ESPID--European Society for Study and Prevention of Infant Deaths

Oxford, England August 27-30, 1993

 Bacterial Endotoxins in Pathogenesis of Toxemia of Pregnancy, Neonatal

Encephalopathies, and Cot Death.

Robert C. Reisinger, DVM, MS 3810 Dustin Road, Burtonsville, MD 20866 U.S.A.

Toxemia of Pregnancy

Blood flow from pregnant uterus (or hydatidiform mole) raises pressure in the inferior vena cave lessening flow through hepatic veins with variable stasis of hepatic circulation. This results in loss of hepatic function to adequately detoxify bacterial endotoxins of intestinal origin. Signs and pathology associated with toxemia of pregnancy in human and other animals are consistent with endotoxemia. Following birth, spontaneous or induced abortion, there is rapid lessening of blood flow from the uterus, drop in pressure in inferior vena cave, normalized blood flow through the liver which is then able to detoxify the build-up of circulating endotoxin. If the preceding events occur in a timely manner, patients return to normal; if not, irreversible sequelae or death may ensue.

Neonatal Encephalopathy

Reisinger, R.C. Discussion on Endotoxemia. Inf. Dis. 128 (Supl): S303-305, July 1973.

Gilles, F.H. et al.: Neonatal endotoxin encephalopathy. AM Neurol. 2:49, 1977.

Cot Death

Endotoxemia is the major cause of Sudden Death Syndrome (SDS) in calves, foals, Rhesus monkeys, etc. The one published study in the human infant has yielded results similar to those found in other animals. (Bendig, J. and Haenel, H.: Gastrointestir.al Microecology of Sudden Unexpected Death of Infants. Nutrition, Proc. Eight Congress Nutr., Prague, Sept. 1969. (ed) Josef Masek, Prague, and Sir David P. Cuthbertson, Glasgow.: Excerptica Medica, pub., Amsterdam. p.212-214, 1970.)

 Reisinger, R.C.: A final mechanism of cardiac and respiratory failure. Pub. in SIDS 1974. Proc. of Camps International. Symp. on SUD in Infancy. Pub: Canadian, Found. for Study of Infant Deaths. 4 Lawson Blvd., Toronto M4V 1Z4.

Reisinger, R.C.: Pathogenesis and prevention of infectious diarrhea (scours) of newborn calves. JAmer Vet Assoc 147:1377-1386, 1965.

Reisinger, R.C.: Studies on the pathogenesis of diarrhea of newborn calves. M.S. thesis. U Wisconsin, Madison, 1957.

Reisinger, R.C.: Parainfluenza 3 virus in cattle. Ann NY Acad Sci 101:576-582, 1962.

Woodruff,P.W.H., O'Carroll, D.I., Koizumi, S., and Fine, J.: Role of Intestinal Flora in Major Trauma. J. Inf. Dis. 128 Supl: S290-294, July 1973.