Risk Factors for Postpartum Maternal Infection Following Spontaneous Vaginal Delivery Complicated by Chorioamnionitis

Daifotis, Helen A.; Smith, Megan M.; Denoble, Anna E.; Dotters‐Katz, Sarah K.

doi:10.1055/s-0040-1709983

Cited by 9 publications

(7 citation statements)

References 17 publications

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“…Spontaneous vaginal delivery (SVD) is a vaginal delivery that happens without using tools to help pull the baby out. This was associated with neonatal septicaemia in our study, here babies could have been exposed to maternal vaginal and fecal bacteria through per-vaginal examination during labour and delivery or as a result of bacteria being introduced into the cervical canal causing vertical transmission from infected mothers to the babies or chorioamnionitis caused by bacteremia that occurs when the amniotic sac breakes before birth [ 55 , 56 ]. which was contrary to other studies that showed cesarean section was more associated with culture-positive cases [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Bacteriological profile, antibiotic susceptibility and factors associated with neonatal Septicaemia at Kilembe mines hospital, Kasese District Western Uganda

et al. 2021

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Introduction Neonatal septicaemia is one of the most common leading causes of neonatal morbidity and mortality in developing countries. It is estimated to affect more than 30 million people worldwide annually, potentially leading to 6 million deaths. Objective(s) To determine the prevalence, bacteriological profile, antibiotic susceptibility and factors associated with neonatal septicaemia among neonates suspected to sepsis at Kilembe mines hospital. Methods We conducted a descriptive cross-sectional study, where purposive sampling technique was used and blood was drawn from 122 neonates suspected to sepsis attending Kilembe Mines Hospital during the period (July to November 2020). Specimens were inoculated in Brain heart infusion broth, transported to Fortportal Regional Referral Hospital, plated daily up to 7 days on blood, chocolate, MacConkey agar and incubated in aerobic and 5% carbondioxide. Pure colonies were identified by Gram stain, biochemical tests and antibiotic sensitivities obtained by Kirby Bauer disc diffusion method. Associations were tested using Chi square with Fisher’s exact or Yates correction tests where necessary and statistical significance was set at P < 0.05. Stata (version 14) used for statistical analysis. Results Blood cultures were positive in 59.0% cases with 55.5% male and 44.4% female. EOS was present in 56.9% and LOS 43.1% of the cases. Gram negative (56.9%) organisms were most implicated with neonatal septicaemia than Gram positives ones (43.1%). Gram positive organisms exhibited better susceptibility to amikacin, linezolid and vancomycin but more resistant to ampicillin and gentamicin. Of the aminoglycosides, amikacin exhibited a verge over netilmicin and gentamicin against Gram negative isolates. Risk factors of neonatal septicaemia were mother’s age of ≥25 years, employed mothers, tertiary-level of education, SVD, ANC attendance of ≥4 times, UTI during pregnancy, PROMS, foul Smelling liquor, urban residence, neonatal birth weight of ≥2500 g, Apgar score 1st and 5th min ≥6 and resuscitation. Conclusion Multi-drug resistant organisms were isolated. Therefore caution is required in selection of antibiotic therapy and avoid empirical treatment.

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Section: Discussionmentioning

confidence: 99%

Bacteriological profile, antibiotic susceptibility and factors associated with neonatal Septicaemia at Kilembe mines hospital, Kasese District Western Uganda

et al. 2021

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“…Se informa leucocitosis en aproximadamente el 70-90% de los casos de corioamnionitis clínica. Sin embargo, la leucocitosis aislada en ausencia de otros signos o síntomas tiene un valor limitado, ya que puede ser inducida por varias otras afecciones, incluido el trabajo de parto y el uso de esteroides (13). Por lo tanto, el monitoreo rutinario del conteo de glóbulos blancos en mujeres de alto riesgo (ruptura prematura de la membrana pretérmino) en ausencia de signos clínicos de corioamnionitis no es útil.…”

Section: Discussionunclassified

“…Otros parámetros de laboratorio que incluyen altos niveles de proteína C reactiva (PCR), proteína de unión a lipopolisacárido, molécula de adhesión intercelular soluble-1 e interleucina-6 se han asociado con un mayor riesgo de corioamnionitis en el contexto de RMP o parto pretérmino (13). Sin embargo, su utilidad para el diagnóstico o la predicción de corioamnionitis como parte de la práctica clínica habitual no está establecida.…”

