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https://www.readbyqxmd.com/read/29026065/urethral-diverticulum-presenting-as-a-large-vaginal-mass-complicating-pregnancy-and-delivery
#1
Everett F Magann, Lisa S Newton, Susan A Barr
BACKGROUND A case report of urethral diverticulum complicating pregnancy is presented. The diagnosis and management are challenging because of the rare nature of this condition, the varied presentations and differential diagnoses, and the possibility of misdiagnosis. CASE REPORT A 25-year-old primigravida with scheduled induction of labor at 39 weeks gestation due to gestational diabetes mellitus presented for a routine antenatal appointment at 38 weeks and four days. On digital cervical examination, she was found to have a large semi-solid anterior vaginal mass, shown by trans-vaginal ultrasound to have a nearly solid appearance of a 5×7 cm mass with septation...
October 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29020780/-selective-feticide-in-monochorionic-twin-pregnancies-with%C3%A2-discordant-fetal-anomalies-management-and-outcome
#2
J Vojtěch, L Hašlík, R Pock, K Běhávková, K Macková, P Hanulíková, H Heřman, L Krofta
OBJECTIVE: To analyze results and outcome after selective feticide for discordant anomalies in monochorionic twins. DESIGN: Prospective cohort study. SETTING: Fetal medicine center, Institute for the Care of Mother and Child, Praha. METHODS: Analysis of outcome of monochorionic pregnancies after intrauterine surgery for structural abnormalities between January 2013 and June 2016. RESULTS: We performed 13 intrauterine operations in monochorionic twins with structural anomalies during the period...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28967071/outcomes-of-cataract-surgery-in-children-with-persistent-hyperplastic-primary-vitreous
#3
Jitender Jinagal, Parul C Gupta, Jagat Ram, Manu Sharma, Simar R Singh, Sonam Yangzes, Jaspreet Sukhija, Ramandeep Singh
PURPOSE: To evaluate postoperative outcomes of cataract surgery in children with persistent hyperplastic primary vitreous (PHPV) and factors affecting outcomes. METHODS: We analyzed 29 eyes of 28 children with PHPV presenting at a tertiary care center in northern India. All eyes underwent phacoaspiration followed by primary posterior capsulotomy with or without cauterization of persistent fetal vasculature under general anesthesia. Hydrophobic intraocular lens was implanted in selective cases...
September 14, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28928588/patient-with-persistent-low-oxygen-saturation-for-emergency-cesarean-section
#4
Shivali Panwar, Kirti Nath Saxena, Prachi Gaba
A 24-year-old woman with previous undiagnosed congenital methemoglobinemia presented for the emergency cesarean section in view of fetal distress. The patient had a persistent low oxygen saturation on pulse oximetry with normal heart rate and blood pressure. Arterial blood gas values were normal. The patient was asymptomatic and respiratory and cardiovascular system examination was normal. The patient underwent cesarean section under general anesthesia and was shifted to the Intensive Care Unit postoperatively...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#5
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28904676/-gestational-diabetes-revealed-by-inaugural-diabetic-ketoacidosis-about-a-case
#6
Serge Irie Bi Gohi, Pete Yaich, Koffi N'guessan, Bernard Ogondon, Yapo Brouh
Ketoacidosis complicating gestational diabetes is rare and responsible for severe maternal-fetal mortality. It is an acute metabolic emergency whose management is multidisciplinary. Early diagnosis and treatment affect the vital prognosis of both the mother and the fetus. We report the case of a 27-year old pregnant woman at term, with a family history of diabetes, admitted to the emergency obstetric care with alertness problems associated with dyspnoea. The diagnosis of inaugural ketoacidosis decompensated due to severe malaria associated with gestational diabetes was retained on the basis of patient's medical history, of clinical examination and paraclinical assessment...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28891072/stable-control-of-physiological-parameters-but-not-infection-in-preterm-lambs-maintained-on-ex-vivo-uterine-environment-therapy
#7
Yuichiro Miura, Haruo Usuda, Shimpei Watanabe, Eleanor Woodward, Masatoshi Saito, Gabrielle C Musk, Suhas G Kallapur, Shinichi Sato, Ryuta Kitanishi, Tadashi Matsuda, John P Newnham, Sarah J Stock, Matthew W Kemp
Ex vivo uterine environment (EVE) therapy is an experimental neonatal intensive care strategy wherein gas exchange is performed by membranous oxygenators attached to the umbilical vessels. Our aim was to assess the ability of a newly refined EVE system to maintain key physiological parameters in preterm lambs within optimal ranges for 48 h. EVE group; n = 6: Preterm lambs were delivered under general anesthesia at 115 ± 2 days of gestational age. Animals were submerged in a bath of artificial amniotic fluid on EVE therapy for 48 h...
