the lungs.

Absence of Wharton’s jelly

2020 ◽  
Vol 13 (11) ◽  
pp. e237222
Author(s):  
Sarah J Murphy ◽  
Nikita Deegan ◽  
Bobby D O'Leary ◽  
Peter McParland
Keyword(s):  
Caesarean Section ◽  
Histological Examination ◽  
Umbilical Cord ◽  
Emergency Caesarean Section ◽  
Wharton’S Jelly ◽  
Female Infant ◽  
Fetal Bradycardia ◽  
Wharton's Jelly ◽  
Emergency Caesarean ◽  
Fetal Movements

Wharton’s jelly is a specialised tissue which surrounds the vasculature within the fetal umbilical cord. We present the case of a 42-year-old woman who gave birth to a female infant via emergency caesarean section. At the time of delivery, absence of Wharton’s jelly was noted. This finding was confirmed by histological examination. Emergency caesarean section was necessitated due to a fetal bradycardia, and of note, the patient had presented twice prior to this with reduced fetal movements.

Production of dendritic cells and cytokine-induced killer cells from banked umbilical cord blood samples

2015 ◽  
Vol 2 (11) ◽  
Author(s):  
Phuc Van Pham ◽  
Binh Thanh Vu ◽  
Viet Quoc Pham ◽  
Phong Minh Le ◽  
Hanh Thi Le ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Killer Cells ◽  
Blood Samples

Comparison of Maternal Sera, Cord Blood, and Neonatal Sera for Detecting Presumptive Congenital Syphilis: Relationship With Maternal Treatment

PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 88-91
Author(s):  
Rakesh S. Chhabra ◽  
Luc P. Brion ◽  
Martha Castro ◽  
Lawrence Freundlich ◽  
Joy H. Glaser
Keyword(s):  
Cord Blood ◽  
Prenatal Exposure ◽  
Congenital Syphilis ◽  
Multiple Comparisons ◽  
Serologic Test ◽  
Blood Samples ◽  
The Past ◽  
Maternal Treatment ◽  
Treatment Administration

The incidence of congenital syphilis has increased rapidly over the past few years. Most infected mothers and their newborns are asymptomatic at birth and diagnosis depends on serologic testing during pregnancy and at delivery. This study was initiated to compare maternal sera, cord blood, and neonatal sera for detecting presumptive congenital syphilis and to assess the role of maternal treatment (administration of penicillin to the mother at least 1 month before delivery) on the serologic results at the time of delivery. The serologic results from all live deliveries complicated by a positive maternal and/or neonatal test for syphilis during a 12-month period were compared using χ2 analysis and multiple comparisons for proportions. Of 3306 livebirths, 73 (2.2%) were complicated by a positive maternal or neonatal serology. At delivery, the serologic test was positive in 68 (94%) of 72 maternal sera, 30 (50%) of 60 cord sera, and 43 (63%) of 68 neonatal sera. In the absence of maternal treatment, 95% of the maternal sera, 66% of the cord blood samples, and 86% of the neonatal sera were positive. If the mother had been treated, 94% of maternal sera, 36% of cord sera, and 39% of neonatal sera were positive. Cord blood and neonatal sera appear to be inferior to maternal sera for detecting prenatal exposure to syphilis. Cord serology is also inferior to neonatal serology at 2 to 3 days of age. The most effective way to identify newborns at risk for congenital syphilis is to obtain a maternal serologic diagnosis during pregnancy and to test maternal and neonatal sera at delivery.

scholarly journals WOMAN-PharmacoTXA trial: Study protocol for a randomised controlled trial to assess the pharmacokinetics and pharmacodynamics of intramuscular, intravenous and oral administration of tranexamic acid in women giving birth by caesarean section

2021 ◽  
Vol 6 ◽  
pp. 157
Author(s):  
Monica Arribas ◽  
Ian Roberts ◽  
Rizwana Chaudhri ◽  
Amber Geer ◽  
Danielle Prowse ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Oral Administration ◽  
Tranexamic Acid ◽  
Pregnant Women ◽  
Umbilical Cord ◽  
Controlled Trial ◽  
Maternal Blood ◽  
Oral Solution ◽  
Adult Women ◽  
Intravenous And Oral Administration

