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https://www.readbyqxmd.com/read/28761227/acute-kidney-injury-in-pregnancy-specific-disorders
#1
REVIEW
J Prakash, V C Ganiger
The incidence of acute kidney injury in pregnancy (P-AKI) has declined significantly over the last three decades in developing countries. However, it is still associated with significant fetomaternal mortality and morbidity. The diagnosis of P-AKI is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate (GFR) are not validated in this population. The incidence of P-AKI with respect to total AKI cases has decreased in the last three decades from 25% in 1980s to 9% in 2000s at our centre...
July 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28749853/the-icu-is-becoming-a-main-battlefield-for-severe-maternal-rescue-in-china-an-8-year-single-center-clinical-experience
#2
Liu Yuqi, Guoliang Tan, Shang Chengming, Sun Xuri
OBJECTIVES: To review the characteristics of and to identify the reasons for severe maternal admissions to the ICU. DESIGN: This was an analytical, observational, open, and retrospective study. SETTING: In our ICU. PATIENTS: A total of 487 severe maternal cases were reviewed during the 8-year study period of January 2009 to December 2016. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: A total of 487 severe maternal cases (12...
July 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28658852/severe-puerperal-sepsis-a-simmering-menace
#3
Sheeba Marwah, Sonam R Topden, Manjula Sharma, Ritin Mohindra, Pratima Mittal
INTRODUCTION: Even decades after the development of effective low-cost antibiotics, sepsis persists as the foremost cause of preventable maternal death worldwide. In developing countries like India, where the paramount impediment to intervention is poverty, maternal mortality due to sepsis is a continuing representation of maternal health inequality. AIM: To determine the incidence, risk factors and mortality in women presenting with puerperal sepsis in a tertiary care health facility in India...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28640002/trends-in-diagnoses-among-hospitalizations-of-hiv-infected-children-and-adolescents-in-the-us-2003-2012
#4
Stacey A Hurst, Alexander C Ewing, Sascha R Ellington, Athena P Kourtis
OBJECTIVE: Using data from 2003-2012, we updated a previous analysis of trends in hospitalizations of HIV-infected children and adolescents in the US. METHODS: We used data from the Kids´ Inpatient Database of the Healthcare Cost and Utilization Project to derive nationally representative estimates of the number of hospitalizations and the rates per 1000 hospitalizations of select discharge diagnoses and procedures in 2003, 2006, 2009, and 2012 among HIV-infected and HIV-uninfected children and adolescents ≤18 years, excluding hospitalizations for conditions related to pregnancy/delivery and neonatal diagnoses...
June 20, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28536811/listeriosis-during-pregnancy
#5
REVIEW
Mitko Madjunkov, Shahnaz Chaudhry, Shinya Ito
PURPOSE: Listeriosis is a rare foodborne illness caused by Listeria monocytogenes. It can be transmitted by consuming contaminated ready-to-eat food, long shelf-life products, deli meats, and soft cheeses. Listeria has a predilection to affect immunocompromised patients, elderly people, pregnant women and neonates. In particular, pregnant women are at ~18 times greater risk of infection than general population due to specific pregnancy-related suppressed cell-mediated immunity and placental tropism of L...
August 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28528140/maternal-and-neonatal-outcomes-of-respiratory-failure-during-pregnancy
#6
Chen-Yiu Hung, Han-Chung Hu, Li-Chung Chiu, Chih-Hao Chang, Li-Fu Li, Chung-Chi Huang, Chuan-Chi Kao, Po-Jen Cheng, Kuo-Chin Kao
BACKGROUND: Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. METHODS: Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test...
May 17, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28397655/-liver-failure-in-neonatal-children-is-a-diagnostic-challenge
#7
Heidi Smedegaard, Vibeke Brix Christensen, Morten Hanefeld Dziegiel, Marianne Hørby Jørgensen
This case report presents a newborn boy with hypoglycaemia, anaemia, jaundice and severe coagulopathy during the first day of his life, imitating sepsis and disseminated intravascular coagulation. One week after the birth he was diagnosed with acute liver failure due to gestational alloimmune liver disease (GALD). Despite the fact that GALD is rare, it must be suspected in all unexplained stillborn children and infants with severe liver disease. If diagnosed, it is possible to prevent death and severe liver failure in future newborns by treating the affected women with immunoglobulin during pregnancy...
