Pyelonephritis/urosepsis.

<p>HICs, high-income countries.</p

Serious and Life-Threatening Pregnancy-Related Infections: Opportunities to Reduce the Global Burden

Serious and Life-Threatening Pregnancy-Related Infections: Opportunities to Reduce the Global Burde

Timing of four clinical syndromes and their pathogens, and potential opportunities for “bundled” diagnostic–therapeutic interventions.

<p>See <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001324#pmed-1001324-t002" target="_blank">Table 2</a> for further details of the interventions.</p

Septic abortion.

<p>HICs, high-income countries.</p

Common syndromes associated with life-threatening maternal infections and the pathogens most frequently associated with these.

<p>Common syndromes associated with life-threatening maternal infections and the pathogens most frequently associated with these.</p

Literature review strategy.

<p>Relevant studies from the years 1980 to 2012 were identified by searching PubMed, Medline, Embase, and WHO publications. The search strategy used was “([infectious syndrome]) AND (Africa OR Asia OR India OR Thailand OR Bangladesh)”; the infectious syndromes included in our search were those that cause the most morbidity and mortality: puerperal sepsis (PPE, chorioamnionitis), septic abortion, pyelonephritis or urosepsis, and soft tissue infections (necrotizing fasciitis, group A streptococcal infection, and methicillin-resistant staphylococcal infection). All titles and abstracts were reviewed, and those including etiology, prevalence, or pregnancy were selected for further analysis.</p

Interventions for reducing serious morbidities and mortalities from pregnancy-related infections.

<p>pPROM, preterm premature rupture of membranes; PROM, premature rupture of membranes.</p

Our conceptual model.

<p>1. Bacteria from the lower genital tract ascends into the choriodecidual space. 2. Inflammatory mediators (e.g. IL-8) produced by decidua and/or membranes diffuse into amniotic fluid and the fetal lung. 3. Fetal lung injury is induced by inflammatory mediators. IL, Interleukin; AF, amniotic fluid.</p

Histopathology of the fetal lungs.

<p>Hematoxylin and eosin stained histologic sections of fetal lung are shown for a saline control (A; lung score = 0) and GBS animal with severe fetal lung injury (B; lung score = 4).</p

Histopathology of chorioamnion.

<p>Hematoxylin and eosin stained histologic sections of chorioamnion (fetal membranes) are shown for a saline control (A) and GBS animal with chorioamnionitis (B). Neutrophils in the chorion are indicated with arrows in panel B, as well as being abundant in the decidua.</p