Background: Intravenous tranexamic acid (TXA) within 3 hours of birth significantly reduces death due to bleeding in women with postpartum haemorrhage (PPH). Most PPH deaths occur in the first hours after giving birth and treatment delay decreases survival.  One barrier to rapid TXA treatment is the need for intravenous injection. Intramuscular injection and oral solution of TXA would be easier and faster to administer and would require less training. However, the pharmacokinetics (PK), pharmacodynamics and safety of TXA administered by different routes in pregnant women have not been established. The main aim of this study is to ascertain whether IM and oral solution of TXA will be absorbed at levels sufficient to inhibit fibrinolysis in pregnant women. Methods: WOMAN-PharmacoTXA is a prospective, randomised, open label trial to be conducted in Zambia and Pakistan.  Adult women undergoing caesarean section with at least one risk factor for PPH will be included.  Women will be randomised to receive one of the following about 1 hour prior to caesarean section: 1-gram TXA IV, 1-gram TXA IM, 4-grams TXA oral solution or no TXA. Randomisation will continue until 120 participants with at least six post randomisation PK samples are included. TXA concentration in maternal blood samples will be measured at baseline and at different time points during 24 hours after receipt of intervention. Blood TXA concentration will be measured from the umbilical cord and neonate. The primary endpoint is maternal blood TXA concentrations over time. Secondary outcomes include umbilical cord and neonate TXA concentration D-dimer concentration, blood loss and clinical diagnosis of PPH, injection site reactions and maternal and neonate adverse events. Discussion: The WOMAN-PharmacoTXA trial will provide important data on pharmacokinetics, pharmacodynamics and safety of TXA after IV, intramuscular and oral administration in women giving birth by caesarean section. Trial registration: ClincalTrials.gov, NCT04274335 (18/02/2020).

scholarly journals Vitamin A intake of Brazilian mothers and retinol concentrations in maternal blood, human milk, and the umbilical cord

2018 ◽  
Vol 46 (4) ◽  
pp. 1555-1569 ◽  
Author(s):  
Thalia Manfrin Martins Deminice ◽  
Ivan Savioli Ferraz ◽  
Jacqueline Pontes Monteiro ◽  
Alceu Afonso Jordão ◽  
Lívia Maria Cordeiro Simões Ambrósio ◽  
...  
Keyword(s):  
Breast Milk ◽  
Vitamin A ◽  
Human Milk ◽  
Pregnant Women ◽  
Umbilical Cord ◽  
Maternal Blood ◽  
Maternal Serum ◽  
Serum Retinol ◽  
Cross Sectional ◽  
Blood Samples

Objectives To analyse intake of vitamin A (VA) and retinol concentrations in maternal blood, breast milk (BM), and the umbilical cord (UC) of newborns, and to determine the associations among these variables. Methods We performed a cross-sectional, epidemiological study of 180 mother–newborn dyads. Maternal and UC blood samples and BM were collected. VA intake by the mother over 30 days was assessed using a questionnaire. Results Mean retinol concentrations in maternal serum, the UC, and BM were 0.65 ± 0.27, 0.36 ± 0.18, and 2.95 ± 2.70 µmol/L, respectively. Retinol concentrations <0.70 µmol/L were found in 57.2% of maternal blood samples and in 94.9% of UC samples. A total of 27.9% of BM samples showed retinol concentrations <1.05 µmol/L. Mean VA intake by the mothers was 1041.33 ± 1187.86 µg retinol activity equivalents/day and was inadequate (<550 µg retinol activity equivalents/day) in 44.7%. Conclusions High proportions of insufficient retinol concentrations were observed in the UC, maternal blood, and BM. A high percentage of pregnant women had inadequate VA intake. Mothers with insufficient serum retinol concentrations had newborns with lower retinol concentrations in the UC. Higher retinol concentrations were observed in maternal blood and the UC with a higher VA intake.