September 11, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28888583/food-and-drug-administration-warning-on-anesthesia-and-brain-development-implications-for-obstetric-and-fetal-surgery
#8
Olutoyin A Olutoye, Byron Wycke Baker, Michael A Belfort, Oluyinka O Olutoye
There has been growing concern about the detrimental effects of certain anesthetic agents on the developing brain. Preclinical studies in small animal models as well as nonhuman primates suggested loss or death of brain cells and consequent impaired neurocognitive function following anesthetic exposure in neonates and late gestation fetuses. Human studies in this area are limited and currently inconclusive. On Dec. 14, 2016, the US Food and Drug Administration issued a warning regarding impaired brain development in children following exposure to certain anesthetic agents used for general anesthesia, namely the inhalational anesthetics isoflurane, sevoflurane, and desflurane, and the intravenous agents propofol and midazolam, in the third trimester of pregnancy...
September 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28868940/vigilance-on-use-of-drugs-herbal-products-and-food-supplements-during-pregnancy-focus-on-fosfomycin
#9
C Mannucci, G Dante, M Miroddi, F Facchinetti, R D'Anna, A Santamaria, M C Lenti, A Vannacci, F Calapai, M Perone, G Migliardi, A Alibrandi, M Navarra, G Calapai
PURPOSE: Urinary tract infection (UTI) is defined as a common bacterial infection that can lead to significant morbidity such as stricture, fistula, abscess formation, bacteremia, sepsis, pyelonephritis, and kidney dysfunction with a mortality rates reported of 1% in men and 3% in women because of development of pyelonephritis. UTIs are more common in women and the 33% of them require antimicrobials treatment for at least one episode by the age of 24 years. UTIs are the most common infections observed during pregnancy and up to 30% of mothers with not treated asymptomatic bacteriuria may develop acute pyelonephritis which consequently can be associated to adverse maternal and fetal outcomes...
September 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28851292/combined-spinal-epidural-anesthesia-for-cesarean-delivery-in-a-patient-with-cor-triloculare-biventriculare
#10
Yuan Han, Zhenfeng Zhang, Qingchun Sun, Ke Ding, Liu Han, Mengmeng Dong, Yifan Xu, Lei Ge
BACKGROUND: Cor triloculare biventriculare accounts for approximately 0.31% of cases of congenital heart disease (CHD). Moreover, people with cor triloculare biventriculare always have shorter life spans, and cases of gestation are rare. There have been various related reports of cor triloculare biventriculare in recent years. CASE PRESENTATION: We described an emergency cesarean section of a 30-year-old, 38-weeks-pregnant woman suffering from cardiac insufficiency and fetal distress...
