scholarly journals Second Trimester Fetal Loss Due to Citrobacter koseri Infection: A Rare Cause of Preterm Premature Rupture of Membranes (PPROM)

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 159
Author(s):  
Maria Paola Bonasoni ◽  
Giuseppina Comitini ◽  
Mariangela Pati ◽  
Giuseppe Russello ◽  
Loredana Vizzini ◽  
...  
Keyword(s):  
Fetal Loss ◽  
Second Trimester ◽  
Maternal Transmission ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Abdominal Organs ◽  
First Case ◽  
The Family ◽  
Severe Infections

Citrobacter koseri is a facultative anaerobic, motile, non-spore-forming Gram-negative bacillus, which belongs to the family of Enterobacteriaceae. Severe infections due to Citrobacter spp. have been reported in the urinary tract, respiratory airways, intra-abdominal organs, skin and soft tissue, eye, bone, bloodstream, and central nervous system. In newborns, C. koseri is a well-known cause of meningitis, cerebral abscesses, brain adhesions, encephalitis, and pneumocephalus. Infection can be acquired through vertical maternal transmission or horizontal hospital settings; however, in many cases, the source is unknown. Preterm premature rupture of membranes (PPROM), caused by C. koseri, has rarely been described. Herein, we describe a case of PPROM at 16 weeks and 3 days of gestation, leading to anhydramnios. The parents opted for legal termination of the pregnancy, as the prognosis was very poor. C. koseri was isolated postmortem from a placental subamniotic swab and parenchymal sample, as well as fetal blood and lung. To the best of our knowledge, this is the first case of early second-trimester PPROM in which C. koseri infection was demonstrated.

scholarly journals Klebsiella pneumoniae Chorioamnionitis: An Underrecognized Cause of Preterm Premature Rupture of Membranes in the Second Trimester

2021 ◽  
Vol 9 (1) ◽  
pp. 96
Author(s):  
Maria Paola Bonasoni ◽  
Andrea Palicelli ◽  
Giulia Dalla Dea ◽  
Giuseppina Comitini ◽  
Paola Nardini ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Maternal Blood ◽  
Community Acquired Pneumonia ◽  
Etiologic Agent ◽  
Intestinal Lumen ◽  
Second Trimester ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Threatened Abortion

Klebsiella pneumoniae is a Gram-negative, rod-shaped bacterium, responsible for hospital and community acquired pneumonia, urinary tract and wound infections, and bloodstream dissemination. K. pneumoniae infection in pregnancy, leading to acute chorioamnionitis (AC), preterm premature rupture of membranes (PPROM) and early pregnancy loss in the second trimester, has been rarely reported. Herein, we present a case of K. pneumoniae AC that caused intrauterine fetal demise (IUFD) at 19 weeks + 5 days. The 36-year-old mother was admitted at 18 weeks + 1 day of gestation for threatened abortion. IUFD occurred 11 days after. Fetal postmortem showed severe AC and funisitis, neutrophils within alveoli and intestinal lumen, associated with rod-like bacteria. Fetal blood and lung cultures grew K. pneumoniae, β-lactamase-non-producing strain. Antibiogram revealed sensitivity for piperacillin/tazobactam. Three days after IUFD, the mother presented with fever (37.8 °C) which persisted for one week. Maternal blood and urine cultures were negative. According to fetal microbiological results, available 6 days after IUFD, initial treatment with amoxicillin/clavulanic acid was replaced with piperacillin/tazobactam with full patient recovery. Therefore, in the event of PPROM and IUFD, fetal microbiological investigations should always be performed to isolate the proper etiologic agent and start the correct medical treatment.

scholarly journals A Complicated Case of Acute Promyelocytic Leukemia in the Second Trimester of Pregnancy Successfully Treated with All-trans-Retinoic Acid

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Kanika Agarwal ◽  
Megha Patel ◽  
Vandana Agarwal
Keyword(s):  
Retinoic Acid ◽  
Acute Promyelocytic Leukemia ◽  
Breech Presentation ◽  
Promyelocytic Leukemia ◽  
Second Trimester ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Trans Retinoic Acid ◽  
All Trans Retinoic Acid

A 40-year-old female at 26-week gestation was diagnosed with acute promyelocytic leukemia (APL) after an abnormal prenatal lab workup showed pancytopenia. She was treated with all-trans-retinoic acid (ATRA), idarubicin, and dexamethasone. After day one of treatment, she developed differentiation syndrome, which was treated with dexamethasone. At 30-week gestation, she had preterm premature rupture of membranes and delivered by cesarean section because of the fetus’ breech presentation. Despite ATRA’s potential for teratogenicity, a viable infant was born without apparent anomalies. Postpartum, she underwent consolidation treatment with ATRA and arsenic trioxide (ATO). The patient continued ATRA therapy after delivery and is currently in remission.

scholarly journals Emergency Cervical Cerclage

2021 ◽  
Vol 10 (6) ◽  
pp. 1270 ◽  
Author(s):  
Magdalena Wierzchowska-Opoka ◽  
Żaneta Kimber-Trojnar ◽  
Bożena Leszczyńska-Gorzelak
Keyword(s):  
Premature Birth ◽  
Emergency Treatment ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Cervical Insufficiency ◽  
Second Trimester ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Cervical Cerclage ◽  
Preterm Premature Rupture

Despite the progress of medicine in the last decades, recurrent pregnancy loss, premature birth, and related complications are still a vast problem. The reasons for recurrent pregnancy loss and preterm delivery are diverse and multifactorial. One of the main reasons for these complications is cervical insufficiency, which means that the cervix is weak and unable to remain closed until the date of delivery. It manifests as painless softening and shortening of the cervix without contractions. The aim of the study was to review the available literature on rescue sutures, which are an emergency treatment in pregnancies with premature cervical dilatation and protrusion of the fetal membranes in the second trimester of pregnancy. This review confirms that emergency cerclage reduces the rate of preterm birth in patients with advanced cervical insufficiency. This procedure prolongs gestational age and improves the chances of survival of the newborn without increasing the risk of chorioamnionitis and preterm premature rupture of membranes.

