Infection & Inflammation

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Infection and Inflammation and its impact on Pregnancy:

Genitourinary tract infections are well-established causes for a large proportion of potentially preventable preterm births and other complications in pregnancy. Adverse outcomes related to infection include:

 
  • preterm birth (PTB)
  • congenital infection
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  • preterm premature rupture of the membranes
  • pneumonia
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  • amniotic fluid infection
  • conjunctivitis
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  • pyelonephritis
  • mental retardation
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  • post partum intrauterine infections (endometritis)
  • fetal and infant death
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  • maternal and neonatal sepsis
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    The rationale for improving pregnancy outcomes by screening and treating infection during pregnancy is supported by the literature and guidelines from both the American College of Obstetrics and Gynecology and the Centers for Disease Control and Prevention. Results from research trials suggest that one preterm birth can be prevented for every:

    • 21 women who receive treatment for asymptomatic bacteriuria2 
    • 10 women who receive treatment for Chlamydia1
    • 10 women treated for bacterial vaginosis3

    References
    1. Martin DH, Eschenbach DA, Cotch MF, et al. "Double-blind, placebo-controlled treatment trial of Chlamydia trachomatis Endocervical infections in pregnant women." Inf Dis Obstet Gyncol 1997;5: 10-7.
    2. Smaill F. "Antibiotics for asymptomatic bacteriuria in pregnancy." Cochrane Database of Systematic Reviews. 2001.
    3. Ugwumadu, A, Manyonda I, Reid F, Hay P. "Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomized controlled trial." Lancet 2003; 361: 983-86.

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    The Care Model for Prenatal Care: this is a model created by Dr. Wagner at the Institute for Healthcare Innovation originally developed for chronic disease but adapted for perinatal care.  The model promotes a comprehensive look at systems that impact health. 

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