Postpartum endometritis and infection following incomplete or complete abortion: Case definition &amp; guidelines for data collection, analysis, and presentation of maternal immunization safety data

Rouse, Caroline E.; Eckert, Linda O.; Muñoz, Flor M.; Stringer, Jeffrey S. A.; Kochhar, Sonali; Bartlett, Linda; Sanicas, Melvin; Dudley, Donald J.; Harper, Diane M.; Bittaye, Mustapha; Meller, Lee; Jehan, Fyezah; Maltezou, Helena C.; Šubelj, Maja; Bardají, Azucena; Kachikis, Alisa; Beigi, Richard H.; Gravett, Michael G.

doi:10.1016/j.vaccine.2019.09.101

Cited by 26 publications

(26 citation statements)

References 43 publications

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“…Specifically, this initiative proposed systematic data collection, specific case definitions of key obstetric and neonatal health outcomes, ontology of key terms and a map of pertinent disease codes. More recently, case definition and guidelines for data collection, analysis and presentation has been proposed for neonatal seizures, neurodevelopmental delay, chorioamnionitis and post-partum endometritis and infection by the GAIA and Brighton collaboration working groups ( 21 – 24 ). Future studies assessing safety of immunization during pregnancy should use the proposed terms and definitions.…”

Section: Safety Of Immunization During Pregnancymentioning

confidence: 99%

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

et al. 2020

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Section: Safety Of Immunization During Pregnancymentioning

confidence: 99%

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

et al. 2020

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“…63 Septic abortion is diagnosed based on fever and uterine tenderness and is treated by prompt removal of any remaining POC and administration of broad-spectrum antibiotics. 63,64 The uterus might be softened by the infection, increasing the risk of uterine perforation or uterine atony, which might require a hysterectomy. Pelvic abscess formation is also a risk and could result in hysterectomy and, potentially, salpingectomy and oophorectomy.…”

Section: Septic Abortionmentioning

confidence: 99%

“…PPE occurs more frequently after cesarean delivery (>20-fold increased risk), particularly after prolonged labor or ruptured membranes (historical rates >25%). 64 , 72 Antibiotic prophylaxis after cord clamping (avoiding infant exposure) reduced PPE by 60% to 70%, 72 and preoperative antibiotic prophylaxis (before skin incision) reduced rates by an additional 40%–50%. 73 , 74 Vaginal cleansing in addition to surgical skin preparation might also reduce postoperative infection rates.…”

Section: Infectious Complications Specific To Pregnancymentioning

confidence: 99%

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Immune Regulation, Maternal Infection, Vaccination, and Pregnancy Outcome

PrabhuDas

Piper

Jean‐Philippe

et al. 2021

Journal of Women's Health

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About 12.5% of all maternal deaths in the United States are due to infectious causes. This proportion, although stable during the past three decades, represents an increase in infectious causes of mortality, as the overall mortality rate in U.S. pregnant women had increased steadily during that same period. During healthy pregnancies, a delicate immunological balance-in which a mother's immune system tolerates the semi-allogeneic fetus yet maintains immune competency against infectious agents-is achieved and maintained. This immunological paradigm, however, results in increased susceptibility to infectious diseases during pregnancy, particularly in later stages and during the early postpartum period. The inflammatory process induced by these infectious insults, as well as some noninfectious insults, occurring during pregnancy can disrupt this carefully achieved balance and, in turn, lead to a state of rampant inflammation, immune activation, and dysregulation with deleterious health outcomes for the mother and fetus. Elucidating mechanisms contributing to the disruption of this immunologic homeostasis, and its disruption by infectious pathogens, might offer opportunities for interventions to reduce maternal and fetal morbidity and mortality.

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“…Puerperal sepsis (P. sepsis) is a genital tract infection that occurs after delivery or miscarriage. It is accountable for >10% of maternal fatalities globally and excessively occur in developing nations [1]. P. sepsis seems to be the world's third leading factor for maternal fatalities following hypertension and hemorrhage, and the 2nd leading factor in Asians and Africans following hemorrhage [2].…”

Section: Introductionmentioning

confidence: 99%

Clinical Presentation and Mortality of Women Presented with Puerperal Sepsis at Tertiary Care Hospital

Samreen

Abbasi

Parveen

2020

JPRI

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Objective: To determine the clinical presentation and mortality of women presented with puerperal sepsis at tertiary care Hospital. Materials and Methods: This cross-sectional study was conducted at obstetrics and gynaecology department of Liaquat University of medical and health Sciences, from April 2018 to march 2019. Women having age more than 15 years and presented with sepsis after birth followed by spontaneous vaginal delivery, instrumental or episiotomy vaginal delivery or caesarean section were included. All the data including clinical features and mortality were recorded by study proforma. Data was analyzed by using SPSS version 20. Results: Most of the patients 46.6%, having age between 26 to 35 years. Majority of the patients 48.3% were delivered by normal vaginal delivery (NVD) and 37.9% underwent caesarean section, while 13.8% given birth as NVD with episiotomy. Almost all cases presented with fever and other common clinical features were abdominal pain, vaginal discharge, wound infection and breast tenderness. According to the maternal outcome 24.1% patients were shifted to intensive care unit (ICU), 34.5% had prolonged hospital stay and mortality rate was 10.3%. There was no significant difference in maternal outcome according to mod of delivery; p-values were quite insignificant. Conclusion: It was concluded that puerperal sepsis is a major contributing factor of maternal adverse outcome. Common clinical features were fever, abdominal pain and vaginal discharge.

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Postpartum endometritis and infection following incomplete or complete abortion: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data

Cited by 26 publications

References 43 publications

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

Immune Regulation, Maternal Infection, Vaccination, and Pregnancy Outcome

Clinical Presentation and Mortality of Women Presented with Puerperal Sepsis at Tertiary Care Hospital

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