August 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28808585/spinal-cord-injury-during-the-second-trimester-of-pregnancy
#11
Ahmad Zaheer Qureshi, Sami Ullah, Anas Jehad AlSaleh, Rubina' Ullah
INTRODUCTION: Pregnancies in women with spinal cord injury (SCI) are at greater risk of morbidity and mortality. Although pregnancy after SCI is well elaborated in the literature, SCI occurring during pregnancy is rarely reported. Abrupt changes in the body physiology because of SCI and the resulting disability add a risk to maternal and fetal well-being. Not only is the burden of care increased but there is also a higher risk of developing pressure ulcers, urinary tract infections, autonomic instability, intrauterine growth retardation and venous thromboembolism...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28805611/propofol-in-combination-with-remifentanil-for-cesarean-section-placental-transfer-and-effect-on-mothers-and-newborns-at-different-induction-to-delivery-intervals
#12
Liguo Hu, Jianhui Pan, Shantang Zhang, Jinjing Yu, Keqiang He, Shuhua Shu, Ruiting Wang
OBJECTIVE: This study aims to describe the administration of propofol in combination with remifentanil for the induction of general anesthesia during cesarean section (CS). Our aim was to evaluate its impact on the drug concentrations of the maternal and neonatal blood at different induction of anesthesia to delivery (I-D) intervals as well as its effect on newborns. MATERIALS AND METHODS: In this double-blind randomized controlled study, patients undergoing elective CS were administered anesthesia at short (n = 20) or long (n = 20) I-D intervals...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28758533/laparoscopic-early-pregnancy-diagnosis-in-the-laboratory-rat
#13
Petros Ypsilantis, Paraskevi Somalou, Eleni Panidou, Constantinos Simopoulos
Timely and accurate diagnosis of pregnancy in the laboratory rat is an invaluable endpoint in embryological and reproductive toxicology studies. The purpose of the present study was to assess the feasibility, sensitivity, accuracy and safety of laparoscopic examination of the uterus for detecting pregnancy at an early stage, and defining the number of fetuses in surviving rat models. Female Wistar rats were subjected to a two-port laparoscopic examination of their uterus from day 6 to day 10 post-coitum (pc)...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28742525/impact-factors-on-fetal-descent-rates-in-the-active-phase-of-labor-a-retrospective-cohort-study
#14
Nina Kimmich, Jana Juhasova, Christian Haslinger, Nicole Ochsenbein-Kölble, Roland Zimmermann
AIM: To assess fetal descent rates of nulliparous and multiparous women in the active phase of labor and to evaluate significant impact factors. METHODS: In a retrospective cohort study at the University Hospital of Zurich, Switzerland, we evaluated 6045 spontaneous vaginal deliveries with a singleton in vertex presentation between January 2007 and July 2014 at 34 0/7 to 42 0/7 gestational weeks. Median fetal descent rates and their 10th and 90th percentiles were assessed in the active phase of labor and different impact factors were evaluated...
July 25, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28734732/perinatal-and-neonatal-use-of-sedation-and-analgesia
#15
REVIEW
Christopher McPherson, Terrie Inder
Optimal obstetric and neonatal care requires the provision of adequate analgesia for painful procedures. However, anesthetic and analgesic agents have the potential to adversely impact the developing fetal/neonatal brain. In this setting, clinicians must assess the risks and benefits of pharmacologic anesthesia and analgesia for specific indications in this population. General anesthesia is required for non-obstetric surgery and cesarean section in the absence of neuraxial anesthesia for the health of the mother and fetus...
October 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28725115/maternal-and-fetal-arterial-blood-gas-data-in-normotensive-singleton-isoflurane-anesthetized-sheep-at-124-126-days-of-gestation
#16
Claire M Loughran, Matthew W Kemp, Gabrielle C Musk
The aim of this case series was to describe the differences between maternal and fetal blood-gas results during anesthesia. Sixteen singleton adult merino ewes weighing 60.1 ± 5.1 kg at 125.7 d (124 to 126 d) gestation were anesthetized. Maternal (radial) and fetal (umbilical) arterial blood gas samples were collected 79 ± 6 min after the start of anesthesia if maternal mean arterial pressure (MAP) was stable and > 65 mmHg. Fetal pH, partial arterial pressure of oxygen (PaO2), glucose, arterial hemoglobin oxygen saturation (SaO2), sodium, and chloride were significantly lower and fetal partial arterial pressure of carbon dioxide (PaCO2), lactate, hematocrit, total hemoglobin, potassium, and calcium were significantly higher than maternal blood-gas values...