Section: Discussionunclassified

“…El parto pretérmino es la consecuencia más demostrada de la CA. Un estudio observacional prospectivo temprano de 2774 parejas de madres e infantes encontró que hasta el 25% de los nacimientos prematuros son atribuibles a CA (13). Esto se confirmó más tarde en un estudio de casos y controles que demostró que los neonatos pretérmino tienen probabilidades significativamente mayores de aislamiento bacteriano y hallazgos histológicos de CA.…”

Section: Discussionunclassified

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Corioamnionitis, definición, métodos de diagnóstico y repercusión clínica

Martínez¹,

Guerrido²,

Vera³

et al. 2020

jah

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La corioamnionitis es una complicación común del embarazo asociada con resultados adversos maternos, perinatales y a largo plazo significativos. El diagnóstico es problemático y se basa en criterios clínicos y de laboratorio utilizados de manera inconsistente con un valor predictivo pobre. El objetivo de este estudio es examinar el desempeño de los criterios clínicos y paraclínicos para el diagnóstico de corioamnionitis, además de analizar la información actual sobre definición, epidemiología y fisiopatología de la enfermedad. La muestra estuvo conformada por 20 artículos de revisión de la literatura, ensayos y metaanálisis publicados entre enero del 2015 y febrero del 2020. Se utilizó Pubmed, Scielo y Elsevier como motores de búsqueda de la información. El idioma se limitó para artículos en inglés y español.

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“…There are multiple risk factors for postpartum endometritis including delivery mode ( 62 ), early and moderately preterm birth ( 63 , 64 ), BMI ( 65 ), bacterial colonization with group A or group B Streptococcus ( 66 ), chorioamnionitis, prolonged rupture of membranes, prolonged operative time, poor nutrition, bacterial vaginosis, and multiple vaginal examination ( 67 , 68 ). Of these risk factors associated with PPE, there are now substantial evidence linking the association of birth mode (CS or vaginal delivery) with PPE ( 40 , 41 ).…”

Section: Methodsmentioning

confidence: 99%

Role of short interpregnancy interval, birth mode, birth practices, and the postpartum vaginal microbiome in preterm birth

Odogwu

2023

Front. Reprod. Health

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There have been widely documented beneficial role of vaginal Lactobacillus species as an important biomarker for vaginal health and healthy pregnancy progression. When translating this to clinical settings, pregnant women with low proportions of Lactobacillus and commensurately high proportion of rich and highly diverse abnormal microbiota are most likely to encounter negative pregnancy outcome such as preterm birth and postpartum complications. However, multiple literatures have also addressed this notion that the absence of a Lactobacillus-dominated microbiota does not appear to directly imply to a diseased condition and may not be a major determinant of negative obstetric outcome. Caesarian delivery is notably a risk factor for preterm birth and postpartum endometritis, yet recent data shows a trend in the overuse of CS across several populations. Growing evidence suggest the potential role of vaginal/uterine cleaning practice during CS procedures in influencing postpartum infections, however there is a controversy that this practice is associated with increased rates of postpartum endometritis. The preponderance of bacterial vaginosis associated bacteria vagitype at postpartum which persist for a long period of time even after lochia regression in some women may suggest why short interpregnancy interval may pose a potential risk for preterm birth, especially multigravidas. While specifically linking a community of microbes in the female reproductive tract or an exact causative infectious agent to preterm birth and postpartum pathologies remains elusive, clinical attention should also be drawn to the potential contribution of other factors such as short interpregnancy interval, birth mode, birth practices and the postpartum vaginal microbiome in preterm birth which is explicitly described in this narrative review.

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Risk Factors for Postpartum Maternal Infection Following Spontaneous Vaginal Delivery Complicated by Chorioamnionitis

Cited by 9 publications

References 17 publications

Bacteriological profile, antibiotic susceptibility and factors associated with neonatal Septicaemia at Kilembe mines hospital, Kasese District Western Uganda

Bacteriological profile, antibiotic susceptibility and factors associated with neonatal Septicaemia at Kilembe mines hospital, Kasese District Western Uganda

Corioamnionitis, definición, métodos de diagnóstico y repercusión clínica

Role of short interpregnancy interval, birth mode, birth practices, and the postpartum vaginal microbiome in preterm birth

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