Abstract：
:Clostridium sordellii is a common soil and enteric bacterium that is infrequently recovered from the vagina. We describe three women in which C. sordellii caused puerperal infection and a distinctive and lethal toxic shock-like syndrome. Patients were less than 1 week post partum and each had a single, limited focus of infection including infection associated with a retained vaginal sponge, a cesarean section operative site, and endometritis. Each patient had a distinctive course characterized by sudden onset of clinical shock marked by severe and unrelenting hypotension associated with marked, generalized tissue edema and "third spacing" with increased hematocrit, presence of marked leukemoid reaction with total neutrophil counts of 84,000/mm3, 66,000/mm3, and 93,600/mm3, absence of rash or fever, limited or no myonecrosis, and a rapid and uniformly lethal course. Hypoalbuminemia was also noted. Similar findings were noted in prior isolated reports of C. sordellii-mediated postpartum or surgical infection. Treatment of animals with C. sordellii or closely related C. difficile toxins produces similar findings. We suggest that localized infection with toxin-producing strains of C. sordellii can produce a rapidly lethal toxic shock-like syndrome. Further study and earlier recognition of this syndrome may be life-saving in other patients.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
McGregor JA,Soper DE,Lovell G,Todd JKdoi
10.1016/0002-9378(89)90768-0subject
Has Abstractpub_date
1989-10-01 00:00:00pages
987-95issue
4eissn
0002-9378issn
1097-6868pii
0002-9378(89)90768-0journal_volume
161pub_type
杂志文章abstract：OBJECTIVE:The objective of this study was to determine whether introduction of laparoscopically assisted vaginal hysterectomy decreases the percentage of women requiring laparotomy for hysterectomy. STUDY DESIGN:A retrospective review of women undergoing hysterectomies from 1990 through 1992 was performed. Type of hys...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(94)70032-x
更新日期：1994-08-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to determine the effect of maternal hypercholesterolemia on hepatic cholesterol metabolism in the offspring in a mouse model. STUDY DESIGN:Male and female wild type and apoE(-/-KO) (knockout for the apoprotein E [apoE]) gene) mice were crossbred to obtain all 4 possible genetic ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2008.06.064
更新日期：2008-09-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to assess whether endometrial polyps (EMPs) represent cancer precursors. STUDY DESIGN:Age standardized incidence ratios (SIRs) of histologically verified endometrial cancers (EmCas) were estimated in women with EMPs and in women with uterine leiomyomata, which is a condition tha...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2010.03.036
更新日期：2010-09-01 00:00:00
abstract：OBJECTIVE:We sought to determine the fetal injury rate associated with shoulder dystocia and to determine whether there is a higher rate of brachial plexus injury or bone fracture when fetal manipulation techniques are required for delivery. STUDY DESIGN:A retrospective review of 285 cases of shoulder dystocia that oc...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(98)70312-6
更新日期：1998-06-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to report our experience with placental bed biopsy with the use of forceps. STUDY DESIGN:Placental bed biopsies were undertaken transcervically under ultrasound guidance in 313 women who underwent termination of pregnancy between 7 and 20 weeks of gestation, in 104 women with a ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2002.126866
更新日期：2002-11-01 00:00:00
abstract：BACKGROUND:Pelvic organ prolapse is common, but the underlying etiologies are poorly understood, which limits our current prevention and treatment options. OBJECTIVE:Our primary objective was to compare the uterosacral ligament histologic features in women with and without prolapse using the novel pelvic organ prolaps...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2020.10.040
更新日期：2021-01-01 00:00:00
abstract：:Substance P is a neuropeptide that has been identified in the ovary, fallopian tube, uterus, and vagina and in the hypothalamic-pituitary axis in both an animal model and human ovaries. We sought to determine if substance P is present in peritoneal fluid and, if so, whether it correlated with the cause of infertility....