March 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28383376/successful-continuation-of-pregnancy-after-treatment-of-group-a-streptococci-sepsis
#8
Ali Alhousseini, Mia E Layne, Bernard Gonik, David Bryant, Sanjay Patwardhan, Manasi Patwardhan
BACKGROUND: Invasive group A streptococci infections in pregnancy have historically led to severe maternal and neonatal morbidity and mortality. We are reporting a rare and novel case of successful treatment of third-trimester group A streptococci infection with early, aggressive intervention and maintenance of the pregnancy to term. CASE: A 35 year old woman initially presented with fever, flu-like symptoms, and preterm contractions at 34 weeks of gestation. She demonstrated signs of early stages of septic shock, ultimately attributed to group A streptococci bacteremia...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28355654/experience-of-point-of-care-devices-in-obstetrical-care
#9
Ove Karlsson
During pregnancy and puerperium, there are pronounced hemostatic changes characterized by increased coagulability and decreased fibrinolysis. In addition, hemostasis can change dramatically during obstetric complications. Several reports have described substandard management of hemostatic defects in this setting and state the need for guidelines and better care. Point-of-care devices can assess hemostatic status and are especially suitable in perioperative settings. Using point-of-care devices, no time is required for transportation, allowing faster availability of results and providing potential for better care of the patient...
March 29, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28179384/a-complicated-multisystem-flare-of-systemic-lupus-erythematosus-during-pregnancy
#10
Philip Webster, Catherine Nelson-Piercy, Liz Lightstone
We report a case of systemic lupus erythematosus (SLE) in a young woman who became pregnant amid a severe flare. She continued to have active disease in the face of aggressive treatments complicated by several side effects of immunosuppressive drugs including recurrent sepsis and gestational diabetes. Her fetus was at risk for congenital heart block during the second and third trimesters. Despite an extremely guarded prognosis, she delivered a healthy baby girl. This case highlights the complexities of SLE management during pregnancy...
February 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28128518/maternal-and-neonatal-outcomes-in-women-with-severe-early-onset-pre-eclampsia-before-26-weeks-of-gestation-a-case-series
#11
M F van Oostwaard, L van Eerden, M W de Laat, J J Duvekot, Jjhm Erwich, Kwm Bloemenkamp, A C Bolte, Jpf Bosma, S V Koenen, R F Kornelisse, B Rethans, P van Runnard Heimel, Hcj Scheepers, W Ganzevoort, Bwj Mol, C J de Groot, Ipm Gaugler-Senden
OBJECTIVE: To describe the maternal and neonatal outcomes and prolongation of pregnancies with severe early onset pre-eclampsia before 26 weeks of gestation. DESIGN: Nationwide case series. SETTING: All Dutch tertiary perinatal care centres. POPULATION: All women diagnosed with severe pre-eclampsia who delivered between 22 and 26 weeks of gestation in a tertiary perinatal care centre in the Netherlands, between 2008 and 2014...
January 27, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28095812/maternal-sepsis-complicating-arabin-cervical-pessary-placement-for-the-prevention-of-preterm-birth-a-case-report
#12
Begoña Martinez de Tejada
BACKGROUND: Preterm delivery is a major health problem and contributes to more than 50% of all neonatal and infant deaths. Recently, there has been a renewed interest in the use of cervical pessaries as a safe and effective intervention with few maternal side-effects for the prevention of preterm birth in both single and twin pregnancies. CASE PRESENTATION: A 43-year-old gravida 5, para 1 (previous preterm birth at 24 weeks) patient with an in vitro fertilization twin pregnancy had an Arabin cervical pessary placed at 19 weeks of pregnancy due to the presence of cervical funneling identified by ultrasound screening...
January 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28013100/the-impact-of-highly-active-antiretroviral-therapy-on-obstetric-conditions-a-review
#13
REVIEW
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
March 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27926655/maternal-morbidity-after-previable-prelabor-rupture-of-membranes
#14
Sarah K Dotters-Katz, Alexis Panzer, Matthew R Grace, Marcela C Smid, J Adeolu Keku, Catherine J Vladutiu, Kim A Boggess, Tracy A Manuck
OBJECTIVE: To identify risk factors for maternal morbidity after previable prelabor rupture of membranes (PROM). METHODS: We conducted a case-control study of singleton and twin pregnancies complicated by previable PROM (14.0-22.9 weeks of gestation) at a single tertiary care referral institution, 2000-2015. Pregnancies complicated by fetal anomalies, previable PROM within 2 weeks of chorionic villus sampling or amniocentesis, and those with contraindications to expectant management (eg, chorioamnionitis) were excluded...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27899925/increased-risk-of-group-b-streptococcus-invasive-infection-in-hiv-exposed-but-uninfected-infants-a-review-of-the-evidence-and-possible-mechanisms
#15
REVIEW
Nicolas Dauby, Mustapha Chamekh, Pierrette Melin, Amy L Slogrove, Tessa Goetghebuer
Group B Streptococcus (GBS) is a major cause of neonatal sepsis and mortality worldwide. Studies from both developed and developing countries have shown that HIV-exposed but uninfected (HEU) infants are at increased risk of infectious morbidity, as compared to HIV-unexposed uninfected infants (HUU). A higher susceptibility to GBS infections has been reported in HEU infants, particularly late-onset diseases and more severe manifestations of GBS diseases. We review here the possible explanations for increased susceptibility to GBS infection...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27885296/outcome-of-twin-deliveries-at-a-tertiary-care-centre-of-eastern-nepal
#16
S Chaudhary, R R Singh, G S Shah, J Agrawal, S Kafle, L Shah
BACKGROUND: Twins, compared to singletons, have higher perinatal mortality and morbidity. The aim of this study was to describe the twinning rate, epidemiological variables and hospital outcome of twin deliveries and to find out ways of better management of twins in our part. METHODS: A retrospective evaluation of the outcome of 92 twin pregnancies during one year study period (1st January 2014 to 31st December 2014) was conducted at BPKIHS. Twins delivered within the institution were included but cases less than 28 weeks gestation were excluded...
