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hemorrhage and pregnancy

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https://www.readbyqxmd.com/read/28211916/role-of-endothelial-nitric-oxide-synthase-and-endothelin-1-polymorphism-genes-with-the-pathogenesis-of-intraventricular-hemorrhage-in-preterm-infants
#1
Dawid Szpecht, Janusz Gadzinowski, Agnieszka Seremak-Mrozikiewicz, Grażyna Kurzawińska, Marta Szymankiewicz
In the pathogenesis of neonatal intraventricular hemorrhage (IVH) in preterm infants, an important role is played by changes in venous and arterial cerebral flows. It has been shown that the ability of autoregulation of cerebral flows in response to variations in arterial blood pressure in preterm infants is impaired. This impaired autoregulation causes an increased risk of germinal matrix rupture and IVH occurrence. We examined three polymorphisms of genes, related to regulation of blood flow, for an association with IVH in 100 preterm infants born from singleton pregnancy, before 32 + 0 weeks of gestation, exposed to antenatal steroids therapy, and without congenital abnormalities...
February 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#2
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...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28195885/eisenmenger-syndrome-and-pregnancy-novel-ecmo-configuration-as-a-bridge-to-delivery-and-recovery-utilizing-a-multidisciplinary-team
#3
Erika B Rosenzweig, Darryl Abrams, Mauer Biscotti, Diane Kerstein, Daphnie Drassinower, Daniel Brodie, Matthew Bacchetta
Pregnancy is typically contraindicated in Eisenmenger syndrome because of its association with excessively high maternal and fetal morbidity and mortality. We report on our novel approach to successfully managing a 29 year-old pregnant woman with an unrepaired patent ductus arteriosus (PDA) with Eisenmenger syndrome through delivery and recovery. Venovenous ECMO was utilized during induction of labor to stabilize maternal hemodynamics and optimize fetal oxygenation by creating an oxygenated right-to-left shunt through the PDA...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28191381/spontaneous-unilateral-adrenal-hemorrhage-in-pregnancy
#4
Salam Kadhem, Rawaa Ebrahem, Cyrus Munguti, Rami Mortada
Spontaneous adrenal hemorrhage (SAH) is a serious medical condition associated with variable clinical presentation depending on the extent of the hemorrhage. Pregnancy-induced adrenal hemorrhage is poorly understood. A low cortisol level in the peripartum period with radiological findings is sufficient to establish the diagnosis. Prompt hormone replacement and supportive care to ensure good clinical outcomes is crucial. Due to the potentially life-threatening complications, physicians should have a high suspicion for adrenal hemorrhage when they evaluate patients with hypotension, fatigue, and abdominal pain during the peripartum period...
January 13, 2017: Curēus
https://www.readbyqxmd.com/read/28184323/congenital-tuberculosis-a-newborn-case-report-with-rare-manifestation
#5
Hadi Khorsand Zak, Shahin Mafinezhad, Ali Haghbin
INTRODUCTION: Congenital tuberculosis is an infrequently encountered condition and only 300 cases were reported in the literature till 1989. There are no specific signs and symptoms pathognomonic for congenital TB, and the devastating consequences in the absence of early therapy signify the importance of early diagnosis and treatment during the neonatal period. CASE PRESENTATION: In this paper we report on a case of congenital TB in a newborn who was admitted to our clinic with seizures and intraventricular hemorrhage (IVH) due to TB meningitis...
October 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28181995/is-the-bishop-score-significant-in-predicting-the-success-of-labor-induction-in-multiparous-women
#6
D Navve, N Orenstein, R Ribak, Y Daykan, G Shechter-Maor, T Biron-Shental
OBJECTIVE: To determine whether the Bishop-score upon admission effects mode of delivery, maternal or neonatal outcomes of labor induction in multiparous women. STUDY DESIGN: A retrospective study including 600 multiparous women with a singleton pregnancy, 34 gestational weeks and above who underwent labor induction for maternal, fetal or combined indications. Induction was performed with one of three methods- oxytocin, a slow release vaginal prostaglandin E2 insert (10 mg dinoprostone) or a transcervical double balloon catheter...
February 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28181672/endometriosis-increases-the-risk-of-obstetrical-and-neonatal-complications
#7
Janne Foss Berlac, Dorthe Hartwell, Charlotte Wessel Skovlund, Jens Langhoff-Roos, Øjvind Lidegaard
INTRODUCTION: The objective was to assess obstetrical complications and neonatal outcomes in women with endometriosis as compared to women without endometriosis. MATERIAL AND METHODS: National cohort including all delivering women and their newborns in Denmark 1997-2014. Data were extracted from the Danish Health Register and the Medical Birth Register. Logistic regression analysis provided odds ratios (OR) with 95% confidence intervals (CI). Sub-analyses were made for primiparous women with a singleton pregnancy and for women with endometriosis who underwent gynecological surgery before pregnancy...
