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Group B Streptococcus
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Asymptomatic group B streptococcus (GBS) colonization in the pregnant patient is associated with an incidence of neonatal GBS disease of 1–2% without intervention. Neonatal disease is divided into early onset and late-onset, with possible complications including sepsis, pneumonia, meningitis, and less frequently focal infections and death.
Nonparametric Methods
Published in Marcello Pagano, Kimberlee Gauvreau, Heather Mattie, Principles of Biostatistics, 2022
Marcello Pagano, Kimberlee Gauvreau, Heather Mattie
The dataset lowbwt contains measurements for a sample of 100 low birth weight infants born in two teaching hospitals in Boston, Massachusetts [81]. The values of Apgar score – an index of neonatal asphyxia or oxygen deprivation – recorded five minutes after birth are saved under the variable name apgar5. The Apgar score is an ordinal random variable that takes values between 0 and 10. Indicators of sex, where 1 represents a male and 0 a female, are saved under the name sex.
Malpresentation And Malposition
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Alexis C. Gimovsky, Andrea Dall’Asta, Giovanni Morganelli, Tullio Ghi
Compared with no ECV, ECV at term is associated with a statistically significant and clinically meaningful 58% reduction in noncephalic birth (relative risk [RR] 0.42, 95% confidence interval [CI] 0.29–0.61) and a 42% decrease in CD (RR 0.58, 95% CI 0.40–0.82) [30]. There are no significant differences in Apgar score ratings <7 at 5 minutes (RR 0.63, 95% CI 0.29–1.36), low umbilical artery pH levels (RR 0.65, 95% CI 0.17–2.44), neonatal admission (RR 0.80, 95% CI 0.48–1.34), perinatal death (RR 0.39, 95% CI 0.09–1.64), or time from enrollment to delivery compared with no ECV [30]. Because ECV is associated with a very low incidence of adverse events and with a significant decrease in CD, all women at or near term with nonvertex presentations should be offered an ECV.
Impact of prolonged use of adjuvant tocolytics after cervical cerclage on late abortion and premature delivery
Published in Journal of Obstetrics and Gynaecology, 2023
Li-Rong Zhao, Shu-Jing Lu, Qing Liu, Ying-Chun Yu, Li Xiao
Pregnancy outcomes are presented in Table 2 and Figure 1. The cerclage was removed in 43 patients at a gestational age of 36–37 weeks, and the success rate was 74.14% (43/58). Seven patients delivered in <28 weeks, six delivered in 28–33+6 weeks, five delivered in 34–37 weeks, and 40 delivered in >37 weeks. Notably, there was a case of triplet pregnancy, two of which were spontaneously aborted. The average delivery gestational age was 35.91 ± 5.16 weeks. The gestational age was prolonged by 16.42 ± 7.84 weeks. The duration of medication (uterine contraction inhibitors or magnesium sulphate) was 15.34 ± 13.16 days. Fifty-four newborns survived and three newborns died because their parents did not continue the treatment. One newborn died because of premature rupture of membranes at 16+5 gestation weeks. There were six cases of neonatal respiratory distress syndrome. Gestational weeks at preterm deliveries ranged between 26 weeks and 4 days to 33 weeks and 2 days, and indication for delivery was foetal heart rate deceleration.
The role of sialic acid-binding immunoglobulin-like-lectin-1 (siglec-1) in immunology and infectious disease
Published in International Reviews of Immunology, 2023
Shane Prenzler, Santosh Rudrawar, Mario Waespy, Sørge Kelm, Shailendra Anoopkumar-Dukie, Thomas Haselhorst
Group B Streptococcus (GBS) also known as Streptococcus agalactiae is the most common bacterial pathogen which is capable of infecting neonates [101]. Due to the colonization of female rectal and vaginal epithelium in some women, neonates are at risk of GBS infections ascending the birth canal and traversing the amniotic membranes or aspirating contaminated amniotic/vaginal fluid at birth [33]. This leads to pneumonia of the neonate most commonly but can also lead to sepsis and meningitis [33]. Serious GBS infections in adults and older children are rare except for those with compromised immune systems [107]. The reason for higher susceptibility of neonates to GBS infection lies in the immaturity of their alveolar macrophages and their corresponding lack of ability to efficiently phagocytize GBS [33]. This was shown in murine models where mouse neonate alveolar macrophages were shown to induce a greater risk of GBS infection while expressing very little Siglec-1 in comparison to older mice [33]. Due to the GBS capsule containing α2,3-linked sialic acids and their interaction with the human Siglec-9 ortholog, Siglec-E inhibits immune signaling and cytokine production through SHP-1/2 mediated TBK1 inhibition [33].
Combined Use of Magnesium Sulfate and Fingolimod for Antenatal Neuroprotection against Inflammation-Mediated Experimental Preterm Brain Injury in a Rat Model
Published in Fetal and Pediatric Pathology, 2022
Serenat Eris Yalcin, Mekin Sezik, And Yavuz, Mehtap Savran, Halil Asci, Ozlem Ozmen
Current treatment strategies for fetal and neonatal infections are largely based on optimal antimicrobial activity, with little emphasis on infection-mediated inflammation. Recent evidence suggests that even when there is no direct bacterial entry into the central nervous system, bacterial infection activates inflammatory pathways that harm the preterm brain [5]. Therefore, together with antimicrobial drugs, safe molecules that inhibit the inflammatory process at an early stage are needed in the prevention of neurologic damage in the fetal brain. Novel therapeutic approaches to modulate infection-mediated inflammatory damage, such as cerebral palsy, may improve long-term outcomes [9]. To prevent adverse pregnancy outcomes caused by inflammation, it is critical to develop therapies that target both maternal and fetal inflammatory responses.