Correlation between Intrapartum Cardiotocogram findings and cord blood pH in term and preterm labors

2021 ◽  
Vol 17 ◽  
Author(s):  
Shubha Rao ◽  
Himanshi Jain ◽  
Anjali Suneel ◽  
Roopa Padavagodu Shivananda ◽  
Akhila Vasudeva
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Preterm Labor ◽  
Fetal Monitoring ◽  
Cord Blood Sample ◽  
Arterial Blood ◽  
Blood Ph ◽  
Preterm Group ◽  
Fetal Acidosis

Background: The purpose of intrapartum fetal monitoring by cardiotocograph (CTG) is to identify early signs of developing hypoxia so that appropriate action can be taken to improve the perinatal outcome. Although CTG findings are well known to monitor the progress of the labor due to the paucity of recommendations, there has always been a clinical dilemma as the term fetuses respond differently than a preterm fetus. However, umbilical cord blood pH can distinguish the infant at high risk for asphyxia and related sequel. Therefore, because of differences in fetal physiology in term and preterm fetuses, CTG findings vary, and hence the validity of CTG to determine fetal acidosis should be different. Aims and Objectives: This study aimed to correlate abnormal intrapartum CTG findings with umbilical cord blood pH in term and preterm labor and thus evaluate the success of CTG in predicting fetal acidosis during labor. Methods: The present study included 210 women in labor (70 preterm and 140 term) with abnormal intrapartum CTG that was classified as per 2015 revised International Federation of Gynecologists and Obstetrician (FIGO) guidelines. Immediately after delivery 2 ml Umbilical artery cord blood sample was taken in a pre-heparinized syringe for analysis, pH <=7.2 was taken as acidosis and pH >7.2 was taken as normal. The measured data were maternal general characteristics which included gravida status, associated comorbidities, method of induction and character of liquor, the intrapartum CTG tracings recorded the cord arterial blood pH and the neonatal characteristics such as APGAR score and neonatal outcome. Results: Data from 70 preterm labor was compared with 140 term labor. In this study, 20.9 % of the babies had acidosis. Suspicious CTG due to decreased variability were more common in the preterm group than in the term group (21.4% vs. 8.6% p<0.05). Positive predictive value (PPV) of abnormal CTG for fetal acidosis in the preterm group was found to be higher than that in term group, PPV of pathological CTG being even higher than suspicious CTG. Women with suspicious CTG had 82 % less risk of fetal acidosis as compared to pathological CTG. Women with Bradycardia had 5.9 times the risk of fetal acidosis as compared with normal and tachycardia. Conclusion: Abnormal CTG should be managed appropriately without any delay to prevent acidosis and cord blood pH should be done in all labors with abnormal CTG. However, our findings of a higher incidence of lower cord blood pH and suspicious CTG due to decreased variability alone, highlight the limitation of criteria currently used for interpretation of CTG in preterm labors.

scholarly journals Cord Malaria Infection, Complement Activation, Oxidative Stress, Gestational Age, and Birth Weight, Characterized by High Plasmodium falciparum Prevalence in Bamenda, Cameroon

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Oumar Mahamat ◽  
Kidio Gisele Ndum ◽  
Sumo Laurentine ◽  
Ntonifor Ngum Helen
Keyword(s):  
Oxidative Stress ◽  
Birth Weight ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Negative Correlation ◽  
Gestational Age ◽  
Blood Samples ◽  
Total Antioxidant ◽  
Weak Negative Correlation ◽  
And Oxidative Stress