February 9, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28176962/renal-angiomyolipoma-in-pregnancy-surgical-management-with-fetal-preservation-approach-in-a-developing-setting
#8
Fred O Ugwumba, Emeka F Nnakenyi, Okechukwu C Okafor, Augustine C Onuh, Paschalina C Ezechukwu, Sunday Urube
Renal angiomyolipomas (RAML) are uncommon benign renal tumours that are associated with a tendency to rupture resulting in sometimes-torrential retroperitoneal hemorrhage as the Wunderlich syndrome or as severe potentially exsanguinating hematuria. When hemorrhage from RAML occurs in pregnancy it presents a unique challenge requiring timely and appropriately adapted intervention with the goal of preventing fatality, preserving renal function as well as preventing fetal loss if possible. We report the management of severe bleeding from RAML in pregnancy and highlight the need to adopt a management strategy that suits the practice environment and offers the patient standard and enduring care...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/28157751/inherited-and-uncommon-causes-of-stroke
#9
Jennifer Juhl Majersik
PURPOSE OF REVIEW: This article is a practical guide to identifying uncommon causes of stroke and offers guidance for evaluation and management, even when large controlled trials are lacking in these rarer forms of stroke. RECENT FINDINGS: Fabry disease causes early-onset stroke, particularly of the vertebrobasilar system; enzyme replacement therapy should be considered in affected patients. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), often misdiagnosed as multiple sclerosis, causes migraines, early-onset lacunar strokes, and dementia...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28156197/risk-factors-for-perinatal-mortality-in-murmansk-county-russia-a-registry-based-study
#10
Anna A Usynina, Andrej M Grjibovski, Alexandra Krettek, Jon Øyvind Odland, Alexander V Kudryavtsev, Erik Eik Anda
BACKGROUND: Factors contributing to perinatal mortality (PM) in Northwest Russia remain unclear. This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry. OBJECTIVE: This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry. METHODS: The study population consisted of all live- and stillbirths registered in the Murmansk County Birth Registry during 2006-2011 (n = 52,806)...
2017: Global Health Action
https://www.readbyqxmd.com/read/28155100/posterior-reversible-encephalopathy-syndrome-in-pregnancy-a-retrospective-series-of-36-patients-from-mainland-china
#11
Y Wen, B Yang, Q Huang, Y Liu
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is associated with variable predisposing risk factors including preeclampsia and eclampsia since it proposed. However, studies of large case series focusing on pregnancy-related PRES are still limited. We performed a large retrospective study of patients with pregnancy-related PRES admitted to our institution. METHODS: This was a single-center, 2010-2015 retrospective cohort study of patients with pregnancy-related PRES who underwent neuroimaging via magnetic resonance imaging or computerized tomography from mainland China...
February 2, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28151819/epidemiology-of-cardiac-arrest-during-hospitalization-for-delivery-in-canada-a-nationwide-study
#12
Mrinalini Balki, Shiliang Liu, Juan Andrés León, Leyla Baghirzada
BACKGROUND: Cardiac arrest in pregnancy is a rare and devastating condition with high mortality and morbidity. The objective of this study was to generate information about maternal cardiac arrest in Canada by examining the frequency, temporal incidence, associated conditions, potential etiologies, and survival rates. METHODS: This retrospective population-based study used hospitalization data from the discharge abstract database of the Canadian Institute for Health Information relating to obstetric deliveries in Canada from April 1, 2002, to March 31, 2015...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28150370/clinical-classification-and-treatment-of-cesarean-scar-pregnancy
#13
Hongwen Zhang, Jingrui Huang, Xianqing Wu, Hong Fan, Han Li, Tian Gao
AIM: Embryo implantation in a cesarean scar resulting in a cesarean scar pregnancy (CSP) is a special form of ectopic pregnancy. The aim of this article is to present our clinical classification and therapeutic strategy for CSP and to assess the efficacy, safety, and social benefits. METHODS: We categorized CSP as either risky or stable. Risky CSP have a high risk of severe hemorrhage and should be treated immediately, while stable CSP patients have neither obvious vaginal bleeding nor significantly elevated serum β-human chorionic gonadotrophin (β-hCG)...
February 2, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28148289/a-rare-case-of-dengue-encephalopathy-complicating-a-term-pregnancy
#14
Lavanya Rajagopala, Ravindra L Satharasinghe, Madhava Karunarathna
BACKGROUND: Dengue fever has an expanded clinical spectrum ranging from an asymptomatic infection to life threatening dengue hemorrhagic fever and refractory shock. Dengue infection in pregnancy can be a diagnostic dilemma, particularly considering the physiological changes in pregnancy and the obstetric complications encountered in clinical practice. Hence the knowledge of its diagnosis and management in its atypical presentations is of paramount importance. Here we report an unusual case of uncomplicated dengue encephalopathy in a term mother, probably the first to be reported from the Indian subcontinent...