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(92)91852-2
更新日期：1992-01-01 00:00:00
abstract：:The effects of maternal hyperexcitability on the fetus were studied in 17 baboons. In the period of agitation, induced by stressful stimulus such as exposure to bright light or by clamping of the toe, the mother exhibited an increase in arterial blood pressure and, in some instances, arrhythmia. These changes were acc...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(16)33032-0
更新日期：1979-06-01 00:00:00
abstract：:Although the fetus is considered to be an "allograft" there is little information concerning the role of lymphokines in human pregnancy. Lymphokines are polypeptides secreted by stimulated lymphocytes that direct the immune response by enabling immune effector cells to communicate with each other. To characterize lymp...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(90)90769-4
更新日期：1990-12-01 00:00:00
abstract：OBJECTIVES:Smoking is associated with a reduced risk of preeclampsia, but what is the outcome of pregnancy when preeclampsia develops in women who smoke? STUDY DESIGN:Single births in Sweden from 1987 through 1993 to nulliparous women aged 15 to 34 years (N = 317,652) were included. Poisson regression analyses were us...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(97)70455-1
更新日期：1997-07-01 00:00:00
abstract：:Perinatal outcome in 398 patients who had Grade II or Grade III placentas was analyzed in a cross-sectional study. Early placental maturation was identified in 51 patients. A trend toward lower mean birth weights was identified in the group with early placental maturation as compared to controls; however, statistical ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(83)90035-2
更新日期：1983-12-01 00:00:00
abstract：OBJECTIVE:Vaginal breech delivery rates have been accepted widely to be in decline and the Term Breech Trial (TBT) has recommended delivery of a breech-presenting infant by elective cesarean section delivery. Our aim was to examine the rate of vaginal delivery of term breech pregnancies in the 8 years before and after ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2012.03.029
更新日期：2012-06-01 00:00:00
abstract：:Pregnancy and peripartum/perinatal periods are characterized by significant biologic as well as psychosocial processes and changes that influence the 2 individuals at focus (mother and fetus), as well as their interactions with the immediate environment. Multiple intertwined pathologic pregnancy processes (hormonal, b...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2005.02.103
更新日期：2005-10-01 00:00:00
abstract：:Analyses of cytoplasmic estrogen receptor and progesterone receptor were performed on tumor specimens from 32 patients with uterine sarcomas. While the median and maximal quantitative levels of binding were lower than those observed in endometrial carcinomas, examples of estrogen receptor- and progesterone receptor-po...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(84)80135-0
更新日期：1984-10-15 00:00:00
abstract：:The first reported case of recurrent acute fatty liver of pregnancy confirmed by biopsy is described. In this case a high index of suspicion led to an early diagnosis and intervention with resultant improved maternal and fetal outcome. Electron microscopic examination of a liver biopsy specimen proved more beneficial ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(90)91191-e
更新日期：1990-08-01 00:00:00
abstract：:The risk of developing cancer in the contralateral breast is five to seven times the risk of cancer occurrence for the normal female population. In patients in 365 consecutive operations, 15 frankly invasive cancers and four metastatic lesions were found in the contralateral breast as well as an additional 28 lesions ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(86)90799-4
更新日期：1986-08-01 00:00:00
abstract：OBJECTIVE:We hypothesized that maternal birth weight was associated with the risk of cesarean delivery for nulliparous women. STUDY DESIGN:In a population-based cohort study, maternal birth data were linked to a Washington State database, including the birth certificates of 18,905 first-born singleton infants (1987-19...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2000.106175
更新日期：2000-06-01 00:00:00
abstract：OBJECTIVE:We compared metronidazole 0.75% gel (containing 37.5 mg metronidazole per dose) with ovules containing metronidazole 500 mg and nystatin 100,000 U, for intravaginal treatment of bacterial vaginosis (BV). STUDY DESIGN:In a single-blinded trial, symptomatic women with BV by both Amsel and Nugent criteria were ...
journal_title：American journal of obstetrics and gynecology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.ajog.2004.06.089
更新日期：2004-12-01 00:00:00
abstract：OBJECTIVE:This study was undertaken to compare surgical techniques for the primary repair of obstetric anal sphincter lacerations. STUDY DESIGN:Patients with complete third- or fourth-degree lacerations were recruited and randomly assigned to either an end-to-end or overlapping repair. Data collection included demogra...
