Cost-effectiveness of intrapartum screening and treatment for maternal group B streptococci colonization

Article Abstract:

Streptococcal bacterial disease can cause many complications in infected newborns and mothers. Infected infants can develop meningitis, an inflammation of the membranes surrounding the brain and spinal cord, as well as neurological problems. In the mother, streptococcal infections cause swelling of the uterus. In 1985 streptococcal disease of the newborn and mother cost the healthcare system $500 million and resulted in 2,000 newborn deaths. In an effort to reduce the cost of streptococcal disease, which affects 2 out of every 1,000 births in the US, preventive antibiotic treatment of high-risk mothers and affected infants has been suggested. However, many women who are treated in the last three months of pregnancy are still infected at the time of delivery. Results from culture techniques are not obtained quickly enough to permit prompt effective treatment. Furthermore, preventive treatment of exposed newborns without symptoms may cause penicillin-resistant organisms to develop. The cost-effectiveness of a program designed to test and treat women during labor was evaluated. Results from a new rapid screening test can be obtained in less than two hours. If the birth rate is assumed to be 3.5 million per year, the screening program would prevent 1,230 newborn deaths from streptococcal disease, which would save $1,100 for every death averted. In high-risk populations such as women with early rupture of the membranes surrounding the fetus or early labor, seven deaths could be prevented with a cost savings of $216,000 for every 10,000 women. Therefore, screening for streptococcal infections during labor is a cost-effective method of reducing complications from streptococcal disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Testing, Streptococcal infections, Prevention, Pregnant women, Medical screening, Health screening

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Acute hemodynamic and respiratory effects of amniotic fluid embolism in the pregnant goat model

Article Abstract:

Amniotic fluid embolism may affect maternal blood pressure. Amniotic fluid embolism is the blocking of a artery by a blood clot or foreign material caused by amniotic fluid forced into maternal circulation by strong uterine contractions. A study examined the affect of infusing amniotic fluid into the circulation of female goats in the last trimester of pregnancy. Infusion of amniotic fluid into maternal circulation caused an increase in both pulmonary (lungs) and systemic blood pressure. The increase in pulmonary or systemic blood pressure was similar regardless of whether the infused amniotic fluid was raw, filtered or filtered and boiled. A significantly larger increase in blood pressure was caused by infusion with amniotic fluid containing meconium, the mucilaginous material in the intestine of a full-term fetus.

Physiological aspects, Hemodynamics, Amniotic fluid embolism

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