- Email: [email protected]
Treatment of the uteroplacental insufficiency, caused by intraamniotic infection
TUESDAY. SEPTEMBER 5
133
during the birth form amnion- if it was stirred, meconiumlly or stinky, no matter weather the mother gives information about infection or not. At the same time, smears from newborn are taken, shortly after birth, form skin, ear or umbilicus. Smears were taken form a group of newborn, born by mothers with stirred amnion, but we were not in position to take smears for the mothers. Smearsform amnion and newborn 98 Smears only from newborn
54
From 98 smears total, the results ere following: Echerichia
colli
Staphylococcus
............... 38 axeus
35
Haemophilius
influence
4
Streptococcus
beta heamoliticus
5
Bacilus proteus Pathogenic The results of this newborn Echerichia
were not found
colli
............... 28 axeus
bacterial
were not found
24
were 54, and the results were following:
colli
Staphylococcus
4 ................10
Smears taken only from newborn Echerichia
32
coli haemoliticus
Bacilus proteus Pathogenic
11
were following:
Staphylococcus Echerichia
.................. 5
bacterial
............... 22 axeus
21
Echerichia
coli haemoliticus
2
Pathogenic
bacterial
9
were not found
The given results shoe that the most dominant are Staphylococcus aureus and Echerichia colli in both groups. These results are important, because some newborn did not have clinical symptoms, while other may show, form skin diseases to sepsis. It is important that these infections are discovered as early as possible, so they can be treated, because the immune system of the newborns is not developed, and the use of antibiotics is limited. Therefore, a permanent control of pregnant women is necessary, so that infections could be discovered, treated, and healthy children born.
P2.08.09 TREATMENT OF THE UTEROPLACENTAL INSUFFICIENCY, CAUSED BY INTR.4AMNIOTIC INFECTION. A.N. Strizhakov, P.V. Budanov, O.R. Baev, Dept. ob/gyn, Moscow Medical Academy, 4 Kolomensky proezd, Moscow, Russia Objectives: When placental insufficiency and intrauterine growth retardation occur in the absence of OPH-hestosis it’s necessary to find out the reason of forming placental insufficiency and to choose the optimal therapy method. Study Methods: In the period from 13 to 41 weeks of pregnancy 123 patients were examined by retro- and prospective methods. 40 of them(relatively healthy pregnant women) formed the control group; 32 patients had intraanmiotic infection and placental insufficiency but didn’t get any antibacterial therapy(they formed the comparison group); 51 patients had intraamniotic infection and placental insufficiency and they received antibacterial therapy. No patients had HIV-infection, syphilis, rubella, thoxoplasmosis, OPH-hestosis. Results: Only 1.5.6%(5) of the patients(which didn’t have antibacterial therapy) improved their hemodinamical indexes in the fetal and maternal circulation system. Intrauterine growth retardation frequency was 28.1%(9). In the case of using system specific antibacterial therapy in 70.6%(36) there was normalization or stabilization of uteroplacental blood flow. Intrauterine growth retardation frequency in the main group was 19.6%(10), that is almost 1.5 times less than in the comparison group. Besides it after having used antibacterial therapy there was a decrease of misscariage frequency, prelabor or premature rupture of membranes, preterm labor, higher Apgar mark. Conclusions: When there is placental insufficiency as result of contamination of fetal tissues system antibacterial therapy should be used because it can eliminate placental insufficiency and decrease the frequency of maternal and perinatal morbidity.
P2.08.10 PREVALENCE OF URINARY TRACT INFECTIONS IN PATIENTS WITH GESTATIONAL DIABETES MELLITUS D.E.E. Rizk (a), N. Mustafa (b), L. Thomas (a), Departments of Obstetrics and Gynecology Medical Microbiology Faculty of Medicine and Health Sciences, United Arab Emirates. Objectives: To determine the prevalence of urinary tract infections in women with gestational diabetes mellitus and compare this with the prevalence in normal pregnant women. Study Methods: Microbiologic evidence of urinary tract infections was studied in 447 pregnant women with (n=149) or without (control group, n=298) gestational diabetes mellitus after mid-pregnancy. Laboratory investigations included chemical analysis, microscopic examination and culture of a clean mid-stream voided urine specimen. Results: 19 women (4.2% ) had asymptomatic bacteriuria (7 study, 12 control, p=O.9). Of these, 7 (38%) d eveloped symptomatic infection despite treatment with antibiotics (2 study, 5 control, p=O.E) and 6 (31%) had recurrence later in pregnancy (3 study, 3 control, p=O.7). 12 more women (2.6 %) had symptomatic infection (5 study, 7 control, p=O.9), 7 had acute cystitis (3 study, 4 control, p=O.7) and 5 had acute pyelonephritis (2 study, 3 control, p=O.7). Escherichia coli was the commonest pathogen accounting for 23 (74%) infection episodes. Conclusions: Gestational diabetes mellitus was not associated with increased risk of urinary tract infections nor of maternal and perinatal morbidity as a result of infection.
