Document Detail

Endotoxemia causing fetal bradycardia during urosepsis.
MedLine Citation:
PMID:  11336765     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Fetal bradycardia is a recognized response to maternal hypothermia associated with hypoglycemia, tocolysis with magnesium sulfate, or urosepsis, and it is thought to be a direct response to the decrease in the maternal core temperature. CASE: A 25-year-old white woman, gravida 1, para 0, at 31 1/7 weeks' gestation was admitted with a diagnosis of pyelonephritis. The baseline fetal heart rate was 120 beats per minute with accelerations. Within 3 hours of admission, the patient became hypothermic (35.1C) and, concomitantly, the fetal heart rate baseline declined to 90 beats per minute with marked variability. Despite sustained maternal hypothermia, the fetal heart rate baseline rose to 120 beats per minute. It was another 6 hours before the patient's temperature rose above 38.5C. Her urine and blood cultures were positive for Serratia rubidacea infection. The patient delivered a healthy infant at 39 weeks' gestation. CONCLUSION: Fetal bradycardia in the presence of urosepsis might be due to the release of endotoxin from gram-negative bacteria, triggering production of cardiotoxic cytokines, rather than to maternal hypothermia alone.
C Buhimschi; C P Weiner
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  97     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-04     Completed Date:  2001-05-24     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  818-20     Citation Subset:  AIM; IM    
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD 21201, USA.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Bradycardia / etiology*
Endotoxemia / complications,  drug therapy*
Heart Rate, Fetal
Hypothermia / etiology*
Infant, Newborn
Pregnancy Complications, Infectious / drug therapy*
Pregnancy Outcome
Prenatal Care
Pyelonephritis / complications,  drug therapy*
Serratia Infections / complications,  drug therapy*
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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