Maternal Obstetric Complications Research Articles

Pentazocine and tripelennamine ('T's and blue's'): effects on the fetus and neonate.

Three groups of women enrolled in a comprehensive perinatal addiction program were studied. Group I (n = 13) were addicted to pentazocine and tripelennamine (T's and blue's), group II were low-dose methadone-maintained women (n = 46) and group III women were drug-free controls (n = 27). No differences were seen in maternal age, gravidity, obstetrical complications, gestational age or neonatal Apgar scores. Significant differences were observed between drug-exposed and drug-free neonates in birth weight, length and head circumference. An evaluation of neonatal behavior using the Brazelton Neonatal Behavioral Assessment Scale revealed that infants of mothers who used T's and blue's throughout pregnancy demonstrated interactive deficits and withdrawal similar to methadone-addicted newborns.

Salmonella meningitis in the newborns and young infants in Jakarta, Indonesia.

Experience with salmonella meningitis in the newborn and young infants below the age of 40 days hospitalized during the period 1976- 1979 was described. They constituted 8.6% of the 324 cases of purulent meningitis in children in approximately 20.000 admissions in the 4-year-period. There was a preponderance of males among the patients and the youngest case was 2 days old. The Salmonella serotypes isolated from cerebral spinal fluid were havana ( 17 cases J and oranienburg (11 cases). Of particular interest is the fact that 4 of the infants and their mothers showed the identical offending organisms isolated from the spinal fluid and rectal swab. The most common predisposing maternal obstetric complications were fever and premature rupture of the amniotic membranes, whereas the predisposing factors in the infants were infections, asphyxia arul prematurity. Ventriculitis, subdural effusion/empyema and hydrocephalus were the most common complications. A brief discussion has been made on the appropriate time to perform ventricular tap.

Non-group D alpha-hemolytic streptococci: New neonatal pathogens

Review of the bacteriologic records of a large city-county hospital from 1970 through 1980 has indicated a substantial increase in the frequency of isolation of non-group D alpha-hemolytic streptococci from blood and cerebrospinal fluid of neonates since 1978. These organisms accounted for 23% of all cases of neonatal septicemia and meningitis in 1980, and as a group were exceeded only by group B streptococci (28%) in prevalence. Most neonates (91.2%) had early-onset infection (mean age = 1.4 days); approximately one-third were premature (less than 36 weeks' gestation). Maternal obstetrical complications were common. Nearly 80% of the infants had signs or symptoms suggesting bacterial sepsis. Findings such as concomitant meningitis, shock, chest roentgenogram abnormalities, leukopenia, abnormal numbers of immature neutrophils, and death were infrequent when compared to those accompanying other invasive neonatal bacterial infections, suggesting that non-group D alpha-hemolytic streptococci may be less virulent for the neonate or that neonatal host defense mechanisms are more effective in containing the infection. Careful surveillance for these potential neonatal pathogens seems warranted.

A New Look at the Medical Risks in Late Childbearing

This paper is a review of the medical risks of late childbearing based on national health statistics and the medical literature. The two main topics covered are maternal risks, such as maternal mortality, obstetrical complications, miscarriage, and infertility, and risks to the infant, such as infant mortality, prematurity, and chromosomal abnormalities. The implications of advanced paternal age are discussed. The review concludes that there is no single age at which the risks of pregnancy and childbirth suddenly escalate. Rather, the increments in risk are gradual. For women who are in good health and have access to prenatal and postpartum care, what risks there are can be substantially mitigated through close medical monitoring.

