Neonatal sepsis in pregnant at term with clinical chorioamnionitis, utility of sepsis score

Gladys Maribel Godoy Torales, Rocio Raquel Rienzi Grassi, Lourdes Angélica León Rodas, Rosa Centurión, María Magdalena Maidana Ricardo, Carlos Daniel Benítez Rolandi, Oscar Ramón Franco Fleitas
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Abstract

Introduction: chorioamnionitis occurs in 3 to 10 % of full-term pregnancies, and newborns are at risk of developing early sepsis. Objectives: to determine the prevalence of neonatal sepsis in children of term pregnant women with chorioamnionitis; describe the clinical characteristics of mothers and newborns; and evaluate the utility of the sepsis scale (Rodwell scale and PCR) for diagnosis. ISSN 2072-8174 versión impresa Rev. Nac. (Itauguá). 2020;12(1):071-090 ISSN 2307-3640 versión online Rev. Nac. (Itauguá). 2020;12(1):071-090 Methodology: descriptive study, of term newborns, product of mothers with clinical chorioamnionitis, born and admitted to the Servicio de Neonatología del Hospital Nacional from January 2013 to June 2016. Stillbirths, carriers of STORCH infections, and they had no blood culture. Results: 71 term infants met inclusion criteria. The maternal population was made up of adolescents and young adults in 98,5 %, nulliparous and prim parous in 94 %, membrane rupture was >18 hours in 34 (47,8 %) and the birth was performed by caesarean section in 24 (35, 2 %). The reasons for cesarean section were stationary dilation and acute fetal distress in 17 (69,8 %). Neonatal sepsis developed 11 (15,4 %), 3 were confirmed with a positive blood culture, 10 symptoms and 7 depression at birth. Neither died. The first sepsis scale performed at 3,8 ± 1,8 hours of life, and the second at a median of 45,5 hours, had a positive predictive value of 50 % and 60 %. The negative predictive value was 85 and 87 % respectively. Conclusion: neonatal sepsis presented in 15,4 %. Almost all were symptomatic and depressed at birth. The sepsis scale was not useful to confirm the diagnosis, but to rule it out.
新生儿脓毒症在足月妊娠与临床绒毛膜羊膜炎,脓毒症评分的效用
绒毛膜羊膜炎发生在足月妊娠的3%至10%,新生儿有发展早期败血症的风险。目的:了解足月妊娠合并绒毛膜羊膜炎患儿新生儿脓毒症的患病率;描述母亲和新生儿的临床特征;评估脓毒症量表(Rodwell量表和PCR)的诊断价值。ISSN 2072-8174 versión impresa Rev. Nac(Itaugua)。2020;12(1):071-090 ISSN 2307-3640 versión online Rev. Nac。(Itaugua)。2020;12(1):071-090方法学:描述性研究,研究对象为2013年1月至2016年6月在Neonatología国立医院服务中心出生并入院的患有临床绒毛膜羊膜炎的足月新生儿。死胎,STORCH感染的携带者,他们没有血培养。结果:71例足月婴儿符合纳入标准。产妇中98.5%为青少年和青壮年,94%为无产和初产,34例(47.8%)胎膜破裂>18小时,24例(35.2%)采用剖宫产。剖宫产的原因是静止扩张和急性胎儿窘迫17例(69.8%)。新生儿败血症11例(15.4%),血培养阳性3例,出生时出现症状10例,抑郁7例。都死了。第一次脓毒症评分在生命3,8±1,8小时进行,第二次脓毒症评分中位数为45,5小时,阳性预测值分别为50%和60%。阴性预测值分别为85%和87%。结论:新生儿败血症发生率为15.4%。几乎所有人在出生时都有症状和抑郁。脓毒症量表不能用于确诊,但可用于排除脓毒症。
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