P2.08.11 BACTERIAL AND YEAST INFECTION IN WOMEN WITH CERVICAL INTRAEPITHELIAL NEOPLASIA I.Takac, D. Arko, B. Gorisek, Gynecology and Perinatology Clinic, Maribor Teaching Hospital Ljubljaska, Maribor, Slovenia. Objectives: To determine bacterial and yeast infection of the uterine cervix in women with different grades of cervical intraepithelial neoplasia (CIN). Study Methods: 578 patients with CIN were included in this study. In order to determine the presence of bacterial and yeast infection, a cervical swab was obtained before conization of the uterine cervix. After surgery and the definitive histology report, the frequency of bacterial and yeast infection in different grades of CIN was calculated. Results: Among 578 patients with CIN, bacterial or yeast infection present in 379 (65.6%) patients. In patients with CINl, infection was present in 20 (71.4%), in CIN2 in 106 (69.7%) and in CIN3 in 252 (63.3%) cases. The differences in the frequency of infection among all three groups are not significant. Conclusions: In patients with CIN bacterial and yeast infection of the uterine cervix is very common. Its occurrence does not depend on the grade of CIN.
P2.08.12 PREVENTION OF HIV TRANSMISSION FROM MOTHER TO CHILD IN SRINAGARIND HOSPITAL C. Sakondhavat, Dept. OB/GYN, Faculty of Medicine, Khon Kaen Univeristy, Khon Kaen, Thailand. Objective: The HIV/AIDS epidemic in Thailand is growing rapidly among women of childbearing age, resulting in an increase in the number of HIV infected children. The aim of the study is to evaluate the effectiveness and feasibility of the use of Zidovudine (ZDV) for the prevention of HIV transmission from mother to child in Srinagarind Hospital. Study Methods: Between Jan. 1996.Dec. 1999, HIV infected pregnant women and their newborns were assisted. Informed consent was obtained and HIV-tests were performed after counseling. ZDV for perinatal prophylaxis starting on week 14 to week 36 of gestation and continued throughout pregnancy was given following an ACTG 076 regimen except that during labor, intravenous ZDV was replaced by oral ZDV 300 mgs, given every 3-hours as a loading dose and ZDV syrup 2 mgs/kg every 6 hours for 7 days orally for the newborns. Newborn HIV-Ab and PCR were done at 6 weeks and 6 months after birth. Results: 84 infected HIV pregnant women were enrolled in the study, 83 of whom were delivered. The overall transmission rate was 5.2% with 3/58 children confirmed infected with HIV by at least two positive PCR test results.
133
during the birth form amnion- if it was stirred, meconiumlly or stinky, no matter weather the mother gives information about infection or not. At the same time, smears from newborn are taken, shortly after birth, form skin, ear or umbilicus. Smears were taken form a group of newborn, born by mothers with stirred amnion, but we were not in position to take smears for the mothers. Smearsform amnion and newborn 98 Smears only from newborn
54
From 98 smears total, the results ere following: Echerichia
colli
Staphylococcus
............... 38 axeus
35
Haemophilius
influence
4
Streptococcus
beta heamoliticus
5
Bacilus proteus Pathogenic The results of this newborn Echerichia
were not found
colli
............... 28 axeus
bacterial
were not found
24
were 54, and the results were following:
colli
Staphylococcus
4 ................10
Smears taken only from newborn Echerichia
32
coli haemoliticus
Bacilus proteus Pathogenic
11
were following:
Staphylococcus Echerichia
.................. 5
bacterial
............... 22 axeus
21
Echerichia
coli haemoliticus
2
Pathogenic
bacterial
9
were not found
The given results shoe that the most dominant are Staphylococcus aureus and Echerichia colli in both groups. These results are important, because some newborn did not have clinical symptoms, while other may show, form skin diseases to sepsis. It is important that these infections are discovered as early as possible, so they can be treated, because the immune system of the newborns is not developed, and the use of antibiotics is limited. Therefore, a permanent control of pregnant women is necessary, so that infections could be discovered, treated, and healthy children born.
P2.08.09 TREATMENT OF THE UTEROPLACENTAL INSUFFICIENCY, CAUSED BY INTR.4AMNIOTIC INFECTION. A.N. Strizhakov, P.V. Budanov, O.R. Baev, Dept. ob/gyn, Moscow Medical Academy, 4 Kolomensky proezd, Moscow, Russia Objectives: When placental insufficiency and intrauterine growth retardation occur in the absence of OPH-hestosis it’s necessary to find out the reason of forming placental insufficiency and to choose the optimal therapy method. Study Methods: In the period from 13 to 41 weeks of pregnancy 123 patients were examined by retro- and prospective methods. 40 of them(relatively healthy pregnant women) formed the control group; 32 patients had intraanmiotic infection and placental insufficiency but didn’t get any antibacterial therapy(they formed the comparison group); 51 patients had intraamniotic infection and placental insufficiency and they received antibacterial therapy. No patients had HIV-infection, syphilis, rubella, thoxoplasmosis, OPH-hestosis. Results: Only 1.5.6%(5) of the patients(which didn’t have antibacterial therapy) improved their hemodinamical indexes in the fetal and maternal circulation system. Intrauterine growth retardation frequency was 28.1%(9). In the case of using system specific antibacterial therapy in 70.6%(36) there was normalization or stabilization of uteroplacental blood flow. Intrauterine growth retardation frequency in the main group was 19.6%(10), that is almost 1.5 times less than in the comparison group. Besides it after having used antibacterial therapy there was a decrease of misscariage frequency, prelabor or premature rupture of membranes, preterm labor, higher Apgar mark. Conclusions: When there is placental insufficiency as result of contamination of fetal tissues system antibacterial therapy should be used because it can eliminate placental insufficiency and decrease the frequency of maternal and perinatal morbidity.