Background. It is unknown whether the presence of Plasmodium falciparum malaria parasites in umbilical cord blood denotes activation of complement and oxidative stress to affect the duration of pregnancy and birth weight. Methods. In a cross-sectional study conducted from January to April 2019 in Bamenda, Cameroon, cord blood samples were collected from 300 women at delivery. Parasitaemia was determined microscopically. Babies’ weight and age of gestation were recorded. Plasma levels of complement and oxidative stress were measured by specific tests. Results. Cord blood malaria prevalence was 21.33%. Babies with an infected cord showed a low birth weight and gestation age than those with uninfected cords. More babies with infected cords had LBW (6.25%) compared to the counterparts (5.50%). The levels of parasitaemia and the babies’ weight showed a weak positive correlation. The prevalence of preterm and postterm birth was 4.33% and 24.33% respectively, with a weak negative correlation between the age of gestation and the umbilical cord parasitaemia. There was correlation between cord parasitaemia and levels of complement haemolytic activity titter (CH50) and specific classical pathway activity (CPA) in cord blood. CH50 and CPA levels, however, were significantly higher in infected cord blood samples, compared with uninfected cord blood samples. CH50 showed a negative correlation with the birth weight and gestational age in infected cord blood samples. The levels of total oxidative stress (TOS) and total antioxidant defense were significantly lower in infected cord blood than uninfected. TOS displayed a positive correlation with the density of parasitaemia and a weak negative correlation with the birth weight and gestational age in infected cord blood. Conclusion. Cord blood infection lowers the complement haemolytic titter, oxygen radicals and total antioxidant defense in neonates. This lowering of complement haemolytic titter and oxygen radical compounds in umbilical cord malaria are associated with low birth weight and preterm birth.

Effect of Chlorhexidine Cleansing of Umbilical Cord for Prevention of Infection

2018 ◽  
Vol 4 (2) ◽  
pp. 35-39
Author(s):  
Md Khairuzzaman ◽  
MA Mannan ◽  
Abdul Matin ◽  
Mst Monjuman Ara Sarker ◽  
Nihar Ranjan Sarker ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Controlled Trial ◽  
Care Group ◽  
Cord Care ◽  
Randomized Controlled ◽  
Group 3 ◽  
Group 2 ◽  
To Receive ◽  
Level Hospital ◽  
Group 1

Background: Chlorhexidine cleansing of the cord can reduce neonatal mortality among newborns.Objective: The aim of study was to determine the effect of cord cleansing with chlorhexidine in reduction of umbilical infection among newborns in hospital settings.Methodology: This randomized controlled trial was carried out between April 2013 to July 2014 and 510 newborns were randomly assigned within a tertiary level hospital in Bangladesh to receive 1 of 3 cord care regimens single cord cleansing with 4% chlorhexidine(Group-1), multiple cord cleansing with 4% chlorhexidine (Group-2)  and clean and dry cord care (Group-3 : control).Results: The risk of umbilical cord infection (omphalitis) was significantly reduced in both the single (Relative risk [RR] 0.15 [95% CI] 0.008-0.93) and multiple chlorhexidine cleansing group (RR 0.37 [95% CI] 0.04- 0.99) compared to the dry cord care group.  The risk of omphalitis was not significantly different between multiple and single chlorhexidine cleansing group (RR 3.14 [0.13-76.54]). Conclusion: Chlorhexidine significantly reduce the risk of umbilical infection in both single and multiple cord cleansing neonates.Bangladesh Journal of Infectious Diseases 2017;4(2):35-39

scholarly journals Raoultella Bacteremia Presenting as an Acute Self-Limited Illness in an Obstetric Patient

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Justin Choi ◽  
Iqra Sheikh ◽  
Melissa Carr ◽  
Robert Shapiro ◽  
Karen Fluet
Keyword(s):  
Abdominal Pain ◽  
Caesarean Section ◽  
Preterm Delivery ◽  
Symptom Onset ◽  
Preterm Labor ◽  
Gravid Female ◽  
Breech Presentation ◽  
Male Infant ◽  
Blood Cultures ◽  
First Case

A 20 year-old female at 27-week gestation was admitted for threatened preterm delivery. Following an initially unremarkable hospital course for 12 days, the patient developed fever, chills, generalized malaise, abdominal pain, and diffuse myalgias on day 13 of hospitalization. Raoultella species was isolated from blood cultures on day 16 of hospitalization. The patient’s condition improved within 24 hours of symptom onset, prior to antibiotic initiation, and a premature, viable male infant at 29 weeks and 6 days of gestation was delivered via caesarean section four days later due to breech presentation in the setting of preterm labor. Here, we present the first case of a Raoultella species infection in a gravid female reported in the literature.

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