Infectious complications of pregnancy

  • 文章类型: Journal Article
    背景:妊娠相关疟疾(PAM)包括妊娠期疟疾(MiP),胎盘疟疾(PM),和先天性疟疾(CM)。哥伦比亚关于PAM的现有证据集中在其中一个演示文稿上(MiP,PM或CM),没有研究纵向分析孕妇的感染,穿过胎盘,直到新生儿的高潮。这项研究确定了MiP的频率,PM,由间日疟原虫引起的CM,恶性疟原虫,或者混合感染,根据厚血涂片(TBS)和定量聚合酶链反应(qPCR)。哥伦比亚西北部PAM的相关因素和临床流行病学结果。
    方法:对431名孕妇进行前瞻性研究,他们的胎盘,以及在“SaludyComunidadCésarUribePiedrahíta”研究小组的数据库中注册的新生儿,该小组在2014年至2020年之间在科尔多瓦和安蒂奥基亚省的地方城市收集了信息。以95%置信区间确定感染频率。用卡方检验进行了比较,学生t检验,患病率比率,并通过对数二项回归控制混杂变量。
    结果:MiP的频率为22.3%(使用TBS为4.6%),PM24.8%(使用TBS为1.4%),和厘米11.8%(0%使用TBS)。使用TBS占优势的间日疟原虫。使用qPCR,MIP和PM的间日疟原虫和恶性疟原虫的比例相似,但恶性疟原虫在CM中占主导地位。未产的频率更高,和以前患有疟疾的妇女。PAM的主要临床疗效是贫血,低出生体重,APGAR评分异常。
    结论:TBS未检测到感染程度,因为大多数病例是亚显微镜下(TBS阴性,qPCR阳性)。这证实了改进病例分子检测的重要性。由于哥伦比亚的控制计划是基于TBS的,因此该国的PAM继续被低估,尽管它对产妇有影响,和先天健康。
    BACKGROUND: Pregnancy Associated Malaria (PAM) include malaria in pregnancy (MiP), placental malaria (PM), and congenital malaria (CM). The evidence available in Colombia on PAM focuses on one of the presentations (MiP, PM or CM), and no study longitudinally analyses the infection from the pregnant woman, passing through the placenta, until culminating in the newborn. This study determined the frequency of MiP, PM, and CM caused by Plasmodium vivax, Plasmodium falciparum, or mixed infections, according to Thick Blood Smear (TBS) and quantitative Polymerase Chain Reaction (qPCR). Identifying associated factors of PAM and clinical-epidemiological outcomes in northwestern Colombia.
    METHODS: Prospective study of 431 pregnant women, their placenta, and newborns registered in the data bank of the research Group \"Salud y Comunidad César Uribe Piedrahíta\" which collected information between 2014 and 2020 in endemic municipalities of the departments of Córdoba and Antioquia. The frequency of infection was determined with 95% confidence intervals. Comparisons were made with the Chi-square test, Student t-test, prevalence ratios, and control for confounding variables by log-binomial regression.
    RESULTS: The frequency of MiP was 22.3% (4.6% using TBS), PM 24.8% (1.4% using TBS), and CM 11.8% (0% using TBS). Using TBS predominated P. vivax. Using qPCR the proportions of P. vivax and P. falciparum were similar for MiP and PM, but P. falciparum predominated in CM. The frequency was higher in nulliparous, and women with previous malaria. The main clinical effects of PAM were anaemia, low birth weight, and abnormal APGAR score.
    CONCLUSIONS: The magnitude of infections was not detected with TBS because most cases were submicroscopic (TBS-negative, qPCR-positive). This confirmed the importance of improving the molecular detection of cases. PAM continue being underestimated in the country due to that in Colombia the control programme is based on TBS, despite its outcomes on maternal, and congenital health.
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  • 文章类型: Case Reports
    The disseminated herpes simplex virus 2 (HSV-2) carries a high mortality rate in pregnant women if left unrecognized. It often presents as unrelieved fever and hepatitis. Diagnosis is challenging due to vague symptoms and potential overlap with other conditions. Pregnancy is a risk factor as it conforms to a partially immunocompromised state. Dissemination to the brain could be devastating, and the treatment requires intravenous antivirals like acyclovir. Fetal outcomes are variable based on previous case reports. We present a case of young female gravida 1 para 1 who presented with disseminated HSV infection mimicking HELLP (Hemolysis, Elevated Liver enzymes, and Low Platelets) syndrome. She responded well to intravenous acyclovir, and the fetus had a viable outcome at the 26th week of gestation. Early diagnosis can prevent progression to fulminant liver failure and the need for a liver transplant.
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  • 文章类型: Journal Article
    目的:验证在大学医院的通用新生儿听力筛查(UNHS)计划中接受护理的围产期/先天性感染(PCI)新生儿的特征。
    方法:采用次要数据进行回顾性横断面研究,从2017年至2019年期间接受治疗的诊断和/或怀疑为PCI的新生儿记录中获取.
    结果:分析的信息涉及到参加该服务并提交给新生儿听力筛查(NHS)的164名新生儿。最普遍的感染是梅毒(67.7%),其次是HIV(20.1%)。NHS失败的新生儿的表达数量(11.5%)。梅毒和HIV病例与老年母亲之间的相关性得到了验证(p<0.035)。
    结论:观察到PCI的患病率增加,证明它是一个重要的指标,而这些感染是可以预防的。在所有分析的年份中,梅毒是最常见的RIHL。NHS是一种早期诊断和干预的手段,必须在儿童生命的头几个月进行。
    OBJECTIVE: To verify the characteristics of neonates with perinatal/congenital infections (PCI) receiving care at a Universal Newborn Hearing Screening (UNHS) program of a university hospital.
