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Topic: Prostaglandin antenatal infection

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	Inherited clinical guideline - Induction of labour (Guideline D - html)
		Prostaglandins should be used in preference to using oxytocin when induction of labour is undertaken in either nulliparous or multiparous women with intact membranes regardless of their cervical favourability.
		Either prostaglandins or oxytocin may be used when induction of labour is undertaken in nulliparous or multiparous women who have ruptured membranes, regardless of cervical status, as they are equally effective.
		Prostaglandins are drugs that help to induce labour by encouraging the cervix to soften and shorten (ripen).
	www.nice.org.uk /templates/core/page/page.aspx?text-size=8&o=17321 (5418 words)

	Encyclopedia (Site not responding. Last check: 2007-10-20)
		Infection occurs in 2 to 5 per cent of those who are colonized, and group B Streptococcus is an important cause of bacteriuria in pregnancy, although only some cases are symptomatic.
		Listeria is usually a blood-borne infection of the fetus and is accompanied by placentitis, funisitis, and microabscesses of the placenta.
		Routine antenatal screening for Toxoplasma antibodies is not usually practised in Britain but some countries screen routinely, recommending that pregnant women who have no detectable antibody should be given appropriate health education to minimize the risk of exposure to T. gondii during the remainder of their pregnancy.
	www.eamg-med.com /members/encyclopedia/13/13_12/13_12_2.shtml (11593 words)

	Preterm Labour - Cambridge University Press (Site not responding. Last check: 2007-10-20)
		The commonest cause of intrauterine infection is ascending infection from the lower genital tract.
		Prostaglandins are known to be involved in the initiation of human labour and are of course widely used for the pharmacological induction of labour.
		Infections such as typhoid fever and maternal pneumonia although historically associated with preterm delivery are usually sensitive to antibiotics and are now less important in most regions.
	www.cambridge.org /us/catalogue/catalogue.asp?isbn=052182186X&ss=exc (3485 words)

	eMedicine - Bacterial Infections and Pregnancy : Article by Haizal Hamza, MD
		Syphilis is caused by Treponema pallidum, a helical, tightly coiled, motile spirochete.
		The stage of maternal disease during which the fetus is exposed to infection determines the morbidity; the earlier the disease stage, the higher the morbidity.
		Bacterial vaginosis is an infection caused by excessive growth of bacteria that may normally be present in the vagina.
	www.emedicine.com /med/topic3269.htm#section~urinary_tract_infections (5043 words)

	Antenatal Steroid Therapy
		Regarding the safety of antenatal steroids in women with premature rupture of the membranes, the collaborative group study found no differences in rates of maternal or fetal infections.
		A PDA in the preterm infant is associated with an increased incidence of bronchopulmonary dysplasia and intraventricular hemorrhage.
		Since antenatal steroids decrease the incidence and severity of RDS and thus the need for mechanical ventilation, this, in theory, would decrease the incidence of PIVH.
	www.medmall.org /resources/medmall_pubs/steroids.html (1042 words)

	Volume 100, Number 5, Part 1, November 2002
		Prostaglandins are 20-carbon cyclopentane carboxylic acids derived from membrane phospholipids (primarily arachadonic acid) via the enzymatic action of phospholipase A and cyclooxygenase (prostaglandin synthetase).
		After this observation, these investigators conducted the first trial of antenatal glucocorticoid therapy in humans and found that 12 mg of betamethasone on two occasions 24 hours apart resulted in a significant decrease in the incidence of respiratory distress syndrome associated with a decrease in perinatal mortality in newborns born before 34 weeks.
		The panel concluded that antenatally administered corticosteroids (betamethasone or dexamethasone) significantly reduce the risk of respiratory distress syndrome, intraventricular hemorrhage, and neonatal death.
	www.acog.org /from_home/publications/green_journal/2002/ong13732fla.htm (11525 words)

