Cholera in Pregnancy: Outcomes from a Specialized Cholera Treatment Unit for Pregnant Women in Léogâne, Haiti
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{"title"=>"Cholera in Pregnancy: Outcomes from a Specialized Cholera Treatment Unit for Pregnant Women in Léogâne, Haiti", "type"=>"journal", "authors"=>[{"first_name"=>"Iza", "last_name"=>"Ciglenecki", "scopus_author_id"=>"13906928800"}, {"first_name"=>"Mathieu", "last_name"=>"Bichet", "scopus_author_id"=>"55842275000"}, {"first_name"=>"Javier", "last_name"=>"Tena", "scopus_author_id"=>"55843722900"}, {"first_name"=>"Erneau", "last_name"=>"Mondesir", "scopus_author_id"=>"55842134000"}, {"first_name"=>"Mathieu", "last_name"=>"Bastard", "scopus_author_id"=>"37096766500"}, {"first_name"=>"Nguyen Toan", "last_name"=>"Tran", "scopus_author_id"=>"56379632900"}, {"first_name"=>"Annick", "last_name"=>"Antierens", "scopus_author_id"=>"55561530700"}, {"first_name"=>"Nelly", "last_name"=>"Staderini", "scopus_author_id"=>"55364073300"}], "year"=>2013, "source"=>"PLoS Neglected Tropical Diseases", "identifiers"=>{"pui"=>"369735759", "issn"=>"19352735", "isbn"=>"1360-2276", "doi"=>"10.1371/journal.pntd.0002368", "scopus"=>"2-s2.0-84883414158", "pmid"=>"23967361", "sgr"=>"84883414158"}, "id"=>"cde73564-4273-3ae7-ae6f-5e557440c866", "abstract"=>"BACKGROUND: The association between cholera in pregnancy and negative fetal outcome has been described since the 19(th) century. However, there is limited published literature on the subject. We describe pregnancy outcomes from a specialized multidisciplinary hospital unit at the onset of a large cholera outbreak in Haiti in 2010 and 2011.\\n\\nMETHODS: Pregnant women with cholera were hospitalized in a specialized unit within the MSF hospital compound in Léogâne and treated using standard cholera treatment guidelines but with earlier, more intense fluid replacement. All women had intravenous access established at admission regardless of their hydration status, and all received antibiotic treatment. Data were collected on patient demographics, pregnancy and cholera status, and pregnancy outcome. In this analysis we calculated risk ratios for fetal death and performed logistic regression analysis to control for confounding factors.\\n\\nRESULTS: 263 pregnant women with cholera were hospitalized between December 2010 and July 2011. None died during hospitalization, 226 (86%) were discharged with a preserved pregnancy and 16 (6%) had live fullterm singleton births, of whom 2 died within the first 5 days postpartum. The remaining 21 pregnancies (8%) resulted in intrauterine fetal death. The risk of fetal death was associated with factors reflecting severity of the cholera episode: after adjusting for confounding factors, the strongest risk factor for fetal death was severe maternal dehydration (adjusted risk ratio for severe vs. mild dehydration was 9.4, 95% CI 2.5-35.3, p = 0.005), followed by severe vomiting (adjusted risk ratio 5.1, 95% 1.1-23.8, p = 0.041).\\n\\nCONCLUSION: This is the largest cohort of pregnant women with cholera described to date. The main risk factor identified for fetal death was severity of dehydration. Our experience suggests that establishing specialized multidisciplinary units which facilitate close follow-up of both pregnancy and dehydration status due to cholera could be beneficial for patients, especially in large epidemics.", "link"=>"http://www.mendeley.com/research/cholera-pregnancy-outcomes-specialized-cholera-treatment-unit-pregnant-women-l%C3%A9og%C3%A2ne-haiti", "reader_count"=>49, "reader_count_by_academic_status"=>{"Unspecified"=>4, "Librarian"=>1, "Researcher"=>13, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>3, "Other"=>2, "Student > Master"=>7, "Student > Bachelor"=>13, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>4, "Librarian"=>1, "Researcher"=>13, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>3, "Other"=>2, "Student > Master"=>7, "Student > Bachelor"=>13, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>5, "Environmental Science"=>1, "Nursing and Health Professions"=>4, "Biochemistry, Genetics and Molecular Biology"=>1, "Agricultural and Biological Sciences"=>8, "Medicine and Dentistry"=>23, "Neuroscience"=>1, "Business, Management and Accounting"=>1, "Social Sciences"=>3, "Earth and Planetary Sciences"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>23}, "Neuroscience"=>{"Neuroscience"=>1}, "Social Sciences"=>{"Social Sciences"=>3}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>8}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>4}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>5}, "Environmental Science"=>{"Environmental Science"=>1}}, "reader_count_by_country"=>{"Brazil"=>1, "United Kingdom"=>1}, "group_count"=>4}

