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Maternal collapse

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https://www.readbyqxmd.com/read/28719429/maternal-salvage-with-extracorporeal-life-support-lessons-learned-in-a-single-center
#1
Philippe Biderman, Uri Carmi, Eric Setton, Michael Fainblut, Oren Bachar, Sharon Einav
The American Heart Association scientific statement on cardiac arrest in pregnancy did not endorse extracorporeal life support for lack of cohort data. We studied all pregnancy and peripartum cases of extracorporeal life support in 1 medical center (n = 11), including collapse due to infection (n = 6, 55%), thromboembolism (n = 3, 27%), and cardiac disease (n = 2, 18%). Half of the cases (n = 5, 45%) involved extracorporeal cardiopulmonary resuscitation. Most mothers survived (n = 7, 64% [95% confidence interval, 32%-88%])...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28652270/neurogenic-pulmonary-oedema-a-rare-cause-of-maternal-collapse
#2
Huma Farooq, Sukrutha Veerareddy, Eli Silber
Acute pulmonary oedema is a significant cause of morbidity and mortality in pregnant and postpartum women. We present an unusual case of near-fatal acute pulmonary oedema in a pregnant woman, which was attributed to the acute onset of neurogenic pulmonary oedema secondary to epileptic seizure activity. The patient required supportive management in the intensive care setting for a short period and subsequently made complete recovery with regular neurological follow-up arranged for the management of her epilepsy...
June 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28625306/spinal-induced-hypotension-incidence-mechanisms-prophylaxis-and-management-summarizing-20-years-of-research
#3
REVIEW
Jennifer E Lee, Ronald B George, Ashraf S Habib
Hypotension commonly occurs in parturients undergoing cesarean delivery under spinal anesthesia. This leads to maternal and neonatal adverse outcomes, including maternal nausea and vomiting and fetal acidosis, and might even lead to cardiovascular collapse if not treated. Arterial dilatation and reduction in systemic vascular resistance are the major contributors to spinal-induced hypotension. Therefore, strategies aimed at expanding the intravascular volume with fluid loading or increasing venous return with lower extremities mechanical compression and lateral tilt have had limited effectiveness in the management of spinal-induced hypotension...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28602042/clinical-indications-for-cesarean-delivery-among-women-living-with-female-genital-mutilation
#4
Maria I Rodriguez, Lale Say, Jasmine Abdulcadir, Michelle J Hindin
OBJECTIVE: To compare primary indications for cesarean delivery among patients with different female genital mutilation (FGM) status. METHODS: The present secondary analysis included data from women who underwent trial of labor resulting in cesarean delivery at 28 obstetric centers in six African countries between November 1, 2001, and March 31, 2003. Associations between cesarean delivery indications and FGM status were assessed using descriptive statistics and multivariable multinomial logistic regression...
June 11, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28574726/failing-states-as-epidemiologic-risk-zones-implications-for-global-health-security
#5
Katherine Hirschfeld
Failed states commonly experience health and mortality crises that include outbreaks of infectious disease, violent conflict, reductions in life expectancy, and increased infant and maternal mortality. This article draws from recent research in political science, security studies, and international relations to explore how the process of state failure generates health declines and outbreaks of infectious disease. The key innovation of this model is a revised definition of "the state" as a geographically dynamic rather than static political space...
May 2017: Health Security
https://www.readbyqxmd.com/read/28570608/the-spread-of-wolbachia-through-mosquito-populations
#6
Francis M Jiggins
In many regions of the world, mosquito-borne viruses pose a growing threat to human health. As an alternative to traditional control measures, the bacterial symbiont Wolbachia has been transferred from Drosophila into the mosquito Aedes aegypti, where it can block the transmission of dengue and Zika viruses. A recent paper has reported large-scale releases of Wolbachia-infected Ae. aegypti in the city of Cairns, Australia. Wolbachia, which is maternally transmitted, invaded and spread through the populations due to a sperm-egg incompatibility called cytoplasmic incompatibility...
