Read by QxMD icon Read

Obstetric Medicine

Manpreet Mona Gill, Winnie Sia, Michael Hoskinson, Erin Niven, Rshmi Khurana
Positron emission tomography scanning is not commonly performed in pregnancy but can be done if required. Fetal doses of radiation can be minimized, and our case exemplifies the safe application of positron emission tomography/computed tomography in pregnancy. A 38-year-old woman in her first ongoing pregnancy presented at 28 weeks' gestation with symptomatic hypercalcemia. Given a history of parathyroid carcinoma, recurrence was suspected. Ultrasound and magnetic resonance imaging failed to locate the lesion...
March 2018: Obstetric Medicine
Sabrina Piedimonte, Mohammad Almohammadi, Todd C Lee
Background: Tricuspid valve endocarditis caused by Group B streptococcus is a rare clinical entity with poor prognosis and has been previously reported following gynecologic procedures. Case summary: We report a case of an 18-year-old female diagnosed with Group B streptococcus tricuspid valve endocarditis with septic emboli following an elective therapeutic abortion. After six weeks of treatment with ceftriaxone, she returned with recurrent symptoms and was found to have embolized a sizable vegetation to the pulmonary artery with probable lung infarction...
March 2018: Obstetric Medicine
Patrick Harrington, Catherine Nelson-Piercy, Catherine Williamson, Nichola Cooper, Rachel Kesse-Adu, Susan Robinson
A 34-year-old woman presented at 29 weeks gestation of a twin pregnancy, with a platelet count of 1 × 109 /l. She was extensively investigated and was subsequently diagnosed with severe immune thrombocytopenia. She did not respond to initial treatment with corticosteroids and intravenous immunoglobulin. She also failed to respond to second-line therapies of Anti-D immunoglobulin, Azathioprine and the thrombopoietin agonist Romiplostim. Her case was further complicated by an episode of obstetric cholestasis possibly related to Azathioprine treatment...
March 2018: Obstetric Medicine
Amy Daly, Annette Robertson, Gabriele Bobek, Sally Middleton, Colin Sullivan, Annemarie Hennessy
Background: There is recent interest exploring the possible impact of sleep disordered breathing on the mechanisms of preeclampsia. A biomarker of preeclampsia, soluble fms-like tyrosine kinase-1, has come to prominence in recent years. The aim of this study was to investigate the relationship between continuous positive airway pressure treatment, sleep disordered breathing and soluble fms-like tyrosine kinase-1 concentrations during pregnancy. Methods: A 38-year-old G1P0 presented at 20 + 5 weeks...
March 2018: Obstetric Medicine
Renuka Shanmugalingam, Danny Hsu, Angela Makris
Pregnancy is a well-recognised trigger of atypical haemolytic syndrome (P-aHUS) and often occurs in the post-partum period. Similar to atypical haemolytic uremic syndrome, it carries a poor prognosis with high morbidity particularly in the form of renal failure. Early recognition and intervention is crucial in its management particularly with the recent availability of eculizumab, a humanized monoclonal antibody to complement component C5, which has demonstrated drastic improvement in prognosis. The issue, however, is arriving at a timely diagnosis given the considerable amount of overlap in the clinical and biochemical manifestation of P-aHUS, HELLP syndrome (haemolysis, elevated liver enzyme and low platelet count) and other hypertensive disorders of pregnancy...
March 2018: Obstetric Medicine
Hannah Bergin, Gillian Wood, Susan P Walker, Lisa Hui
Objective: To evaluate the implementation of the 2013 Royal Australian and New Zealand College of Obstetricians and Gynaecologists 'Management of Hepatitis B in Pregnancy' guideline. Methods: Retrospective cohort study of the clinical management and obstetric outcomes among hepatitis B virus-positive women in a single tertiary maternity hospital. Women with viral load >200,000 IU/ml were referred to a specialised clinic for consideration of tenofovir disoproxil fumarate therapy to reduce mother to child transmission...