July 2017: Canadian Journal of Veterinary Research, Revue Canadienne de Recherche Vétérinaire
https://www.readbyqxmd.com/read/28723831/effect-of-intrathecal-bupivacaine-dose-on-the-success-of-external-cephalic-version-for-breech-presentation-a-prospective-randomized-blinded-clinical-trial
#17
RANDOMIZED CONTROLLED TRIAL
Laurie A Chalifoux, Jeanette R Bauchat, Nicole Higgins, Paloma Toledo, Feyce M Peralta, Jason Farrer, Susan E Gerber, Robert J McCarthy, John T Sullivan
BACKGROUND: Breech presentation is a leading cause of cesarean delivery. The use of neuraxial anesthesia increases the success rate of external cephalic version procedures for breech presentation and reduces cesarean delivery rates for fetal malpresentation. Meta-analysis suggests that higher-dose neuraxial techniques increase external cephalic version success to a greater extent than lower-dose techniques, but no randomized study has evaluated the dose-response effect. We hypothesized that increasing the intrathecal bupivacaine dose would be associated with increased external cephalic version success...
October 2017: Anesthesiology
https://www.readbyqxmd.com/read/28713516/sequential-compression-pump-effect-on-hypotension-due-to-spinal-anesthesia-for-cesarean-section-a-double-blind-clinical-trial
#18
Fatemeh Javaherforoosh Zadeh, Mostafa Alqozat, Reza Akhond Zadeh
BACKGROUND: Spinal anesthesia (SA) is a standard technique for cesarean section. Hypotension presents an incident of 80-85% after SA in pregnant women. OBJECTIVE: To determine the effect of intermittent pneumatic compression of lower limbs on declining spinal anesthesia induced hypotension during cesarean section. METHODS: This double-blind clinical prospective study was conducted on 76 non-laboring parturient patients, aged 18-45 years, with the American Society of Anesthesiologist physical status I or II who were scheduled for elective cesarean section at Razi Hospital, Ahvaz, Iran from December 21, 2015 to January 20, 2016...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28697490/the-influence-of-blood-pressure-on-fetal-aortic-distensibility-an-animal-validation-study
#19
Christoph Wohlmuth, Kenneth J Moise, Ramesha Papanna, Ciprian Gheorghe, Anthony Johnson, Yisel Morales, Helena M Gardiner
BACKGROUND/AIMS: Aortic distension waveforms describe the change in diameter or cross-sectional area over the cardiac cycle. We aimed to validate the association of aortic fractional area change (AFAC) with blood pressure (BP) in a fetal lamb model. METHODS: Four pregnant ewes underwent open fetal surgery under general anesthesia at 107-120 gestational days. A 4-Fr catheter was introduced into the fetal femoral artery and vein, or the carotid artery and jugular vein...
July 12, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28689624/neonatal-effects-after-vasopressor-during-spinal-anesthesia-for-cesarean-section-a-multicenter-randomized-controlled-trial
#20
K Uerpairojkit, R Anusorntanawat, A Sirisabya, M Chaichalothorn, S Charuluxananan
BACKGROUND: Placental transfer of ephedrine causes fetal effects when compared with phenylephrine. This study compared their drug effects on neonatal parameters after cesarean delivery under spinal anesthesia. METHODS: Three-hundred-and-fifty-four women undergoing elective cesarean delivery who needed intravenous vasopressor following spinal anesthesia were randomized into two groups. Group E received boluses of ephedrine 6mg, and Group P phenylephrine 100µg, titrated to maintain systolic blood pressure near baseline values...
July 6, 2017: International Journal of Obstetric Anesthesia
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