Transmission of group B streptococci among parturient women and their neonates

An investigation was performed to establish the rate of group B streptococcal colonization among third-trimester parturients, their neonates, and nursery personnel. No significant differences in colonization rate (or distribution of serologic types) were found among parturients (25.4 per cent), neonates (26.2 per cent), or nursery personnel (32.2 per cent). Although race, ses, birth weight, and maternal obstetrical complications did not influence the prevalence of asymptomatic colonization with group B streptococci, low birth weight and prolonged rupture of membranes were significantly increased among neonates with proved infection of early onset type. Type III strains were common among asymptomatically colonized neonates (36 per cent) but appeared particularly virulent, accounting for 75 per cent of cerebral spinal fluid isolates from infants with early onset meningitis and 94 per cent from neonates with late onset meningitis. The high incidence of group B streptococcal colonization among parturients and neonates in our population (254/1,000 and 262/1,000, respectively) and the relatively low attack rate for proved neonatal infection (2.9/1,000) would seem to make the antibiotic prophylaxis of gravid female carriers rather impractical. Please note the following usage throughout the paper: Colonized -group B streptococci isolated from culture(s) in a patient without clinical or cultural evidence of invasive or disseminated disease; noncolonized —no group B streptococci detected in culture(s) from a patient with no evidence of group B streptococcal disease.

Suppurative meningitis due to streptococci of lancefield group B: A study of 33 infants

Thirty-three infants with meningitis due to group B streptococcus were evaluated. There was a preponderance of females and white infants among the study group. Twenty of 23 serotyped cerebrospinal fluid isolates were type III. Twelve infants had early onset of meningitis (<10 days of age) characterized by an association with predisposing maternal obstetric complications, nonspecificity of symptoms and signs, severe illness, frequent isolation of group B streptococci from sites other than cerebrospinal fluid or blood, and a mortality rate of 58 per cent. Twenty-one infants had late onset of illness (>10 days of age) characterized by a history of few, if any, predisposing maternal obstetrical complications, typical symptoms and signs of meningitis, less severe illness, infrequent isolation of group B streptococci from sites other than cerebrospinal fluid or blood, and a mortality rate of 14 per cent. Uncomplicated recovery of the patient seemed to correlate with late onset of symptoms and the presence of mild disease on admission. Neurologic sequelae were detected in only one of 23 survivors. Thirty-three infants with meningitis due to group B streptococcus were evaluated. There was a preponderance of females and white infants among the study group. Twenty of 23 serotyped cerebrospinal fluid isolates were type III. Twelve infants had early onset of meningitis (<10 days of age) characterized by an association with predisposing maternal obstetric complications, nonspecificity of symptoms and signs, severe illness, frequent isolation of group B streptococci from sites other than cerebrospinal fluid or blood, and a mortality rate of 58 per cent. Twenty-one infants had late onset of illness (>10 days of age) characterized by a history of few, if any, predisposing maternal obstetrical complications, typical symptoms and signs of meningitis, less severe illness, infrequent isolation of group B streptococci from sites other than cerebrospinal fluid or blood, and a mortality rate of 14 per cent. Uncomplicated recovery of the patient seemed to correlate with late onset of symptoms and the presence of mild disease on admission. Neurologic sequelae were detected in only one of 23 survivors.

An outbreak of urinary tract infections and septicemia due to Escherichia coli in male infants

Eleven previously normal male infants under 2 months of age were admitted forpyelonephritis and sepsis due to E. coli to two Baltimore hospitals during one 12 week period in 1958. Bacteriologic records from one of the hospitals indicated that there was during this time an unusually high incidence of these infections. Strains of E. coli recovered from the blood of 2 of the infants, the only ones available later for study, were both identified as E. coli 04 : K12 (L) : H5. The clinical records of 10 of the infants were reviewed. Maternal obstetric complications were frequent, although the infants' neonatal courses were normal. Six of the infants were discharged from the same newborn nursery during a 3 month period. Clinically and pathologically these infants were similar to previously reported sporadic cases of pyelonephritis and sepsis. The strains of E. coli O4 isolated during the outbreak and a strain of E. coli O7 recovered from another isolated case of pyelonephritis and sepsis were more virulent for mice than an enteropathogenic strain of E. coli O111.