March 2018: Obstetric Medicine
Mai He, Alison Migliori, Nisreen S Maari, Niharika D Mehta
Massive perivillous fibrinoid deposition is a rare placental pathology associated with significant adverse pregnancy outcome and can recur. We provide a detailed case review of a woman through 10 of her pregnancies, including 8 consecutive pregnancy losses and 2 live births. We also conducted a retrospective chart review of all massive perivillous fibrinoid deposition placenta specimens at our institution over an eight-year period. A total of 42 cases of massive perivillous fibrinoid deposition were identified from 2007 to 2015, yielding an incidence of 0...
March 2018: Obstetric Medicine
K S Gilmore, C McLintock
Objective: We reviewed outcomes of 52 pregnancies in 45 women with immune thrombocytopenic purpura who delivered at Auckland Hospital with an antenatal platelet count of <100 × 109 /L. Outcome measures: Primary outcomes were maternal platelet count at delivery and treatment response. Secondary outcomes included post-partum haemorrhage (PPH). Results: Most women had thrombocytopenia at delivery. Treatment with prednisone was given in 14 (27%) pregnancies with responses considered safe for delivery in 11 pregnancies (79%)...
March 2018: Obstetric Medicine
Emily Moroney, Elske Posma, Alicia Dennis, Yves d'Udekem, Rachael Cordina, Dominica Zentner
More women with congenital heart disease survive to childbearing ages, due to improvements in surgical practice and postoperative care. This review discusses pregnancy in women with a single ventricle, describing maternal obstetric and cardiovascular complications and the increased risks of prematurity and adverse neonatal outcomes. Recommendations are made based on current understanding, guidelines and published literature, with recognition that there is much knowledge yet to be gained.
March 2018: Obstetric Medicine
James A Ker, Priya Soma-Pillay
Pregnancy, viewed as a stress test of the haemodynamic system, may unmask underlying cardiac disease. Pregnancy may also induce de novo cardiac disease. N-terminal pro brain-type natriuretic peptide (NT-proBNP) is a useful biomarker in all clinical conditions in which the ventricle is stressed and especially stretched in the general population. In hypertensive diseases of pregnancy, increased levels of NT-proBNP in preeclampsia are associated with increased cardiac filling pressures and diastolic dysfunction...
March 2018: Obstetric Medicine
Reeva Makhijani, Vicky H Bhagat, Mariam Fayek
The incidence of colorectal cancer in pregnancy is between 0.002 and 0.008%. Diagnosis is often delayed as symptoms of colorectal cancer can mimic as common complaints of pregnancy. We present the case of a 29-year-old with a history of chronic constipation who presented in the second trimester with abdominal pain, inability to tolerate anything orally and no bowel movement in more than three weeks. Non-contrast MRI at presentation failed to show an obstructing mass. Patient was treated conservatively for presumed pseudo-obstruction secondary to worsening constipation from chronic ondansetron use and pregnancy...
December 2017: Obstetric Medicine
Nadia Gabarin, Edgar T Jaeggi, Danna A Spears, Mathew Sermer, Candice K Silversides, Catriona J Bhagra
The occurrence of a maternal and fetal tachyarrhythmia together in pregnancy is exceedingly rare. We report a case of a persistent fetal atrial ectopic tachycardia occurring in conjunction with a maternal atrial tachycardia with left ventricular systolic dysfunction. Amiodarone was effective in treating both maternal and fetal arrhythmias.
December 2017: Obstetric Medicine
Jinny Y Foo, Gregory K Davis, Mark A Brown
We report a case of a left frontal lobe meningioma presenting in a woman with proteinuric preeclampsia in her first term pregnancy. The patient had a background of antepartum migraines that resolved in the second trimester of pregnancy. Postpartum, she required urgent surgery and sustained convulsions after surgery. She had no residual disease and has had another successful pregnancy. This case highlights the importance of cerebral imaging in the context of an atypical clinical course of preeclampsia. Although headaches are common in pregnancy and usually benign, other, more serious, diagnoses should be considered with atypical headaches, a change in the nature of the headache, and headaches that persist despite appropriate treatment...
