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DRCOG MCQs for Circuit C Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Chorio-amnionitis is caused by multiple organisms ascending from the cervix and vagina. Prolonged rupture of membranes is a risk factor. The clinical presentation is one of high maternal fever, fetal tachycardia and uterine irritability. A high vaginal swab should be taken and the mother should be started on systemic broad-spectrum antibiotics such as cefradine and metronidazole. Labour should be induced.
Low Birthweight and Fetal Growth Retardation: Some Preventable Aspects
Published in Asim Kurjak, John M. Beazley, Fetal Growth Retardation: Diagnosis and Treatment, 2020
After malnutrition, infection is likely to be the second most important cause of both fetal growth retardation and preterm delivery throughout the world.11 The infection may just involve the mother with a knock-on effect on the fetus through her illness (e.g., malnutrition, pyrexia, drugs, etc.). Alternatively the infection may involve the fetus and/or placenta as with blood-born organisms such as syphilis, rubella, and malaria. Or infection, usually bacterial, may pass up the birth canal to cause chorion-amnionitis, a condition being increasingly recognized in association with both premature labor and fetal growth retardation, especially in developing countries.12,13 It has been suggested that coitus may on occasion precipitate such infection by dislodging the cervical plug of mucus and permitting organisms to reach the amniotic mambranes. Most vaginal organisms will metabolize prostaglandin precursors in the amnion into prostaglandins. Chorion-amnionitis, rupture of the membranes, placental infection, and premature labor are among the complications which may ensue.14 A similar train of events may be precipitated by the examining finger of the obstetrician or midwife. Indeed the “membrane sweep” used to be a popular method of inducing labor. Trainee obstetricians are now usually taught not to insert a finger into the cervix before the time for delivery has arrived.
Unexplained Fever in Obstetrics
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
In modern obstetric preterm delivery, this remains the single most important factor in neonatal mortality. Chorioamnionitis must be looked for in any women with premature rupture of membranes (PROM) even though it may occur in patients with intact membranes. In the latter, occult genital tract infection is the cause, predisposing to preterm delivery with many pathogens being responsible. Studies have shown the close relationship of vaginal colonization by Streptococcus B hemolyticus and chorioamnionitis, with subsequent severe neonatal disease. The classical signs of amnionitis are maternal and fetal tachycardia, maternal fever, purulent or foul-smelling vaginal discharge, and leukocytosis. When all of these are present, we are already dealing with a severe disease. The infection may be fatal to the fetus and a source of severe morbidity to the mother, without previous warning. In a recent study only 27 of 333 cases of histopathologic chorioamnionitis of 8.1% had maternal fever. The authors estimated that approximately 25% of the preterm deliveries were statistically attributable to chroioamnionitis. A high suspicion of amnionitis should be entertained in any woman with PROM presenting with fever without any apparent cause.
An infant of 26 weeks gestation with congenital miliary tuberculosis complicated by chronic lung disease requiring CPAP was diagnosed on Day 104 of life: congenital tuberculosis was confirmed by detection of calcified ovaries in his mother
Published in Paediatrics and International Child Health, 2022
Akina Matsuda, Naoto Nishizaki, Hanako Abe, Akira Mizutani, Takahiro Niizuma, Kaoru Obinata, Kyoko Oguma, Shintaro Makino, Makoto Ishitate, Toshiaki Shimizu
Generally, TB is diagnosed in mothers following suspicion of the disease in their infants and almost all mothers who deliver an infant with congenital TB are diagnosed after their infants [14]. In this case, pregnancy was achieved via IVF-ET [7,15,16]. Genital TB, a major cause of infertility in women from endemic countries or those of high-risk ethnic groups, is also a risk factor for congenital TB, particularly among those with increasing access to assisted reproductive technology including IVF-ET. Only a few cases of congenital TB after IVF-ET have been detected [7]. Furthermore, in this case, routine placental pathology did not identify acid-fast bacilli. Routine placental pathology is primarily aimed at assessing chorio-amnionitis. Therefore, Ziehl–Neelsen staining is needed to identify acid-fast bacilli. In this case, detailed examination of the placental pathology after the infant developed TB symptoms revealed findings indicative of congenital TB, i.e. necrotising granulomatous deciduitis and sub-chorionitis, with acid-fast bacilli detected on Ziehl–Neelsen staining.
Comparison between maternal and neonatal outcome of PPROM in the cases of amniotic fluid index (AFI) of more and less than 5 cm
Published in Journal of Obstetrics and Gynaecology, 2018
Ashraf Sadat Mousavi, Neda Hashemi, Maryam Kashanian, Narges Sheikhansari, Arash Bordbar, Shayesteh Parashi
In contrast, the other study (Mercer et al. 2006), which was performed on a larger sample size (290 patients), could not show more cases of amnionitis in the cases of amniotic fluid index (AFI) of less than 5 cm, however, latency period was shorter in this group (Mercer et al. 2006). Also, neonatal RDS, but not neonatal sepsis and pneumonia, were more frequently reported. Therefore, there are some controversies regarding the significance of volume of amniotic fluid in the cases of PPROM.
Clinical management of women with listeriosis risk during pregnancy: a review of national guidelines
Published in Expert Review of Anti-infective Therapy, 2018
Lisa Pucci, Mario Massacesi, Giuseppina Liuzzi
During pregnancy, the infection can cause a variety of diseases, ranging from a mild chill to a severe illness. The bacterium indeed can spread to the fetus and may cause severe complications such as amnionitis, preterm labor, spontaneous abortion, stillbirth, or infection of the neonate.