    METHODS: A retrospective cross-sectional study was conducted with secondary data, obtained from records of neonates with diagnosis of and/or suspicion for PCI who received care between 2017 and 2019.
    RESULTS: The information analyzed referred to 164 neonates who attended the service and were submitted to Newborn Hearing Screening (NHS). The most prevalent infection was syphilis (67.7%), followed by HIV (20.1%). An expressive number of neonates failed NHS (11.5%). An association was verified between the cases of syphilis and HIV and older mothers (p < 0.035).
    CONCLUSIONS: An increase in the prevalence of PCI was observed, proving it to be an important indicator, whereas these infections can be prevented. In all the years analyzed, syphilis was the most recurrent RIHL. NHS is a means of early diagnosis and intervention that must necessarily be performed in the first months of the child\'s life.
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  • 文章类型: Case Reports
    Disseminated herpes simplex virus 2 (HSV-2) infection, is a rare but devastating infection in pregnancy women. We present the case of a 30-year-old gravida 3, para 2-0-0-2, at 26 weeks 2 days gestation who presented with eleven days of vague and indolent symptoms before a diagnosis of disseminated HSV-2 infection with associated hepatitis was made. While the patient clinically improved with empiric acyclovir treatment, possibility of significant harm to the fetus remained, and the patient request elective termination. The authors review the epidemiology, diagnosis, treatment, and prognosis of disseminated HSV-2 infection in pregnancy.
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  • 文章类型: Comparative Study
    BACKGROUND: Congenital syphilis continues to be a public health problem in Mexico.
    OBJECTIVE: To assess the similarities and differences between national standards, guidelines and international documents related to the detection of syphilis in pregnant women and congenital syphilis.
    METHODS: Two algorithms were developed based on the standard of female care during pregnancy and on the standard for prevention and control of sexually transmitted infections. Based on the Centers for Disease Control (CDC) guidelines, algorithms were developed for syphilis during pregnancy, syphilis in the newborn and sexual contacts.
    RESULTS: The standard for pregnancy mentions that syphilis testing should be carried out in every pregnant woman on her first contact or at delivery, without diagnostic tests being specified. The Official Mexican Standard (NOM) on sexually transmitted infections mentions the traditional algorithm for syphilis detection, treatment follow-up, coinfection with human immunodeficiency virus and congenital syphilis criteria. The CDC recommend reverse algorithm, antibody titer, treatment and follow-up as part of diagnosis.
    CONCLUSIONS: The elimination of mother-to-child transmission of syphilis requires NOMs updating and homogenizing, as well as the study of stillbirths and neonates born to mothers with syphilis.
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  • 文章类型: Journal Article
    UNASSIGNED: Congenital syphilis continues to be a public health problem in Mexico.
    UNASSIGNED: To assess the similarities and differences between national standards, guidelines and international documents related to the detection of syphilis in pregnant women and congenital syphilis.
    UNASSIGNED: Two algorithms were developed based on the standard of female care during pregnancy and on the standard for prevention and control of sexually transmitted infections. Based on the Centers for Disease Control (CDC) guidelines, algorithms were developed for syphilis during pregnancy, syphilis in the newborn and sexual contacts.
    UNASSIGNED: The standard for pregnancy mentions that syphilis testing should be carried out in every pregnant woman on her first contact or at delivery, without diagnostic tests being specified. The Official Mexican Standard (NOM) on sexually transmitted infections mentions the traditional algorithm for syphilis detection, treatment follow-up, coinfection with human immunodeficiency virus and congenital syphilis criteria. The CDC recommend reverse algorithm, antibody titer, treatment and follow-up as part of diagnosis.
    UNASSIGNED: The elimination of mother-to-child transmission of syphilis requires NOMs updating and homogenizing, as well as the study of stillbirths and neonates born to mothers with syphilis.
    UNASSIGNED: La sífilis congénita continúa siendo un problema de salud pública en México.
    UNASSIGNED: Evaluar las similitudes y diferencias entre normas nacionales, guías y documentos internacionales relacionados con la detección de sífilis en embarazadas y sífilis congénita.
    UNASSIGNED: Se elaboraron dos algoritmos basados en las normas sobre atención de la mujer durante el embarazo y sobre prevención y control de infecciones de transmisión sexual. A partir de la guía de Centers for Disease Control and Prevention (CDC) se realizaron algoritmos sobre sífilis durante el embarazo, sífilis en recién nacido y contactos sexuales.
    UNASSIGNED: La norma sobre embarazo menciona que la prueba de sífilis debe efectuarse a toda mujer embarazada en su primer contacto o durante el parto, sin especificar pruebas diagnósticas. La norma oficial mexicana (NOM) sobre infecciones de transmisión sexual menciona el algoritmo tradicional para detección de sífilis, seguimiento al tratamiento, coinfección con virus de inmunodeficiencia humana y criterios de sífilis congénita. CDC recomienda algoritmo reverso, título de anticuerpos, tratamiento y seguimiento como parte del diagnóstico.
    UNASSIGNED: La eliminación de la transmisión maternoinfantil de sífilis requiere actualizar y homogeneizar las NOM, así como el estudio de mortinatos y de recién nacidos de madres con sífilis.
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