February 2, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28133896/efficacy-comparison-of-transcatheter-arterial-embolization-with-gelatin-sponge-and-polyvinyl-alcohol-particles-for-the-management-of-cesarean-scar-pregnancy-and-follow-up-study
#15
Yan Ma, Chao Yang, Xiaonan Shao
AIM: The aim of this study was to compare the therapeutic efficacy of transcatheter arterial embolization (TAE) with gelatin sponge (GS) and polyvinyl alcohol (PVA) particles for cesarean scar pregnancy (CSP). METHODS: A total of 35 patients with CSP, who were classified into either the GS group (n = 22) or the PVA group (n = 13), underwent TAE and postoperative ultrasound-guided curettage. Their hospital stay, first-scheme success rate, intra-curettage blood loss, serum β-human chorionic gonadotropin (hCG) level, and other indicators were simultaneously recorded...
January 30, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28130210/antenatal-management-in-fetal-and-neonatal-alloimmune-thrombocytopenia-a-systematic-review
#16
Dian Winkelhorst, Michael F Murphy, Andreas Greinacher, Nadine Shehata, Tamam Bakchoul, Edwin Massey, Jillian Baker, Lani Lieberman, Susano Tanael, Heather Hume, Donald M Arnold, Shoma Baidya, Gerald Bertrand, James Bussel, Mette Kjaer, Cécile Kaplan, Jens Kjeldsen-Kragh, Dick Oepkes, Greg Ryan
Several strategies can be used to manage fetal or neonatal alloimmune thrombocytopenia (FNAIT) in subsequent pregnancies. Serial fetal blood sampling (FBS) and intrauterine platelet transfusions (IUPT), and weekly maternal intravenous immunoglobulin infusion (IVIG), with or without additional corticosteroid therapy are common options, but the optimal management has not been determined. The aim of this systematic review was to assess antenatal treatment strategies for FNAIT. Four randomized controlled trials and twenty-two non-randomized studies were included...
January 27, 2017: Blood
https://www.readbyqxmd.com/read/28115056/the-clinical-outcome-of-cesarean-scar-pregnancies-implanted-on-the-scar-versus-in-the-niche
#17
Andrea Kaelin Agten, Giuseppe Cali, Ana Monteagudo, Johana Oviedo, Joanne Ramos, Ilan Timor-Tritsch
BACKGROUND: The term "cesarean scar pregnancy" (CSP) refers to placental implantation within the scar of a prior cesarean delivery. The rising numbers of cesarean deliveries in the last decades have lead to an increased incidence of CSP. Complications of CSP include: morbidly adherent placenta, uterine rupture, severe hemorrhage, and preterm labor. It is suspected that CSPs implanted within a dehiscent scar ("niche") behave differently compared to those implanted on top of a well healed scar...
January 20, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28110751/novel-regulators-of-hemodynamics-in-the-pregnant-uterus
#18
N C Clark, C A Pru, J K Pru
The uterus is a highly dynamic organ, undergoing dramatic physiological changes during normal cyclicity and pregnancy. Many of these changes involve remodeling of the uterine vasculature in order to provide oxygen and nutrients to the developing embryo/fetus. Vasculogenesis, angiogenesis, vasodilation/vasoconstriction, and vascular permeability are coordinated by a vast network of autocrine, paracrine, and endocrine-signaling factors that derive from a number of cellular sources at the maternal:fetal interface, as well as from tissue outside the uterus...
2017: Progress in Molecular Biology and Translational Science
https://www.readbyqxmd.com/read/28109894/pregnancy-outcomes-following-direct-uterine-fibroid-thermal-ablation-a-review-of-the-literature
#19
REVIEW
Julia Keltz, Mark Levie, Scott Chudnoff
The objective of this review is to describe the reproductive outcomes of women after radiofrequency volumetric thermal ablation (RFVTA) of fibroids or magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU). This is a literature review of the current case reports of reproductive outcomes following direct fibroid thermal ablation at multiple academic and private centers throughout the world. A literature search was performed using PubMed and Medline. All publications that included data of women who underwent radiofrequency fibroid ablation or magnetic resonance-guided high-intensity focused ultrasound of fibroids and subsequently conceived were included...
January 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28107771/a-prospective-study-of-maternal-fetal-and-neonatal-outcomes-in-the-setting-of-cesarean-section-in-low-and-middle-income-countries
#20
Margo S Harrison, Omrana Pasha, Sarah Saleem, Sumera Ali, Elwyn Chomba, Waldemar A Carlo, Ana L Garces, Nancy F Krebs, K Michael Hambidge, Shivaprasad S Goudar, Bhala Kodkany, Sangappa Dhaded, Richard J Derman, Archana Patel, Patricia L Hibberd, Fabian Esamai, Edward A Liechty, Janet L Moore, Dennis Wallace, Elizabeth M McClure, Menachem Miodovnik, Marion Koso-Thomas, Jose Belizan, Robert L Goldenberg
Cesarean section (CS) rates are increasing globally with an unclear effect on pregnancy outcomes. The study objective was to quantify maternal and perinatal morbidity and mortality in low- and middle-income countries associated with CS compared to vaginal delivery (VD) both within and across sites MATERIAL AND METHODS: A prospective population-based study including home and facility births in 337,153 women with a VD and 47,308 women with a CS from 2010 to 2015 was performed in Guatemala, India, Kenya, Pakistan, Zambia, and Democratic Republic of Congo...
January 20, 2017: Acta Obstetricia et Gynecologica Scandinavica
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