Active Expectant Management of Second-Trimester Preterm Premature Rupture of Membranes

2003 ◽  
Vol 101 (Supplement) ◽  
pp. 36S
Author(s):  
Lee Yang ◽  
Susan K. Hendricks ◽  
Donald R. Taylor ◽  
Roderick F. Hume ◽  
Byron C. Calhoun ◽  
...  
Keyword(s):  
Expectant Management ◽  
Second Trimester ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture

Preterm Premature Rupture of Membranes in Twins: Comparison of Rupture in the Presenting Versus Non-presenting Sac

2020 ◽  
Vol 42 (2) ◽  
pp. 163-168 ◽  
Author(s):  
Elad Mei-Dan ◽  
Zoe Hutchison ◽  
Mark Osmond ◽  
Susan Pakenham ◽  
Eugene Ng ◽  
...  
Keyword(s):  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture

scholarly journals Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) – Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and the Management of Preterm Premature Rupture of Membranes

2019 ◽  
Vol 79 (08) ◽  
pp. 813-833 ◽  
Author(s):  
Richard Berger ◽  
Harald Abele ◽  
Franz Bahlmann ◽  
Ivonne Bedei ◽  
Klaus Doubek ◽  
...  
Keyword(s):  
Preterm Birth ◽  
German Society ◽  
Consensus Conference ◽  
Tertiary Prevention ◽  
Short Version ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Gynecology And Obstetrics ◽  
Self Help Groups

Abstract Aims This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recently published scientific literature, the experience of the members of the guideline commission and the views of self-help groups. Methods The members of the participating medical societies and organizations developed Recommendations and Statements based on the international literature. The Recommendations and Statements were adopted following a formal consensus process (structured consensus conference with neutral moderation, voting done in writing using the Delphi method to achieve consensus). Recommendations Part 2 of this short version of the guideline presents Statements and Recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes.

scholarly journals Neonatal lymphocyte subpopulations analysis and maternal preterm premature rupture of membranes: a pilot study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Margherita Amadi ◽  
Silvia Visentin ◽  
Francesca Tosato ◽  
Paola Fogar ◽  
Giulia Giacomini ◽  
...  
Keyword(s):  
T Cells ◽  
Immune System ◽  
T Cell ◽  
T Helper Cells ◽  
Lymphocyte Subpopulations ◽  
T Helper ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Helper Cells

Abstract Objectives Preterm premature rupture of membranes (pPROM) causes preterm delivery, and increases maternal T-cell response against the fetus. Fetal inflammatory response prompts maturation of the newborn’s immunocompetent cells, and could be associated with unfavorable neonatal outcome. The aims were to examine the effects of pPROM (Mercer BM. Preterm premature rupture of the membranes: current approaches to evaluation and management. Obstet Gynecol Clin N Am 2005;32:411) on the newborn’s and mother’s immune system and (Test G, Levy A, Wiznitzer A, Mazor M, Holcberg G, Zlotnik A, et al. Factors affecting the latency period in patients with preterm premature rupture of membranes (pPROM). Arch Gynecol Obstet 2011;283:707–10) to assess the predictive value of immune system changes in neonatal morbidity. Methods Mother-newborn pairs (18 mothers and 23 newborns) who experienced pPROM and controls (11 mothers and 14 newborns), were enrolled. Maternal and neonatal whole blood samples underwent flow cytometry to measure lymphocyte subpopulations. Results pPROM-newborns had fewer naïve CD4 T-cells, and more memory CD4 T-cells than control newborns. The effect was the same for increasing pPROM latency times before delivery. Gestational age and birth weight influenced maturation of the newborns’ lymphocyte subpopulations and white blood cells, notably cytotoxic T-cells, regulatory T-cells, T-helper cells (absolute count), and CD4/CD8 ratio. Among morbidities, fewer naïve CD8 T-cells were found in bronchopulmonary dysplasia (BPD) (p=0.0009), and more T-helper cells in early onset sepsis (p=0.04). Conclusions pPROM prompts maturation of the newborn’s T-cell immune system secondary to antigenic stimulation, which correlates with pPROM latency. Maternal immunity to inflammatory conditions is associated with a decrease in non-major histocompatibility complex (MHC)-restricted cytotoxic cells.

Preterm premature rupture of membranes

The Lancet ◽  
1996 ◽  
Vol 347 (8995) ◽  
pp. 203-204 ◽  
Author(s):  
P.E. Hay ◽  
D. Taylor-Robinson ◽  
R.F. Lamont ◽  
C.J. Hyde ◽  
A. Fry-Smith ◽  
...  
Keyword(s):  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture
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