Puerperal and postpartum infections after cesarean section are a leading cause of maternal and neonatal morbidity and mortality worldwide. Postpartum infections account for a significant, and often preventable, portio...Puerperal and postpartum infections after cesarean section are a leading cause of maternal and neonatal morbidity and mortality worldwide. Postpartum infections account for a significant, and often preventable, portion of the global healthcare burden. Puerperal sepsis is one of the top five causes of maternal deaths worldwide and accounts for 10% - 15% of deaths in the postpartum period. Postpartum infections also present a significant social burden: they increase maternal anxiety and the risk of postpartum depression, interfere with bonding, and negatively impact breastfeeding. To prevent complications and improve outcomes, the evaluation of these infections must be accurate and prompt. This review provided a summary of causes, clinical presentation, laboratory tests, imaging modalities, treatment options, complications, and prognosis of puerperal and postpartum infections following cesarean section. Future directions in the evaluation of these infections were also discussed, including the development of novel diagnostic assays, the use of point-of-care testing and risk factors responsible for the onset of infections. This review emphasized the significance of early diagnosis and prompted treatment of these infections in order to prevent complications and enhance maternal and neonatal outcomes. This article also provided an exhaustive overview of the evaluation and management of puerperal and postpartum infections and the clinical outcome of infections for both mother and neonate.展开更多
BACKGROUND In recent years,people have paid more attention to oral health with the development of stomatology.Due to the various physiological changes during pregnancy,such as changing hormone levels and immune functi...BACKGROUND In recent years,people have paid more attention to oral health with the development of stomatology.Due to the various physiological changes during pregnancy,such as changing hormone levels and immune functions,oral diseases have a high incidence during pregnancy,and the prevention and treatment of oral diseases have also received the attention of both dentists and obstetricians.However,the anesthetic management of pregnant patients with oral disease,especially severe maxillofacial infections,and patients who need surgical treatment or have obstetric emergencies and need to terminate their pregnancy is not clear.CASE SUMMARY This article describes a parturient patient with a severe masseteric space infection who had an emergency cesarean section.CONCLUSION This case report aims to discuss the important anesthetic considerations for these patients.展开更多
Objective:To compare the effectiveness of an evidence-based bundle in minimizing cesarean section(CS)-related surgical site infections(SSIs)with that of standard routine care.Methods:This was a single-center,parallel,...Objective:To compare the effectiveness of an evidence-based bundle in minimizing cesarean section(CS)-related surgical site infections(SSIs)with that of standard routine care.Methods:This was a single-center,parallel,and randomized clinical trial conducted at KAHER’s Dr.Prabhakar Kore Charitable Hospital,Belagavi,India,from January 2021 to December 31,2021.Three hundred twenty women undergoing CS delivery were selected and allocated into two groups(1:1)using simple randomization with fixed allocation.An evidence-based surgical bundle(a combination of more than three perioperative interventions)was used for the intervention group,whereas the control group received routine standard perioperative care.The primary outcome was the incidence of SSI(superficial,deep,and organ or space SSIs)within 6 weeks postpartum in both groups.Categorical and continuous data were analyzed using appropriate statistical tests with a significance threshold set at P<0.05.Results:In this study,16 and 17 participants each from the control and intervention groups,respectively,were lost to follow-up,resulting in a total of 144 and 143 study participants included in the respective groups.Twenty-eight(19.4%)and 14(9.8%)women developed SSI in the control and intervention groups,respectively(P=0.02).Methicillin-resistantStaphylococcus aureus was the most common cause of SSI in both groups(63.6%(7/11)and 100%(3/3)in the control and intervention groups,respectively).Conclusion:The use of the evidence-based bundle for CS-related SSI prevention effectively decreased the incidence of SSI by half compared to standard routine practice.Implementing the use of this bundle in routine perioperative care will reduce the cost of CS and improve health outcomes in CS.展开更多
Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recover...Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recovery with a control group were retrieved from the databases including Pubmed, Cochrane Library, Science Direct, Web of Science, CBM, CNKI, Wanfang and VIP, et al. After screening literatures, evaluating the quality of studies, extracting data, the RevMan5.3 software was used for data analysis. Results: A total of 13 RCTs including 2233 patients were analyzed in the study. The results showed that chewing gum after cesarean delivery can effectively shorten the recovery time of bowel sounds, passage of flatus and first defecation (all P Conclusion: Chewing sugar-free gum after cesarean section can promote the early recovery of gastrointestinal function, but the side effects of chewing gum are still unclear, which needs more clinical, large sample and high-quality studies to further verify.展开更多
Objective: To study the correlation of serum inflammatory factors with immune response and stress hormones in patients with cesarean incision infection. Methods: Puerperae who underwent cesarean section and got postop...Objective: To study the correlation of serum inflammatory factors with immune response and stress hormones in patients with cesarean incision infection. Methods: Puerperae who underwent cesarean section and got postoperative incision infection in Maternal and Child Health Care in Lintong between January 2014 and December 2016 were selected as the infection group of the research, and puerperae who underwent cesarean section and were without postoperative incision infection in Maternal and Child Health Care in Lintong during the same period were selected as the control group of the research. The contents of inflammatory factors and stress hormones in serum as well as the contents of immune cells and the levels of erythrocyte immunity indexes in peripheral blood were measured. Results:TNF-α, IL-1, IL-6, IL-8, Cor, NE, INS and AT-II contents in serum of infection group were significantly higher than those of control group;CD3+CD4+T cell and CD16+CD25+NK cell contents as well as DTER, ATER, NTER and FEER levels in peripheral blood were lower than those of control group whereas CD3+CD8+T cell content and FEIR level were higher than those of control group. TNF-α, IL-1, IL-6 and IL-8 contents in serum of infection group were negatively correlated with CD3+CD4+T cell and CD16+CD25+NK cell contents as well as DTER, ATER, NTER and FEER levels in peripheral blood, and positively correlated with CD3+CD8+T cell content and FEIR level in peripheral blood as well as Cor, NE, INS and AT-II contents in serum. Conclusion: The abnormal activation of inflammatory response and the abnormal secretion of inflammatory factors are closely related to the immune response disorder and stress response activation.展开更多
文摘Puerperal and postpartum infections after cesarean section are a leading cause of maternal and neonatal morbidity and mortality worldwide. Postpartum infections account for a significant, and often preventable, portion of the global healthcare burden. Puerperal sepsis is one of the top five causes of maternal deaths worldwide and accounts for 10% - 15% of deaths in the postpartum period. Postpartum infections also present a significant social burden: they increase maternal anxiety and the risk of postpartum depression, interfere with bonding, and negatively impact breastfeeding. To prevent complications and improve outcomes, the evaluation of these infections must be accurate and prompt. This review provided a summary of causes, clinical presentation, laboratory tests, imaging modalities, treatment options, complications, and prognosis of puerperal and postpartum infections following cesarean section. Future directions in the evaluation of these infections were also discussed, including the development of novel diagnostic assays, the use of point-of-care testing and risk factors responsible for the onset of infections. This review emphasized the significance of early diagnosis and prompted treatment of these infections in order to prevent complications and enhance maternal and neonatal outcomes. This article also provided an exhaustive overview of the evaluation and management of puerperal and postpartum infections and the clinical outcome of infections for both mother and neonate.
文摘BACKGROUND In recent years,people have paid more attention to oral health with the development of stomatology.Due to the various physiological changes during pregnancy,such as changing hormone levels and immune functions,oral diseases have a high incidence during pregnancy,and the prevention and treatment of oral diseases have also received the attention of both dentists and obstetricians.However,the anesthetic management of pregnant patients with oral disease,especially severe maxillofacial infections,and patients who need surgical treatment or have obstetric emergencies and need to terminate their pregnancy is not clear.CASE SUMMARY This article describes a parturient patient with a severe masseteric space infection who had an emergency cesarean section.CONCLUSION This case report aims to discuss the important anesthetic considerations for these patients.
