Maternal group B streptococcal vertebral osteomyelitis: an unusual complication of vaginal delivery
Article Abstract:
A 42-year-old woman developed symptoms of vertebral osteomyelitis (bone infection in the vertebrae of the spine) within 24 hours of delivering a healthy male infant. Her complaints of headache and neck pain were thought to result from neck strain, and she was discharged from the hospital, only to be readmitted several days later with clear signs of osteomyelitis on imaging studies. Two cervical (neck) vertebrae had been partially destroyed by the infection, and vertebral surgery was performed. The patient was treated with antibiotics and discharged to home several weeks later with abnormal sensations in her arms and legs. Analysis of the material removed from the infected area showed that she had a streptococcus B infection. This organism, commonly found in the vagina and rectum, undoubtedly travelled in the bloodstream, reaching and colonizing the cervical vertebrae, which is an uncommon occurrence. Serious infection in adults by group B streptococci is rare, except during the weeks immediately following childbirth. Vertebral osteomyelitis, even when treated with antibiotics, has a mortality as high as 20 percent, and a paralysis rate as high as 50 percent. The patient in the report had known bone abnormalities in her cervical spine prior to delivery. The possibility of streptococcus B infection in women after delivery must be considered, and early diagnosis and treatment are essential to arrest the aggressive course of the disease. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1990
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Influence of maternal body habitus and glucose tolerance on birth weight
Article Abstract:
Infants born with macrosomia, or an abnormally large body, have an increased risk of birth-related complications including birth-related injury, stillbirth, asphyxia (a condition resulting from inadequate oxygen intake); abnormally low calcium and glucose levels; and death. Certain conditions of the mother, such as obesity; glucose intolerance (the inability of the tissues to use glucose); and high parity (increased number of previous pregnancies) increase the risk of macrosomia. Women who develop diabetes during pregnancy tend to be obese, and obesity of the pregnant women is partially responsible for overgrowth of the fetus. The relationship between the maternal body habitus (body appearance), maternal glucose metabolism, and fetal growth was assessed in 2,069 pairs of mother and infants. Blood glucose levels tended to be higher among Chinese women as compared with black women, but similar for white and Latina women. Glucose levels were related to increases in birth weight. There was a strong association between body mass index (a measure of body weight) and glucose levels among Chinese infants. These findings suggest that the body habitus of the mother influences the relationship between maternal glucose tolerance and birth weight. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1991
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Factors associated with rectal injury in spontaneous deliveries
Article Abstract:
Injury to the rectum during childbirth can cause debilitating long-term consequences. Several factors, such as the condition of the mother, the weight of the infant, and various procedures performed during delivery, including episiotomy, a surgical cut in the vagina to prevent tearing during delivery, may influence the risk of rectal injury. The use of episiotomies is controversial. A study of 2706 spontaneous cephalic deliveries, deliveries where the fetus emerges head first, was conducted to determine the risk of rectal injury according to six factors. The risk of rectal injury increased for women who are subjected to episiotomies, women whose babies are delivered by physicians rather than midwives and women whose babies are delivered in a delivery room rather than a labor bed. In addition, increased risk was found for Hispanic, Filipino and Chinese women, compared to the risk for whites.
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1989
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