June 2017: PLoS Biology
https://www.readbyqxmd.com/read/28345398/challenges-in-the-surgical-management-of-ectopic-pregnancy-in-a-low-resource-setting-mpilo-central-hospital-bulawayo-zimbabwe
#7
Solwayo Ngwenya
Background Ectopic pregnancy contributes to maternal morbidity and mortality, especially in low-resourced countries with limited facilities for early diagnosis and treatment. It is a very challenging condition to diagnose. Patients may collapse and die while undergoing investigation. Aims To assess surgical treatment given to patients presenting at Mpilo Central Hospital, the challenges that are faced and the outcomes; and also to document how women survive this dangerous condition in a setting challenged by low resources...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28261573/understanding-the-full-spectrum-of-organ-injury-following-intrapartum-asphyxia
#8
REVIEW
Domenic A LaRosa, Stacey J Ellery, David W Walker, Hayley Dickinson
Birth asphyxia is a significant global health problem, responsible for ~1.2 million neonatal deaths each year worldwide. Those who survive often suffer from a range of health issues including brain damage-manifesting as cerebral palsy (CP)-respiratory insufficiency, cardiovascular collapse, and renal dysfunction, to name a few. Although the majority of research is directed toward reducing the brain injury that results from intrapartum birth asphyxia, the multi-organ injury observed in surviving neonates is of equal importance...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#9
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28177969/zika-virus-practical-information-for-the-plastic-and-reconstructive-surgeon
#10
Nicholas A Calotta, Justin M Sacks, Anand R Kumar
The ongoing Zika virus outbreak in South, Central, and, most recently, North America has become a global health care emergency. Originally thought to be a benign, self-limiting viral syndrome, the newest epidemic has provided convincing evidence that maternal Zika virus infection can lead to neonatal malformations, the so-called congenital Zika syndrome. The alarming number of microcephalic neonates being born during the current outbreak is most notable, though several other anomalies, such as arthrogryposis, redundant scalp tissue, and cranial collapse, have been reported...
April 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28162042/the-syrian-public-health-and-humanitarian-crisis-a-displacement-in-global-governance
#11
Sumaira Akbarzada, Tim K Mackey
Ongoing failure by the international community to resolve the Syrian conflict has led to destruction of critical infrastructure. This includes the collapse of the Syrian health system, leaving millions of internally displaced persons (IDPs) in urgent need of healthcare services. As the conflict intensifies, IDP populations are suffering from infectious and non-communicable disease risks, poor maternal and child health outcomes, trauma, and mental health issues, while healthcare workers continually exit the country...
February 4, 2017: Global Public Health
https://www.readbyqxmd.com/read/28046002/competition-for-materno-fetal-resource-partitioning-in-a-rabbit-model-of-undernourished-pregnancy
#12
Jorge Lopez-Tello, Maria Arias-Alvarez, Maria Angeles Jimenez-Martinez, Rosa Maria Garcia-Garcia, Maria Rodriguez, Pedro Luis Lorenzo Gonzalez, Ruben Bermejo-Poza, Antonio Gonzalez-Bulnes, Pilar Garcia Rebollar
The major goal of animal production is to obtain abundant and healthy meat for consumers. Maternal food restriction (MFR) is often applied in farms to reduce production costs. However, the suitability of MFR in livestock animals is questionable, as this management may compromise maternal fitness due to a severe negative energetic balance and can induce Intrauterine Growth Restriction (IUGR) and prenatal programming in the offspring. Here, we sought to determine, using pregnant rabbits, the consequences of MFR on maternal endocrine and metabolic status and conceptus development...
2017: PloS One
https://www.readbyqxmd.com/read/28031077/deployment-of-medical-relief-teams-of-the-indian-army-in-the-aftermath-of-the-nepal-earthquake-lessons-learned
#13
Ashutosh Chauhan, Bhushan Kumar Chopra
In April 2015 a 7.8-magnitude earthquake hit Nepal. As part of relief operations named Operation Maitri, the Indian Armed Forces deployed 3 field hospitals in the disaster zone. Rapid deployment of mobile surgical teams to far-flung, inaccessible areas was done by helicopters. In an operational deployment spanning 1 month, a total of 7532 patients were treated and 105 surgeries were carried out on 83 patients. One-fifth of the patients were less than 18 years of age. One-third of the patients had traumatic injuries directly attributable to the earthquake, whereas the remaining patients were treated for diseases of poor sanitation and hygiene as well as chronic illness that had been neglected owing to the collapse of the local health infrastructure...
June 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/27927722/age-dependent-control-of-energy-homeostasis-by-brown-adipose-tissue-in-progeny-subjected-to-maternal-diet-induced-fetal-programming
#14
Olivier Dumortier, Estelle Roger, Didier F Pisani, Virginie Casamento, Nadine Gautier, Patricia Lebrun, Hereroa Johnston, Pascal Lopez, Ez-Zoubir Amri, Céline Jousse, Pierre Fafournoux, Marc Prentki, Charlotte Hinault, Emmanuel Van Obberghen
Epidemiological and animal studies show that deleterious maternal environments predispose aging offspring to metabolic disorders and type 2 diabetes. Young progenies in a rat model of maternal low-protein (LP) diet are normoglycemic despite collapsed insulin secretion. However, without further worsening of the insulin secretion defect, glucose homeostasis deteriorates in aging LP descendants. Here we report that normoglycemic and insulinopenic 3-month-old LP progeny shows increased body temperature and energy dissipation in association with enhanced brown adipose tissue (BAT) activity...