journal_title：American journal of obstetrics and gynecology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.ajog.2004.11.045
更新日期：2005-05-01 00:00:00
abstract：OBJECTIVE:To assess the effectiveness of inner thigh "Taping" compared with "Traction" using a weighted bag when an intracervical Foley catheter is used for cervical ripening. STUDY DESIGN:We performed a randomized controlled trial at a tertiary hospital on women with a singleton pregnancy in cephalic presentation adm...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ajog.2013.05.028
更新日期：2013-09-01 00:00:00
abstract：OBJECTIVE:Preeclampsia affects 6% to 8% of pregnancies. There are few data regarding hypertensive disorders that are diagnosed in the postpartum period. Our purpose was to determine the demographics, outcomes, and treatment of this complication. STUDY DESIGN:This was a multicenter retrospective study of women who had ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.ajog.2004.02.037
更新日期：2004-05-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to compare fetal middle cerebral artery peak systolic velocity with amniotic fluid delta optical density at 450 nm in the prediction of fetal anemia. STUDY DESIGN:A prospective study that involved 28 singleton pregnancies that were at-risk for fetal anemia was carried out in a t...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2003.63
更新日期：2003-01-01 00:00:00
abstract：OBJECTIVE:Our purpose was to determine, in the murine model, whether human ovarian cancer cells injected intraperitoneally are subject to osmotic lysis by peritoneal lavage with sterile water, thereby decreasing the establishment of peritoneal implants. STUDY DESIGN:Preliminary experiments on six nude mice determined ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(96)70095-9
更新日期：1996-12-01 00:00:00
abstract：OBJECTIVE:The antepartum course and short-term neonatal outcome for patients with premature rupture of membranes between 26 and 33 weeks' gestation with positive cervical cultures for group B streptococcus or Neisseria gonorrhoeae were reviewed. STUDY DESIGN:A retrospective analysis of 182 patients managed expectantly...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(92)91369-l
更新日期：1992-03-01 00:00:00
abstract：:A case of primary hypothyroidism associated with postpartum galactorrhea-amenorrhea is reported. The configuration of the sella was compatible with pituitary adenoma, but prolactin dynamics did not support an autonomous secretory state. Replacement therapy with thyroxine led to complete reversal of clinical, radiologi...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(16)33129-5
更新日期：1978-08-15 00:00:00
abstract：:Congenital cytomegalovirus (CMV) is the most common viral infection, affecting nearly 40,000 infants each year in the United States. Of seronegative women, 1-4% will acquire a primary infection during pregnancy, and the majority of these women will be asymptomatic. Prior maternal exposure to CMV does not preclude neon...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2016.02.042
更新日期：2016-06-01 00:00:00
abstract：:This review focuses on the contribution of psychosocial stress to the racial/ethnic disparities in preterm delivery in the United States and addresses the subset of psychosocial stressors that are disproportionately prevalent among minority women. We argue that chronic exposure to poverty, racism, and insecure neighbo...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2005.01.072
更新日期：2005-05-01 00:00:00
abstract：OBJECTIVE:We sought to determine maternal factors that influence success of labor induction and whether the probability of cesarean delivery changed with time during induction. STUDY DESIGN:We performed a retrospective cohort study of 1650 singleton pregnancies induced at a gestation of 37 weeks or longer, with birthw...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2008.06.072
更新日期：2008-09-01 00:00:00
abstract：OBJECTIVE:The objective of the study was to determine whether the epidemiology of low-grade ovarian serous cancers is distinct from that of high-grade ovarian serous cancers. STUDY DESIGN:The National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program reports incidence, and survival, data from...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2008.01.035
更新日期：2008-04-01 00:00:00
abstract：:In the roundtable that follows, clinicians discuss a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed: Maayan-Metzger A, Schushan-Eisen I, Todris L, et al. Maternal hypotension during elective cesarean section and s...
journal_title：American journal of obstetrics and gynecology
pub_type： 评论,杂志文章
doi：10.1016/j.ajog.2009.11.012
更新日期：2010-01-01 00:00:00