P2.08.10 PREVALENCE OF URINARY TRACT INFECTIONS IN PATIENTS WITH GESTATIONAL DIABETES MELLITUS D.E.E. Rizk (a), N. Mustafa (b), L. Thomas (a), Departments of Obstetrics and Gynecology Medical Microbiology Faculty of Medicine and Health Sciences, United Arab Emirates. Objectives: To determine the prevalence of urinary tract infections in women with gestational diabetes mellitus and compare this with the prevalence in normal pregnant women. Study Methods: Microbiologic evidence of urinary tract infections was studied in 447 pregnant women with (n=149) or without (control group, n=298) gestational diabetes mellitus after mid-pregnancy. Laboratory investigations included chemical analysis, microscopic examination and culture of a clean mid-stream voided urine specimen. Results: 19 women (4.2% ) had asymptomatic bacteriuria (7 study, 12 control, p=O.9). Of these, 7 (38%) d eveloped symptomatic infection despite treatment with antibiotics (2 study, 5 control, p=O.E) and 6 (31%) had recurrence later in pregnancy (3 study, 3 control, p=O.7). 12 more women (2.6 %) had symptomatic infection (5 study, 7 control, p=O.9), 7 had acute cystitis (3 study, 4 control, p=O.7) and 5 had acute pyelonephritis (2 study, 3 control, p=O.7). Escherichia coli was the commonest pathogen accounting for 23 (74%) infection episodes. Conclusions: Gestational diabetes mellitus was not associated with increased risk of urinary tract infections nor of maternal and perinatal morbidity as a result of infection.
P2.08.11 BACTERIAL AND YEAST INFECTION IN WOMEN WITH CERVICAL INTRAEPITHELIAL NEOPLASIA I.Takac, D. Arko, B. Gorisek, Gynecology and Perinatology Clinic, Maribor Teaching Hospital Ljubljaska, Maribor, Slovenia. Objectives: To determine bacterial and yeast infection of the uterine cervix in women with different grades of cervical intraepithelial neoplasia (CIN). Study Methods: 578 patients with CIN were included in this study. In order to determine the presence of bacterial and yeast infection, a cervical swab was obtained before conization of the uterine cervix. After surgery and the definitive histology report, the frequency of bacterial and yeast infection in different grades of CIN was calculated. Results: Among 578 patients with CIN, bacterial or yeast infection present in 379 (65.6%) patients. In patients with CINl, infection was present in 20 (71.4%), in CIN2 in 106 (69.7%) and in CIN3 in 252 (63.3%) cases. The differences in the frequency of infection among all three groups are not significant. Conclusions: In patients with CIN bacterial and yeast infection of the uterine cervix is very common. Its occurrence does not depend on the grade of CIN.
P2.08.12 PREVENTION OF HIV TRANSMISSION FROM MOTHER TO CHILD IN SRINAGARIND HOSPITAL C. Sakondhavat, Dept. OB/GYN, Faculty of Medicine, Khon Kaen Univeristy, Khon Kaen, Thailand. Objective: The HIV/AIDS epidemic in Thailand is growing rapidly among women of childbearing age, resulting in an increase in the number of HIV infected children. The aim of the study is to evaluate the effectiveness and feasibility of the use of Zidovudine (ZDV) for the prevention of HIV transmission from mother to child in Srinagarind Hospital. Study Methods: Between Jan. 1996.Dec. 1999, HIV infected pregnant women and their newborns were assisted. Informed consent was obtained and HIV-tests were performed after counseling. ZDV for perinatal prophylaxis starting on week 14 to week 36 of gestation and continued throughout pregnancy was given following an ACTG 076 regimen except that during labor, intravenous ZDV was replaced by oral ZDV 300 mgs, given every 3-hours as a loading dose and ZDV syrup 2 mgs/kg every 6 hours for 7 days orally for the newborns. Newborn HIV-Ab and PCR were done at 6 weeks and 6 months after birth. Results: 84 infected HIV pregnant women were enrolled in the study, 83 of whom were delivered. The overall transmission rate was 5.2% with 3/58 children confirmed infected with HIV by at least two positive PCR test results.