	The Journal of Family Practice
		Progesterone’s presumed mechanisms are inhibition of the oxytocin effect of prostaglandin F2a and stimulation of α-adrenergic receptors, thereby increasing the α-adrenergic tocolytic response.
		Prostaglandin inhibitors may be the preferred choice of tocolytics if hydramnios is suspected in conjunction with preterm labor.
		Antenatal corticosteroids reduce mortality, incidence and severity of respiratory distress syndrome, and intraventricular hemorrhage in preterm infants (LOE: 1).
	www.jfponline.com /Pages.asp?AID=1888&UID= (3221 words)

	eMedicine - Extremely Low Birth Weight Infant : Article by KN Siva Subramanian, MD (Site not responding. Last check: 2007-10-20)
		Infection remains a major contributing factor to the morbidity and mortality of ELBW infants and can present at any point in the clinical course.
		Early infection that occurs during the first 3-4 days of life is believed to result from maternal factors, particularly if chorioamnionitis was diagnosed prenatally.
		Signs of infection are myriad, may be nonspecific, and include temperature instability (hypothermia or hyperthermia), tachycardia, decreased activity, poor perfusion, apnea, bradycardia, feeding intolerance, increased need for oxygen or higher ventilatory settings, and metabolic acidosis.
	www.emedicine.com /ped/topic2784.htm (5572 words)

	Antenatal Steroid Therapy
		Regarding the safety of antenatal steroids in women with premature rupture of the membranes, the collaborative group study found no differences in rates of maternal or fetal infections.
		A PDA in the preterm infant is associated with an increased incidence of bronchopulmonary dysplasia and intraventricular hemorrhage.
		Since antenatal steroids decrease the incidence and severity of RDS and thus the need for mechanical ventilation, this, in theory, would decrease the incidence of PIVH.
	www.rain.org /~medmall/resources/medmall_pubs/steroids.html (1042 words)

	Prevention of Perinatal Group B Streptococcal Disease
		Intrauterine infection of the fetus results from ascending spread of GBS from the vagina of a colonized woman who is typically asymptomatic.
		These reports established that infections caused by antibiotic-resistant organisms were more frequently preceded by antibiotic use than were infections caused by susceptible organisms, and that more doses or longer duration of anti-biotics before delivery increased the chance that a neonatal infection, if it occurred, would be caused by an antibiotic-resistant organism.
		The reported increases in antibiotic-resistant early-onset infections in a few studies are not of sufficient magnitude to outweigh the benefits of intrapartum antibiotic prophylaxis to prevent perinatal GBS disease.
	www.cdc.gov /mmwr/preview/mmwrhtml/rr5111a1.htm (11720 words)

	Patent ductus arteriosus
		Large shunts may lead to failure to thrive, recurrent infection of the upper respiratory tract and congestive heart failure.
		Antenatal diagnosis of patent arterial duct is not possible as it is a normal structure during antenatal life.
		In preterm infants with symptomatic heart failure secondary to persistent patency of the arterial duct, treatment may be achieved by surgical ligation or with a prostaglandin synthetase inhibitor.
	www.orpha.net /static/GB/patent_ductus_arteriosus.html (2500 words)

	JPMA ::: (Site not responding. Last check: 2007-10-20)
		Infection is now considered one of the major causes of PLWB deliveries, responsible for about 30-50% of all cases.20,21 During normal pregnancy, maternal hormones and locally acting intra-amniotic cytokines play a key role in regulating the onset of labor, uterine contractions and delivery.
		These indicated that local infection is not the sole cause of this condition.23 These findings lead to the reasoning that an infection might be distant from the placental complex or the genito-urinary tract.
		Periodontal infections which are Gram-negative anaerobic infections of gums and the surrounding structures can occur in all ages in a given population.24 Chronic periodontitis can be regarded as a progression of the combination of infection and inflammation from gingivitis to the deeper tissues of periodontal membrane resulting in its attachment loss.
	www.jpma.org.pk /jpma/10oct05/fulltex12.htm (2039 words)

	[No title]
		Studies have shown that spontaneous abortion, preterm labor, premature birth, preterm premature rupture of the membranes, amniotic fluid infection, postpartum endometritis, and postcesarean wound infections are increased because of infection with bacterial vaginosis during pregnancy.
		Phospholipase A2 is a precursor of prostaglandin synthesis and the destruction of lysosomes within deciduae or chorioamnion cells may induce prostaglandin synthesis resulting in uterine contractions.
		increase the synthesis of prostaglandins in the membranes.
	www.lib.umich.edu /dentlib/nihcdc/searches/tanzer/tanzerLacto2bEM.txt (10867 words)

	FINAL REPORT OF THE CONSENSUSDEVELOPMENT PANEL (Site not responding. Last check: 2007-10-20)
		Antenatal administration of betamethasone to prevent respiratory distress syndrome in preterm infants: Report of a UK multicenter trial.
		In this gestational age range, the incidence of RDS in infants who were treated with antenatal corticosteroids was similar to that of the untreated controls (14 of 30 infants versus 12 of 24 infants, respectively).
		Antenatal glucocorticoid therapy for the prevention of respiratory distress syndrome in the premature infant.
	www.nichd.nih.gov /publications/pubs/corticosteroids/corticosteroids5.html (15607 words)

