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11. Listeriosis revisited: the role of the obstetrician

Author

Buchdahl, R., Hird, M., Gamsu, H., Tapp, A, Gibb, D., and Tzannatos, C.

Subjects
Food contamination -- Evaluation, Premature labor -- Causes of, Listeriosis -- Case studies, Listeria monocytogenes, Pregnancy, Complications of -- Causes of, Health
Abstract

Listeriosis is a disease caused by the bacteria Listeria monocytogenes. It can be transmitted to humans when infected food (primarily dairy products, vegetables, meat, poultry and shellfish) is eaten. The number of reported cases has increased in England and France. Patients with depressed immune systems, pregnant women and newborns are at the greatest risk for the infection. The infection is almost always fatal in newborns. The experience of three infants born with listeriosis is reported. In all three cases the fetuses were alive when their mothers arrived at the hospital. All three mothers reported flu-like symptoms and fever before delivery, which developed prematurely. Labor began when the membranes surrounding the fetus, which contained amniotic fluid contaminated with fetal stool (meconium), ruptured prematurely. Meconium-stained amniotic fluid is not a common finding before the 34th week of pregnancy (later in pregnancy it is a sign of fetal distress) and is sometimes a sign that the fetus is infected with Listeria. All three women had eaten foods that might have been contaminated. Soft cheeses, chilled cooked chicken or prepacked salads were suspected contaminants. Two of the newborns died soon after delivery. The third infant suffered severe neurological and developmental impairments. Listeria infection should be suspected if a pregnant woman in early labor has ruptured fetal membranes, unexplained fever and meconium-stained amniotic fluid. Pregnant women should be instructed to eat fully-cooked meats and poultry and should recook food that has been chilled in the refrigerator. Non-refrigerated soft cheeses should be avoided. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

36. Retention of the Second Twin

Author

LONG, M. G., primary, GIBB, D. M. F., additional, KEMPLEY, S., additional, CARDOZO, L. D., additional, NICOLAIDES, K., additional, and GAMSU, H., additional

Published
1992
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47. Randomised controlled trial of two methods of weaning from high frequency positive pressure ventilation.

Author

GREENOUGH, A., POOL, J., and GAMSU, H.

Abstract

Forty preterm infants suffering from respiratory distress syndrome were entered into a randomised controlled trial to assess the importance of the length of inspiratory time during weaning from high frequency positive pressure ventilation (HFPPV). Two weaning regimes were compared: in one (group A) inspiratory time was limited to 0.5 seconds throughout weaning, in the other (group B) ventilator rate was reduced by increasing both inspiratory and expiratory time (inspiration:expiration ratio constant) until inspiratory time reached 1.0 seconds. At ventilator rates of 20 and 40 breaths/minute an acute comparison was made in all 40 infants of the two inspiratory times; despite the lower mean airway pressure associated with the shorter inspiratory time blood gases were maintained. There was no difference in the incidence of pneumothoraces or need for reventilation between the two regimens but infants in group A had a shorter duration of weaning. We conclude limitation of inspiratory time to 0.5 seconds during weaning from HFPPV is advantageous to preterm infants with respiratory distress syndrome. [ABSTRACT FROM AUTHOR]

Published
1989
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48. Outcome of neonatal necrotising enterocolitis: results of the BAPM/CDSC surveillance study, 1981-84.

Author

PALMER, S. R., BIFFIN, A., and GAMSU, H. R.

Abstract

Neonatologists in 100 special care baby units in the United Kingdom and Ireland collaborated in a four year surveillance study of neonatal necrotising enterocolitis. The average overall annual reporting rate of necrotising enterocolitis for infants in England and Wales was 0.3/1000 live births, but ranged from 9.5/1000 live births in infants weighing less than 1000 g at birth to 0.2/1000 live births in infants weighing 2500 g or more. There were more deaths among girls, infants who weighed less than 1500 g at birth, those whose bleeding was abnormal or who had low peripheral platelet counts, infants with Gram negative bacteraemia, and very low birthweight infants who developed it during the first few days of life. In both boys and girls, and in all birthweight groups, operation was associated with increased mortality. [ABSTRACT FROM AUTHOR]

Published
1989
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