December 2017: Obstetric Medicine
Farshad Tahmasebi, Khawar Hussain, Georgina Smart, Manish Gupta, Upal Hossain
An asymptomatic 36-year-old woman presented with significantly elevated white blood cells (165.9 × 109 /L) at antenatal booking, in her first pregnancy. Further investigations revealed the diagnosis of chronic lymphocytic leukaemia with monoallelic deletion of chromosome 13q14. She was supported and monitored through out pregnancy, without treatment, and delivered a healthy baby boy at term with no complications and is currently being followed up by the haem-oncology team.
December 2017: Obstetric Medicine
Adam Morton
Acute fatty liver of pregnancy is a rare mitochondrial hepatopathy characterised by microvesicular fatty infiltration, and is believed to be due to impaired fatty acid oxidation. Hepatitis following influenza virus infection is uncommon. Rarely influenza virus infection may be complicated by Reye's syndrome, another hepatic microvesicular fat disease. A case of influenza A hepatitis in third trimester of pregnancy, followed by the evelopment of presumed acute fatty liver of pregnancy is described in this report and a potential mechanism why this may have occurred is discussed...
December 2017: Obstetric Medicine
Rhiannon George-Carey, Maryam Parisaei, Wiece Koniman, Micaela Pluckinski, Jonathan Lambert
Hodgkin's lymphoma is rarely diagnosed in pregnancy, occurring in 1:6000 deliveries. However, improvements in survival and the use of less gonadotoxic treatments have increased the number of Hodgkin's lymphoma survivors becoming pregnant. Both de novo and relapsed Hodgkin's lymphoma in pregnancy pose difficult decisions for both clinicians and patients. This review discusses important diagnostic and treatment considerations of relapsed Hodgkin's lymphoma in pregnancy. We discuss a difficult case which illustrates these particular dilemmas and suggests the evidence behind different modalities of investigation and management...
December 2017: Obstetric Medicine
Anish Keepanasseril, K Keerthana, Arun Keepanasseril, Dilip K Maurya, D Kadambari, Sharath Sistla
Klippel-Trenaunay syndrome is characterised by vascular abnormality which increases the risk of thromboembolism and haemorrhage. Physiological changes in pregnancy pose an increased risk to these complications. Being an uncommon disorder, there is limited literature about the management of women with pregnancy and Klippel-Trenaunay syndrome. We report in detail two of three pregnancies in a woman with Klippel-Trenaunay syndrome who had repeated episodes of haematochezia leading to anaemia, managed with Argon laser Photo-Coagulation in pregnancy and also reviewed the complications and the management of pregnant women with Klippel-Trenaunay syndrome...
December 2017: Obstetric Medicine
Tabassum Firoz, Susannah L Woodd
No abstract text is available yet for this article.
December 2017: Obstetric Medicine
Jyoti Balani, Steve Hyer, Argyro Syngelaki, Ranjit Akolekar, Kypros H Nicolaides, Antoinette Johnson, Hassan Shehata
Objectives: To examine whether the reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is mediated by changes in insulin resistance. Methods: This was a secondary analysis of obese pregnant women in a randomised trial (MOP trial). Fasting plasma glucose and insulin were measured in 384 of the 400 women who participated in the MOP trial. Homeostasis model assessment of insulin resistance (HOMA-IR) was compared in the metformin and placebo groups and in those that developed preeclampsia versus those that did not develop preeclampsia...
December 2017: Obstetric Medicine
Mathieu Puyade, Emilie Cayssials, Fabrice Pierre, Olivier Pourrat
Background: The most frequent myeloproliferative neoplasms are essential thrombocythemia and chronic myelogenous leukemia, which usually manifests with thrombocytosis. Only essential thrombocythemia is associated with morbidity during pregnancy (recurrent miscarriages, intrauterine fetal death, small for gestational age and preeclampsia). The aim of this paper is to describe outcomes of pregnancy in women with myeloproliferative neoplasms seen at a single academic institution. Methods: Data were collected retrospectively from 2002 to 2015...
December 2017: Obstetric Medicine
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"