PURPOSE: Antenatal dexamethasone administration is associated with a significant lowering respiratory distress syndrome (RDS) incidence, but can increase neonatal infection. Ambroxol has been accepted as an alternative treatment to dexamethasone and is of at least equal efficacy but without adverse reaction. The aim of this study was to evaluate the effectiveness of ambroxol versus dexamethasone in RDS incidence and neonatal infection. METHODS: In this study, 30 infants, who received prenatal dexamethasone therapy, were compared retrospectively to 19 infants who received prenatal ambroxol therapy and 45 infants who received placebo during 28 to 34 weeks' of gestation. RESULTS: RDS incidence was comparable in both the dexamethasone (10.0%) and ambroxol (10.5%) groups but higer in the control group (26.6%). The puerperal infection rate in the mothers of these infants was 33.3% in the dexamethasone group, 10.5% in the ambroxol group and 20.0% in the control group. Neonatal infection in the 28 days following delivery was 56.6% in the dexamethasone group, 26.3% in the ambroxol group and 26.6% in the control group. Neonatal infection rate of the dexamethasone group was higher than ambroxol and control groups (P<0.05). When premature rupture of membrane was controlled, the sepsis rate (<28 days) was significantly lower in the ambroxol group than in the dexamethasone group (P<0.05), but puerperal infection and sepsis (<7 days) were not significantly different. CONCLUSOIN: Ambroxol was as effective as the dexamethasone in reducing the RDS incidence. Neonatal and puerperal infection were significantly higher in the dexamethasone group than in the ambroxol group.
Ambroxol* ; Dexamethasone* ; Humans ; Incidence ; Infant ; Membranes ; Mothers ; Pregnancy ; Puerperal Infection ; Retrospective Studies ; Rupture ; Sepsis

*Eclampsia ; *Infusions, Parenteral ; *Ireland ; *Maternal Mortality ; *Postpartum Hemorrhage ; *Puerperal Infection ; *Shock, Hemorrhagic ; *Pregnancy

Puerperal sepsis is one of the leading causes of maternal morbidity and mortality worldwide. Postpartum pelvic infections can cause various complications, including wound infections and necrotizing fasciitis. Several microorganisms are known to cause such infections; however, no study has reported on Staphylococcus caprae, a coagulase-negative staphylococcus that is isolated frequently from animals and infrequently from human specimens, as a causative agent. Here, we report a rare case of septic shock complicated by necrotizing fasciitis after a cesarean section. This is the first report of a human isolate of S. caprae in association with puerperal sepsis and necrotizing fasciitis.
Animals ; Cesarean Section ; Escherichia coli ; Escherichia ; Fasciitis, Necrotizing ; Female ; Goats ; Humans ; Mortality ; Pelvic Infection ; Postpartum Period ; Pregnancy ; Puerperal Infection ; Sepsis ; Shock, Septic ; Staphylococcus ; Wound Infection

BACKGROUND: Various operative procedures and techniques have been made in attempts to diminish the incidence of postoperative wound infection. The use of two surgical knives was found to have no correlation to wound infection in several orthopedic-related surgeries. No studies, however, could be found on the effects of using such technique in cesarean section. The purpose of this study is to determine whether the use of different surgical blades for skin cutting and deep tissue incision decrease the incidence of post-cesarean infectious morbidity.
METHODS: A total of 190 obstetric patients admitted for scheduled or nonscheduled cesarean section were randomly assigned to two groups by sealed number envelopes. The first group was composed of patients who used only one blade for skin and deep tissue incision. The second group used separate blades. Patients from both groups were assessed days 0 to 2 post-cesarean and 2-4 weeks after (on follow-up). The temperature pattern post-operative was monitored as well as presence of wound discharge, foul-smelling vaginal discharge, persistent abdominal pain, and persistent fever that may indicate surgical site infection, postpartum endometritis, and pelvic abscess. Statistical analysis was performed using the Fisher's Exact test.
RESULTS: Nineteen (11.3%) of 168 patients had superficial surgical site infection, 11 (13.3%) from the single blade group, compared with 8 (9.4%) from the double blade group. The difference between the two groups was not statistically significant (p=0.29). None of the patients developed deep incisional or organ space surgical site infection, endometritis, or pelvic abscess post-cesarean. There was also no significant difference for the two groups in temperature pattern and presence of wound discharge or wound dehiscence.
CONCLUSION: The use of different surgical blades for skin cutting and deep tissue incision does not show to decrease post-cesarean infectious morbidity. It is unnecessary to use two knives for surgical incisions in cesarean section.

Human ; Female ; Adult ; Pregnancy ; Surgical Wound Infection ; Endometritis ; Surgical Wound ; Abscess ; Temperature ; Puerperal Infection ; Cesarean Section ; Morbidity ; Vaginal Discharge ; Abdominal Pain ; Postpartum Period

Group G beta-hemolytic Streptococcus is a normal flora of skin, pharynx, female genital tract, and intestine. Group G beta-hemolytic Streptococcus has been reported to cause a variety of human infections, such as pharyngitis, soft tissue infection, arthritis, osteomyelitis, respiratory infection, endocarditis, meningitis, puerperal infection, neonatal sepsis and peritonitis. But liver abscess caused by group G beta-hemolytic Streptococcus has not been reported to date. We report two cases of liver abscess caused by group G beta-hemolytic Streptococcus. One patient with underlying neurofibromatosis presented with fever and diarrhea; the other patient presented with fever and pain on the right upper quadrant of abdomen. Hepatic abscess was diagnosed by computerized tomography and confirmed by percutaneous needle aspiration. Cultures of pus obtained by aspiration revealed group G beta-hemolytic Streptococcus, which were susceptible all tested antibiotics, including penicillin.
Abdomen ; Anti-Bacterial Agents ; Arthritis ; Diarrhea ; Endocarditis ; Female ; Fever ; Humans ; Intestines ; Liver Abscess* ; Liver* ; Meningitis ; Needles ; Neurofibromatoses ; Osteomyelitis ; Penicillins ; Peritonitis ; Pharyngitis ; Pharynx ; Puerperal Infection ; Sepsis ; Skin ; Soft Tissue Infections ; Streptococcus* ; Suppuration