文摘Objective:To compare the effectiveness of an evidence-based bundle in minimizing cesarean section(CS)-related surgical site infections(SSIs)with that of standard routine care.Methods:This was a single-center,parallel,and randomized clinical trial conducted at KAHER’s Dr.Prabhakar Kore Charitable Hospital,Belagavi,India,from January 2021 to December 31,2021.Three hundred twenty women undergoing CS delivery were selected and allocated into two groups(1:1)using simple randomization with fixed allocation.An evidence-based surgical bundle(a combination of more than three perioperative interventions)was used for the intervention group,whereas the control group received routine standard perioperative care.The primary outcome was the incidence of SSI(superficial,deep,and organ or space SSIs)within 6 weeks postpartum in both groups.Categorical and continuous data were analyzed using appropriate statistical tests with a significance threshold set at P<0.05.Results:In this study,16 and 17 participants each from the control and intervention groups,respectively,were lost to follow-up,resulting in a total of 144 and 143 study participants included in the respective groups.Twenty-eight(19.4%)and 14(9.8%)women developed SSI in the control and intervention groups,respectively(P=0.02).Methicillin-resistantStaphylococcus aureus was the most common cause of SSI in both groups(63.6%(7/11)and 100%(3/3)in the control and intervention groups,respectively).Conclusion:The use of the evidence-based bundle for CS-related SSI prevention effectively decreased the incidence of SSI by half compared to standard routine practice.Implementing the use of this bundle in routine perioperative care will reduce the cost of CS and improve health outcomes in CS.
文摘Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recovery with a control group were retrieved from the databases including Pubmed, Cochrane Library, Science Direct, Web of Science, CBM, CNKI, Wanfang and VIP, et al. After screening literatures, evaluating the quality of studies, extracting data, the RevMan5.3 software was used for data analysis. Results: A total of 13 RCTs including 2233 patients were analyzed in the study. The results showed that chewing gum after cesarean delivery can effectively shorten the recovery time of bowel sounds, passage of flatus and first defecation (all P Conclusion: Chewing sugar-free gum after cesarean section can promote the early recovery of gastrointestinal function, but the side effects of chewing gum are still unclear, which needs more clinical, large sample and high-quality studies to further verify.
文摘Objective: To study the correlation of serum inflammatory factors with immune response and stress hormones in patients with cesarean incision infection. Methods: Puerperae who underwent cesarean section and got postoperative incision infection in Maternal and Child Health Care in Lintong between January 2014 and December 2016 were selected as the infection group of the research, and puerperae who underwent cesarean section and were without postoperative incision infection in Maternal and Child Health Care in Lintong during the same period were selected as the control group of the research. The contents of inflammatory factors and stress hormones in serum as well as the contents of immune cells and the levels of erythrocyte immunity indexes in peripheral blood were measured. Results:TNF-α, IL-1, IL-6, IL-8, Cor, NE, INS and AT-II contents in serum of infection group were significantly higher than those of control group;CD3+CD4+T cell and CD16+CD25+NK cell contents as well as DTER, ATER, NTER and FEER levels in peripheral blood were lower than those of control group whereas CD3+CD8+T cell content and FEIR level were higher than those of control group. TNF-α, IL-1, IL-6 and IL-8 contents in serum of infection group were negatively correlated with CD3+CD4+T cell and CD16+CD25+NK cell contents as well as DTER, ATER, NTER and FEER levels in peripheral blood, and positively correlated with CD3+CD8+T cell content and FEIR level in peripheral blood as well as Cor, NE, INS and AT-II contents in serum. Conclusion: The abnormal activation of inflammatory response and the abnormal secretion of inflammatory factors are closely related to the immune response disorder and stress response activation.