	Henci Goer: Articles: Elective Induction of Labor
		Since the interval between rupture and birth may be long with an induction, rupturing membranes increases the risk of infection in women who subsequently have vaginal exams and women colonized with group B strep.
		They are not as effective as prostaglandin E2 at either promoting successful labor induction or achieving vaginal birth, and they may increase the risk of infection.
		A fever in labor indicates a possible infection in mother or baby and leads to a cascade of interventions.
	www.hencigoer.com /articles/elective_induction (2932 words)

	Preterm Labor
		Further research may be justified (when sensitive markers for subclinical infection become available) in order to determine if there is a subgroup of women who could experience benefit from antibiotic treatment for preterm labour prior to membrane rupture, and to identify which antibiotic or combination of antibiotics is most effective.
		During threatened preterm delivery, both general and local signs of infection increase the risks of amniotic infection, premature rupture of membranes, preterm delivery, and neonatal and/or maternal morbidity of infectious origin.
		Cortisol increases expression of prostaglandin dehydrogenase in the chorion by reversing the stimulatory effect of progesterone, and may represent "progesterone withdrawal" in the primate.
	www.tabebak.com /preterm_labor.htm (5710 words)

	NGC - NGC Summary
		Is not associated with an increase in maternal or neonatal infection
		A - Prostaglandins should be used in preference to oxytocin when induction of labour is undertaken in either nulliparous or multiparous women with intact membranes, regardless of their cervical favourability.
		A - Either prostaglandins or oxytocin may be used when induction of labour is undertaken in nulliparous or multiparous women who have ruptured membranes, regardless of cervical status, as they are equally effective.
	www.guideline.gov /summary/summary.aspx?doc_id=2951 (2061 words)

	Biennial Highlights: Evaluating reproductive health care
		Recruitment is nearing completion for the first multicentre trial to evaluate the impact of a new antenatal care programme on the health of mothers and newborns.
		The new programme consists of four antenatal visits, and it limits antenatal tests, clinical procedures, and follow-up actions to those scientifically proved to be effective in improving the health of mothers and newborns.
		The Programme is planning to conduct a series of studies on the prevalence of genital tract infections in selected populations and epidemiological studies on lower genital tract infection and the effect of male chlamydial infection on sperm function.
	www.who.int /reproductive-health/publications/biennial_reports/2000-01/1996-97/4.html (947 words)

	Nassau University Medical Center (Site not responding. Last check: 2007-10-20)
		Prostaglandins are chemicals which are found in nearly every cell of the body.
		The levels of prostaglandins in the body increase as menstruation approaches, with the highest levels at the onset of the menstrual period.
		Since an excess of prostaglandins in the lining of the uterus seems to be one of the major causes of dysmenorrhea, medication that reduces the amount of prostaglandins may be helpful in relieving the pain.
	www.numc.edu /index.php?id=53 (3266 words)

	Fetal Responses to Maternal and Intra-Amniotic Lipopolysaccharide Administration in Sheep -- Grigsby et al. 68 (5): ...
		The role of prostaglandins in endotoxemia and comparisons in response in the nonpregnant, maternal, and fetal models.
		Alterations in prostaglandin physiology in the nonpregnant, pregnant, and fetal experimental animal.
		Administration of extra-amniotic arachidonic acid and the suppression of uterine prostaglandin synthesis during pregnancy in the rhesus monkey.
	www.biolreprod.org /cgi/content/full/68/5/1695 (4963 words)

	Inflammatory Markers in Intrauterine and Fetal Blood and Cerebrospinal Fluid Compartments Are Associated with Adverse ... (Site not responding. Last check: 2007-10-20)
		infection and lung and brain injury (4, 5).
		Vigneswaran R 2000 Infection and preterm birth: evidence of a common causal relationship with bronchopulmonary dysplasia and cerebral palsy.
		Dammann O, Leviton A 1998 Infection remote from the brain, neonatal white matter damage, and cerebral palsy in the preterm infant.
	www.pedresearch.org /cgi/content/full/55/6/1009 (4933 words)