May 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/27721728/spontaneous-bacterial-peritonitis-and-anasarca-in-a-female-patient-with-ovarian-hyperstimulation-syndrome-complicated-by-respiratory-and-kidney-failure
#17
Muhammad Abdul Mabood Khalil, Muhammad Salman Ghazni, Jackson Tan, Nazish Naseer, Muhammad Ashhad Ullah Khalil
Ovarian hyperstimulation syndrome (OHSS) was first described in 1960. It may occur as a complication of gonadotropin hormone therapy during assisted pregnancy or for primary infertility. A 26-year-old female patient with polycystic ovarian syndrome and primary infertility was treated to conceive. She received intravenous gonadotropin-releasing hormone (GnRH) along with follicle-stimulating hormone in an outside private clinic. She presented to the emergency department with abdominal and chest pain, loose stool, vomiting, shortness of breath and decreasing urine output...
May 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27617671/neutrophil-extracellular-traps-promote-hypercoagulability-in-patients-with-sepsis
#18
Shuofei Yang, Haozhe Qi, Kejia Kan, Jiaquan Chen, Hui Xie, Xiangjiang Guo, Lan Zhang
BACKGROUND: Patients with sepsis commonly exhibit a hypercoagulability with high risk of venous thromboembolism (VTE). Neutrophil extracellular traps (NETs) are found to trigger inflammation and coagulation. We aim to determine whether NETs promoted the hypercoagulability and early anticoagulation reduced NETs releasing during sepsis. METHODS: In this prospective study, septic patients between September 2013 and June 2015 were included. Patients of age <18 years, acute organ failure, pregnancy, coagulation disorders, receiving anticoagulation before admission were excluded...
February 2017: Shock
https://www.readbyqxmd.com/read/27435163/metformin-in-women-with-type-2-diabetes-in-pregnancy-mity-a-multi-center-randomized-controlled-trial
#19
Denice S Feig, Kellie Murphy, Elizabeth Asztalos, George Tomlinson, Johanna Sanchez, Bernard Zinman, Arne Ohlsson, Edmond A Ryan, I George Fantus, Anthony B Armson, Lorraine L Lipscombe, Jon F R Barrett
BACKGROUND: The incidence of type 2 diabetes in pregnancy is rising and rates of serious adverse maternal and fetal outcomes remain high. Metformin is a biguanide that is used as first-line treatment for non-pregnant patients with type 2 diabetes. We hypothesize that metformin use in pregnancy, as an adjunct to insulin, will decrease adverse outcomes by reducing maternal hyperglycemia, maternal insulin doses, maternal weight gain and gestational hypertension/pre-eclampsia. In addition, since metformin crosses the placenta, metformin treatment of the fetus may have a direct beneficial effect on neonatal outcomes...
July 19, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27400016/outcomes-of-pregnancies-complicated-by-preterm-premature-rupture-of-membranes-between-20-and-24-weeks-of-gestation
#20
Mia Kibel, Elizabeth Asztalos, Jon Barrett, Michael S Dunn, Carly Tward, Alex Pittini, Nir Melamed
OBJECTIVE: To assess the natural history and contemporary outcomes in pregnancies complicated by previable preterm premature rupture of membranes (PROM). METHODS: Retrospective study of all women with a singleton or twin pregnancy admitted to a single tertiary referral center who experienced preterm PROM between 20 and 23 6/7 weeks of gestation during 2004-2014 and underwent expectant management. Women electing termination of pregnancy and pregnancies complicated by major fetal anomalies were excluded...
August 2016: Obstetrics and Gynecology
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