The effect of bacteriostatic lubricant on group B streptococcal cultures of the female genital tract

Article Abstract:

Group B streptococcus (Streptococcus agalactiae) is the organism most often associated with sepsis (systemic infection) in newborn infants in the United States, and it is present in the genital tract of a substantial number of pregnant women. The organism is thought to be especially dangerous in women with preterm labor, since premature infants are highly vulnerable to its effects, which can be fatal. Some clinicians believe that women in preterm labor should be evaluated for group B streptococci infection; however, this is often not discussed until after a pelvic examination has been performed with the aid of a bacteriostatic lubricant (one capable of killing bacteria). Thus, it is possible that a culture taken soon thereafter would reflect the effects of the lubricant and not contain the full complement of bacterial species in the genital tract. This was evaluated by studying 50 pregnant women who had undergone recent testing for group B streptococci. The women were either in preterm labor or had a history of that condition. Seven days after their initial cultures, the women returned for a second examination. On this occasion, samples for culturing were taken from regions of the genital tract, and then a digital examination was performed with the aid of a bacteriostatic lubricant. Immediately thereafter, a repeat culture was obtained. Half the group had tested positive for group B streptococci on initial culture, and half had tested negative. Results showed that all patients tested the same at their second and third cultures (during the second examination) as they had at the first culture. The results were also quantitatively the same, indicating that the bacteriostatic lubricant had not affected the presence of group B streptococci in the genital tract of these pregnant women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Streptococcal infections, Diseases, Infants (Premature), Premature infants, Communicable diseases, Antibacterial agents, Microbiology, Pregnancy, Communicable diseases in pregnancy

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Reliability of fetal buttock blood sampling in assessing the acid-base balance of the breech fetus

Article Abstract:

When the fetus is in the breech position before delivery (the baby is positioned in the uterus so that the buttocks, rather than the head, would be delivered first), cesarean section is often selected as the method of delivery. Vaginal delivery can be successful in certain cases, but even in these, information may be urgently needed regarding the fetus's well-being. Obtaining fetal blood samples in such a situation is, obviously, difficult; but it is possible that blood sampled from the fetal buttock would give a good indication of some critical physiological variables. To evaluate the validity of this method, 10 infants in the breech position were studied. Results from fetal buttock blood sampling within 15 minutes before delivery were compared with results from sampling the blood in the umbilical cord no more than 1 minute after delivery (the conventional method). Of particular concern was fetal pH (the acidity of the bodily fluids). Comparisons between the two sampling methods showed that the pH values from buttock samples and cord samples were highly correlated. It appears that fetal buttock blood sampling can help in rapidly identifying dangerous pH levels in breech babies, which necessitate emergency cesarean section. (Consumer Summary produced by Reliance Medical Information, Inc.)

Management, Fetus, Medical examination, Fetal distress, Fetal blood, Breech delivery, Fetal presentation, Breech birth

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Plasma fibronectin concentrations during normal term labor

Article Abstract:

Blood levels of fibronectin, a protein with diverse biological effects on cell adhesion, wound healing, and blood clotting, were measured during labor and delivery in 30 women. The purpose was to establish baseline levels of fibronectin, against which changes during certain infections associated with pregnancy could be compared. Thirty nonpregnant women served as control subjects. Results showed that the average fibronectin concentrations at the time of admission to the hospital and at delivery were 400 and 410 micrograms per milliliter, respectively. Both these values, which did not significantly differ from each other, were higher than the values for controls (283 micrograms per milliliter). The physiologic roles of fibronectin are described. It appears that the higher levels of this protein during pregnancy do not change during labor. Low levels of fibronectin in the context of an infection could indicate a defect in the pregnant woman's immune system. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Testing, Physiological aspects, Labor (Obstetrics), Fibronectins

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