	Outcome of staged reconstructive surgery for hypoplastic left heart syndrome following antenatal diagnosis -- Andrews ...
		A total of 174 cases of HLHS were diagnosed antenatally at Guy's Hospital (fig 1).
		Thus there were 50 babies diagnosed antenatally who underwent stage I (29%).
		Antenatal diagnosis of HLHS has obvious benefits for parents, not least in giving them time in which to come to terms with
	adc.bmjjournals.com /cgi/content/full/85/6/474 (3041 words)

	Case Based Pediatrics Chapter
		The pathogenesis of spontaneous, isolated PTL is multifactorial; however, many cases appear to result from occult upper genital tract infections with activation of the decidua.
		Other strategies involved in the treatment of preterm labor are: cervical cerclage, tocolytics (beta sympathomimetics such as terbutaline and ritodrine, magnesium sulfate, prostaglandin synthetase inhibitors such as indomethacin), and antibiotics.
		The major risks to the fetus are infection and preterm birth.
	www.hawaii.edu /medicine/pediatrics/pedtext/s03c04.html (2236 words)

	Detailed Paper about PostDates - from Ronnie Falcão's Midwife Archives
		The aim of antenatal care is to monitor the well-being of mother and fetus, and to detect early signs of possible problems.
		prostaglandin gel (inserted either into the vagina or directly to the cervix): again, there is much discussion as to the effectiveness of prostaglandin gels, some lending support for its use, others finding no significant improvement.
		Co-author of this paper, Julie Bullard, believes in twice weekly antenatal care after 42 weeks with the additional observations: fetal kick chart, counseling, special consideration of girth and fundal measurements, and non-stress testing with listening to the FHR without external stimulation,(i.e., nipple stimulation or uterine massage).
	gentlebirth.org /archives/datesppr.html (8331 words)

	Termination of Pregnancy (ToP) - Patient UK
		Infection - up to 10% of termination reduced by prophylactic antibiotics or pre-procedure screening for infection.
		and/or infection screening with treatment using metronidazole 1g rectally at time of abortion plus doxycycline 100mg BD for 7 days starting post-abortion, or metronidazole 1 g rectally at the time of abortion plus azithromycin 1 g orally on the day of abortion.
		Medical abortion using mifepristone plus prostaglandin is appropriate, eg Mifepristone 600mg orally followed 36-48 hours by Gemeprost 1mg vaginally.
	www.patient.co.uk /showdoc/40000047 (1908 words)

	Management of the neonate with symptomatic congenital heart disease -- PENNY and SHEKERDEMIAN 84 (3): 141 -- Archives ...
		It was hoped that the antenatal diagnosis of congenital heart defects would reduce subsequent mortality by ensuring early
		Although in general it appears that antenatal diagnosis and in utero transfer have not had the impact on neonatal mortality
		Differentiation of systemic infection and congenital obstructive left heart disease in the very young infant.
	fn.bmjjournals.com /cgi/content/full/84/3/F141 (3481 words)

	Vaginal infection and birth weight
		Frequency of vaginal infection was 96.6%; bacteria were isolated in 144 cases (96.6%).
		Data was analysed using SPSS version 8 and effect of vaginal infection on initiative of labour and birth weight was determined, using Fisher exact test for significance between infected and non infected mothers.
		Single infection was present in 121 of 144 infected mothers (84%) and multiple infection in 23(16%).
	www.pmrc.org.pk /vaginal.htm (1307 words)

	Detailed Paper about PostDates - from Ronnie Falcão's Midwife Archives
		The aim of antenatal care is to monitor the well-being of mother and fetus, and to detect early signs of possible problems.
		prostaglandin gel (inserted either into the vagina or directly to the cervix): again, there is much discussion as to the effectiveness of prostaglandin gels, some lending support for its use, others finding no significant improvement.
		Co-author of this paper, Julie Bullard, believes in twice weekly antenatal care after 42 weeks with the additional observations: fetal kick chart, counseling, special consideration of girth and fundal measurements, and non-stress testing with listening to the FHR without external stimulation,(i.e., nipple stimulation or uterine massage).
	www.gentlebirth.org /archives/datesppr.html (8298 words)

	Problem Spot Links (Site not responding. Last check: 2007-10-20)
		Antibiotics are not useful for viral pneumonias, but are sometimes used to prevent or treat associated bacterial infection when the lungs have been damaged by a viral infection.
		The most common cause of death is infection due to immunosuppression as a result of medications used to manage the disease.
		For example, an infection called tick relapsing fever was reported in 1905, and the wood tick, which carries an agent that causes Rocky Mountain spotted fever, was identified soon after.
	www.problemspot.com /links_1-19.html (2708 words)

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