| Good pregnancy outcome with emergent cerclage placed in the presence of intra-amniotic microbial invasion. | |
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MedLine Citation:
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PMID: 17597442 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cervical insufficiency with dilation can be associated with amniotic fluid microbial invasion. Cerclage placement in the presence of infection is contraindicated because it is associated with poor fetal and maternal outcome. A 30-year-old gravida 4 para 0 with cervical insufficiency had emergent cervical suture placement at 19 weeks. The patient underwent amniocentesis to screen for infection. After the screen for infection using amniotic fluid glucose and white blood cells had indicated negative results, the patient had cerclage placed. Post cerclage placement, amniotic culture results were positive for KLEBSIELLA PNEUMONIAE, CITROBACTER FREUNDII, and STAPHYLOCOCCUS coagulase negative. The patient was counseled about the need to remove the cerclage and she declined. She was treated with azithromycin and Unasyn and a repeat amniocentesis 7 days later indicated negative results. The patient had a 14 week cerclage to delivery interval, delivery at 33 2/7 weeks. Immediate evaluations of the newborn were negative for infection. Our satisfactory outcome with treatment of very early intra-amniotic infection suggests that this option may be considered in strictly selected patients in similar clinical scenarios as an alternative to cerclage removal and evacuation of the uterus. |
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Authors:
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Elisha Mvundura; Alessandro Ghidini; Sarah H Poggi |
Publication Detail:
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Type: Case Reports; Journal Article Date: 2007-06-27 |
Journal Detail:
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Title: American journal of perinatology Volume: 24 ISSN: 0735-1631 ISO Abbreviation: Am J Perinatol Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-07-31 Completed Date: 2007-11-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8405212 Medline TA: Am J Perinatol Country: United States |
Other Details:
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Languages: eng Pagination: 413-5 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, Georgetown University Hospital, Washington, District of Columbia 20007, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amniocentesis Amniotic Fluid / microbiology* Ampicillin / therapeutic use Anti-Bacterial Agents / therapeutic use Azithromycin / therapeutic use Cerclage, Cervical* Citrobacter freundii / isolation & purification Female Humans Klebsiella pneumoniae / isolation & purification Pregnancy Pregnancy Complications, Infectious / diagnosis*, drug therapy, microbiology Pregnancy Outcome* Sulbactam / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 68373-14-8/Sulbactam; 69-53-4/Ampicillin; 76497-13-7/sultamicillin; 83905-01-5/Azithromycin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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