March 2017: Diabetes
https://www.readbyqxmd.com/read/27888446/cesarean-section-in-the-setting-of-severe-pulmonary-hypertension-requiring-extracorporeal-life-support
#15
Ryosuke Hara, Shuhei Hara, Chin Siang Ong, Gary Schwartz, Christopher Sciortino, Narutoshi Hibino
We describe the use of veno-arterial extracorporeal membrane oxygenation (ECMO) in a 35-year-old female with severe fixed pulmonary hypertension who went into cardiogenic shock during a Cesarean section. Pregnancy in the presence of severe pulmonary hypertension is typically contraindicated due to high maternal mortality rates. This patient visited our hospital at 37 weeks of gestation after experiencing dyspnea and chest pain. Clinical evaluation revealed severe fixed pulmonary hypertension. At the time of the planned delivery, femoral lines were placed; in case of emergency, ECMO became necessary during the delivery...
November 25, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27887572/maternal-smoking-impacts-key-biological-pathways-in-newborns-through-epigenetic-modification-in-utero
#16
Daniel M Rotroff, Bonnie R Joubert, Skylar W Marvel, Siri E Håberg, Michael C Wu, Roy M Nilsen, Per M Ueland, Wenche Nystad, Stephanie J London, Alison Motsinger-Reif
BACKGROUND: Children exposed to maternal smoking during pregnancy exhibit increased risk for many adverse health effects. Maternal smoking influences methylation in newborns at specific CpG sites (CpGs). Here, we extend evaluation of individual CpGs to gene-level and pathway-level analyses among 1062 participants in the Norwegian Mother and Child Cohort Study (MoBa) using the Illumina 450 K platform to measure methylation in newborn DNA and maternal smoking in pregnancy, assessed using the biomarker, plasma cotinine...
November 25, 2016: BMC Genomics
https://www.readbyqxmd.com/read/27870297/household-financial-distress-and-initial-endowments-evidence-from-the-2008-financial-crisis
#17
Arna Olafsson
This paper studies in utero exposure to the 2008 financial crisis. Exploiting the sudden and unexpected collapse of the Icelandic economy, I find that first-trimester exposure to the crisis led to a sizable and significant reduction in birth weight, increased the probability of a low birth weight ( < 2500 g), and decreased the probability of a high birth weight ( > 4000 g). I also find evidence that the collapse reduced the sex ratio, indicating selection in utero due to maternal prenatal stress exposure...
November 2016: Health Economics
https://www.readbyqxmd.com/read/27865449/characterizing-nuclear-and-mitochondrial-dna-in-spent-embryo%C3%A2-culture-media-genetic-contamination-identified
#18
Elizabeth R Hammond, Brent C McGillivray, Sophie M Wicker, John C Peek, Andrew N Shelling, Peter Stone, Larry W Chamley, Lynsey M Cree
OBJECTIVE: To characterize nuclear and mitochondrial DNA (mtDNA) in spent culture media from normally developing blastocysts to determine whether it could be used for noninvasive genetic assessment. DESIGN: Prospective embryo cohort study. SETTING: Academic center and private in vitro fertilization (IVF) clinic. PATIENT(S): Seventy patients undergoing intracytoplasmic sperm injection (ICSI) and 227 blastocysts. INTERVENTION(S): Culture media assessment, artificial blastocoele fluid collapse and DNA analysis using digital polymerase chain reaction (dPCR), long-range PCR, quantitative PCR (qPCR), and DNA fingerprinting...
January 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/27680784/a3-oxidative-stress-in-maternal-serum-as-endothelial-dysfunction-marker-in-preeclampsia-an-electron-paramagnetic-resonance-epr-pilot-study
#19
D Mannaerts, E Faes, J Gielis, J Briedé, P Cos, E Van Craenenbroeck, W Gyselaers, J Cornette, M Spaanderman, Y Jacquemyn
AIMS: Oxidative stress is crucial in the pathophysiology of preeclampsia. Reactive oxygen species (ROS) like the superoxide radical O2-, are produced by the ischemic placenta, causing systemic inflammation and endothelial dysfunction. EPR uses microwave radiation and a high magnetic field and is the most direct and reliable method to detect free radicals. We explored the feasibility of determining O2- concentration in maternal serum and compared pre-eclamptic and uncomplicated pregnancies...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27580649/investigating-the-pertussis-resurgence-in-england-and-wales-and-options-for-future-control
#20
Yoon Hong Choi, Helen Campbell, Gayatri Amirthalingam, Albert Jan van Hoek, Elizabeth Miller
BACKGROUND: In 2012 England and Wales experienced a resurgence of pertussis and an increase in infant deaths. This occurred 8 years after acellular pertussis (aP) vaccine replaced whole cell (wP) primary vaccine despite continued high coverage for the primary series and pre-school aP booster. We developed a mathematical model to describe pertussis transmission dynamics in England and Wales since the 1950s and used it to investigate the cause of the resurgence and the potential impact of additional vaccination strategies...
September 1, 2016: BMC Medicine
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