30 research outputs found
Tuberculosis in Pregnancy
Tuberculosis (TB) during pregnancy and in the perinatal period was once considered to be an
infrequent event in the United States. After a decade of steady decline, however, the disease has
begun a resurgence. According to the CDC, a 20% increase in the number of reported cases
occurred between 1985 and 1992. The factors associated with this increase are the emergence of
human immunodeficiency virus (HIV) infection, the development of drug-resistant organisms,
substance abuse, homelessness, and immigration. Environmental factors promoting transmission
can be found in overcrowded areas such as correctional facilities, nursing homes, hospitals, and
migrant-worker camps. For a large number of medically underserved women, the obstetrician is
the only interface with medical care, as most of these patients do not have primary-care providers.
It is important, therefore, that health-care providers recognize the clinical symptoms of TB and
follow the recognized guidelines for antenatal screening for TB because the omission of these steps
can lead to potentially disastrous sequelae in the fetus and neonate
Epidemiology of Sexually Transmitted Diseases Among Pregnant Adolescents
Objective: The purpose of this study was to determine the
epidemiology of sexually transmitted diseases (STDs) among pregnant adolescents
An Unusual Case of Urinary Tract Infection in a Pregnant Woman With Photobacterium damsela
We describe a case of a urinary tract infection with an unusual pathogen, Photobacterium damsela, in a pregnant female. This pathogen has been described as having a virulent life threatening nature, so a detailed history and prompt treatment is needed
Epidemiology and Clinical Outcome of Patients Hospitalized With Pelvic Inflammatory Disease Complicated by Tubo-Ovarian Abscess
Objective: The purpose of this retrospective study was to compare the clinical outcome and characteristics of pelvic inflammatory disease (PID) complicated by tubo-ovarian abscess (TOA) with PID
without TOA
Factors associated with attendance at the postpartum blood pressure visit in pregnancies complicated by hypertension.
OBJECTIVES: Women with hypertensive disorders of pregnancy should have a blood pressure evaluation no later than 7-10 days after delivery. The objective of this study was to identify the factors associated with patient attendance at the postpartum blood pressure follow-up visit.
STUDY DESIGN: This was a retrospective cohort study of postpartum women who had a hypertensive disorder of pregnancy. Postpartum follow-up rates were recorded, and characteristics of women who attended a postpartum visit for blood pressure evaluation were compared to women who did not return for the visit. Multiple logistic regression was performed.
MAIN OUTCOME MEASURES: Characteristics of women who returned for a blood pressure visit.
RESULTS: There were 378 women who met inclusion criteria; 193(51.1%) attended the blood pressure visit. Women who returned were older and more likely to have preeclampsia, severe features, magnesium sulfate use, or severe hypertension during hospitalization. They were less likely to have gestational hypertension. Adjusted analysis demonstrated that black/non-Hispanic women (OR 0.53, 95% CI 0.34-0.83), the presence of any preeclampsia diagnosis (OR 2.19, 95% CI 1.03-4.81), and whether the woman underwent a cesarean delivery (OR 3.06, 95% CI 1.85-5.14) remained significant factors in predicting adherence.
CONCLUSIONS: Women who returned for a blood pressure visit were more likely to have had significant hypertensive disease or a cesarean delivery. Non-Hispanic black women had the lowest rate of follow-up. Given black women have the highest rates of maternal morbidity and mortality nationwide, effective interventions to increase follow-up for them are needed
Risk Factors for Hepatitis C Infection Among Sexually Transmitted Disease-Infected, Inner City Obstetric Patients
Objective: To test the hypothesis that our inner city obstetric patients who have been infected with sexually transmitted diseases (STDs) will have a higher prevalence of hepatitis C virus infection than the general population and to identify specific risk factors and high-risk groups. Methods: All patients in our prenatal clinic (July 1997–April 1999) who tested positive for one or more STDs were asked to return for hepatitis C antibody testing. Medical charts of all patients who returned for hepatitis C testing were reviewed. Results: A total of 106 patients with STDs were tested for hepatitis C. Positive screening tests for anti-hepatitis C antibody were found in 6.6% (7/106) of the patients (95% CI = 2.7–13.1%). This frequency is significantly higher than the hepatitis C prevalence (1.8%) in the general United States population (p = 0.006). Multiple logistic regression analysis confirmed only older age (p = 0.016) and positive HIV status (p = 0.023) to be significant predictors of hepatitis C infection. Conclusions: Inner city STD-infected obstetric patients are at high risk for hepatitis C infection compared with the general population. Increasing age and HIV-positive status are risk factors which are significantly associated with hepatitis C infection
Evaluation and Treatment of Cardiac Tamponade in a Pregnant Patient
Cardiac tamponade is an uncommon but life-threatening emergency that may occur in pregnant women. There is a plethora of causes, but prompt diagnosis and intervention is imperative to optimize both maternal and fetal outcomes. We report on a case of a large pericardial effusion leading to cardiac tamponade occurring in the 32nd week of gestation in a previously healthy woman. Rapid recognition and a multidisciplinary team meeting resulted in a therapeutic pericardial window and drainage and relief of symptoms. The woman underwent an uncomplicated repeat cesarean delivery at term with a positive neonatal outcome. This case highlights the importance of a rapid diagnosis and a team-based approach to managing a complex medical condition like cardiac tamponade in pregnancy