Scopus | Further Information

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  • {"files"=>["https://ndownloader.figshare.com/files/1171534"], "description"=>"<p>Léogâne, Haiti, 2010–2011.</p>", "links"=>[], "tags"=>["Infectious diseases", "Bacterial diseases", "cholera", "Obstetrics and gynecology", "pregnancy", "Miscarriage and stillbirth", "women", "admitted"], "article_id"=>773906, "categories"=>["Medicine"], "users"=>["Iza Ciglenecki", "Mathieu Bichet", "Javier Tena", "Erneau Mondesir", "Mathieu Bastard", "Nguyen-Toan Tran", "Annick Antierens", "Nelly Staderini"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0002368.g001", "stats"=>{"downloads"=>0, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Number_of_pregnant_women_admitted_in_the_cholera_treatment_unit_per_week_/773906", "title"=>"Number of pregnant women admitted in the cholera treatment unit per week.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-08-15 03:28:37"}
  • {"files"=>["https://ndownloader.figshare.com/files/1171535"], "description"=>"*<p>RR, risk ratio.</p>†<p>CI, confidence interval.</p>#<p>, P-value<0.05.</p>", "links"=>[], "tags"=>["Infectious diseases", "Bacterial diseases", "cholera", "Obstetrics and gynecology", "pregnancy", "Miscarriage and stillbirth", "fetal", "december"], "article_id"=>773907, "categories"=>["Medicine"], "users"=>["Iza Ciglenecki", "Mathieu Bichet", "Javier Tena", "Erneau Mondesir", "Mathieu Bastard", "Nguyen-Toan Tran", "Annick Antierens", "Nelly Staderini"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0002368.t002", "stats"=>{"downloads"=>1, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Risk_factors_for_fetal_death_during_cholera_episode_L_233_og_226_ne_Haiti_December_2010_8211_July_2011_/773907", "title"=>"Risk factors for fetal death during cholera episode. Léogâne, Haiti, December 2010–July 2011.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-08-15 03:28:37"}
  • {"files"=>["https://ndownloader.figshare.com/files/1171536"], "description"=>"<p>Pregnancy outcomes in specialized cholera unit, Léogâne, Haiti, December 2010–July 2011.</p>", "links"=>[], "tags"=>["Infectious diseases", "Bacterial diseases", "cholera", "Obstetrics and gynecology", "pregnancy", "Miscarriage and stillbirth", "outcomes", "specialized", "december"], "article_id"=>773908, "categories"=>["Medicine"], "users"=>["Iza Ciglenecki", "Mathieu Bichet", "Javier Tena", "Erneau Mondesir", "Mathieu Bastard", "Nguyen-Toan Tran", "Annick Antierens", "Nelly Staderini"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0002368.t001", "stats"=>{"downloads"=>1, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Pregnancy_outcomes_in_specialized_cholera_unit_L_233_og_226_ne_Haiti_December_2010_8211_July_2011_/773908", "title"=>"Pregnancy outcomes in specialized cholera unit, Léogâne, Haiti, December 2010–July 2011.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-08-15 03:28:37"}
  • {"files"=>["https://ndownloader.figshare.com/files/1171537"], "description"=>"<div><p>Background</p><p>The association between cholera in pregnancy and negative fetal outcome has been described since the 19<sup>th</sup> century. However, there is limited published literature on the subject. We describe pregnancy outcomes from a specialized multidisciplinary hospital unit at the onset of a large cholera outbreak in Haiti in 2010 and 2011.</p><p>Methods</p><p>Pregnant women with cholera were hospitalized in a specialized unit within the MSF hospital compound in Léogâne and treated using standard cholera treatment guidelines but with earlier, more intense fluid replacement. All women had intravenous access established at admission regardless of their hydration status, and all received antibiotic treatment. Data were collected on patient demographics, pregnancy and cholera status, and pregnancy outcome. In this analysis we calculated risk ratios for fetal death and performed logistic regression analysis to control for confounding factors.</p><p>Results</p><p>263 pregnant women with cholera were hospitalized between December 2010 and July 2011. None died during hospitalization, 226 (86%) were discharged with a preserved pregnancy and 16 (6%) had live fullterm singleton births, of whom 2 died within the first 5 days postpartum. The remaining 21 pregnancies (8%) resulted in intrauterine fetal death. The risk of fetal death was associated with factors reflecting severity of the cholera episode: after adjusting for confounding factors, the strongest risk factor for fetal death was severe maternal dehydration (adjusted risk ratio for severe vs. mild dehydration was 9.4, 95% CI 2.5–35.3, p = 0.005), followed by severe vomiting (adjusted risk ratio 5.1, 95% 1.1–23.8, p = 0.041).</p><p>Conclusion</p><p>This is the largest cohort of pregnant women with cholera described to date. The main risk factor identified for fetal death was severity of dehydration. Our experience suggests that establishing specialized multidisciplinary units which facilitate close follow-up of both pregnancy and dehydration status due to cholera could be beneficial for patients, especially in large epidemics.</p></div>", "links"=>[], "tags"=>["Infectious diseases", "Bacterial diseases", "cholera", "Obstetrics and gynecology", "pregnancy", "Miscarriage and stillbirth", "outcomes", "specialized", "women"], "article_id"=>773909, "categories"=>["Medicine"], "users"=>["Iza Ciglenecki", "Mathieu Bichet", "Javier Tena", "Erneau Mondesir", "Mathieu Bastard", "Nguyen-Toan Tran", "Annick Antierens", "Nelly Staderini"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0002368", "stats"=>{"downloads"=>5, "page_views"=>18, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cholera_in_Pregnancy_Outcomes_from_a_Specialized_Cholera_Treatment_Unit_for_Pregnant_Women_in_L_233_og_226_ne_Haiti_/773909", "title"=>"Cholera in Pregnancy: Outcomes from a Specialized Cholera Treatment Unit for Pregnant Women in Léogâne, Haiti", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-08-15 03:28:37"}

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Relative Metric

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