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Cardiac pregnancy

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https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#1
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/28202440/exposure-to-placental-ischemia-impairs-postpartum-maternal-renal-and-cardiac-function-in-rats
#2
Nina D Paauw, Jaap A Joles, Frank T Spradley, Bhavisha Bakrania, Zsuzsanna K Zellenger, Arie Franx, Marianne C Verhaar, Joey P Granger, A Titia Lely
INTRODUCTION: Women with a history of preeclampsia (PE) have an increased risk to develop cardiovascular and renal diseases later in life, but the mechanisms underlying this effect are unknown. In rats, we assessed whether placental ischemia results in long-term effects on the maternal cardiovascular and renal systems using the Reduced Uterine Perfusion Pressure (RUPP) model for PE. METHODS: Sprague-Dawley rats received either a SHAM or RUPP operation at gestational day 14...
February 15, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28202385/long-term-consequences-of-disrupting-adenosine-signaling-during-embryonic-development
#3
REVIEW
Scott A Rivkees, Christopher C Wendler
There is growing evidence that disruption in the prenatal environment can have long-lasting effects on an individual's health in adulthood. Research on the fetal programming of adult diseases, including cardiovascular disease, focuses on epi-mutations, which alter the normal pattern of epigenetic factors such as DNA methylation, miRNA expression, or chromatin modification, rather than traditional genetic alteration. Thus, understanding how in utero chemical exposures alter epigenetics and lead to adult disease is of considerable public health concern...
February 12, 2017: Molecular Aspects of Medicine
https://www.readbyqxmd.com/read/28195551/b-type-natriuretic-peptide-and-echocardiography-reflect-volume-changes-during-pregnancy
#4
Janet M Burlingame, Kelly Yamasato, Hyeong Jun Ahn, Todd Seto, W H Wilson Tang
OBJECTIVE: To evaluate B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac structure and function in normal women through pregnancy and the postpartum. METHODS: In this prospective observational study, we obtained serial transthoracic echocardiograms, BNP, and NT-proBNP at seven intervals from 6 weeks' gestation through 12 months postpartum. Women with hypertension or cardiac disease were excluded. Using 6-12 months postpartum as reference for non-pregnant levels, echocardiogram measurements and BNP/NT-proBNP were compared over time using linear mixed models with Tukey-Kramer adjustment for multiple comparisons...
February 14, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28195383/the-morphological-ultrasound-types-known-as-blob-and-bagel-signs-should-be-reclassified-from-probable-to-definite-ectopic-pregnancy
#5
Batool Nadim, Fernando Infante, Lu Chuan, Nalayini Sathasivam, George Condous
OBJECTIVES: In a recent consensus statement on early pregnancy nomenclature by Barnhart 2011, a definite ectopic pregnancy(EP) was defined morphologically on transvaginal ultrasound (TVS) as an extra-uterine gestational sac(GS) with yolk sac and/or embryo(with or without cardiac activity) whilst a probable EP defined as an inhomogeneous adnexal mass("blob" sign) or extra-uterine sac-like structure("bagel" sign). This study aims to determine whether the ultrasound markers used to define probable EP can be used to predict a definite tubal EP...
February 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28194919/management-of-pulmonary-vasodilator-therapy-in-three-pregnancies-with-pulmonary-arterial-hypertension
#6
Atsushi Daimon, Chizuko A Kamiya, Naoko Iwanaga, Tomoaki Ikeda, Norifumi Nakanishi, Jun Yoshimatsu
Pregnancy with pulmonary arterial hypertension (PAH) has a significantly high risk of maternal death and women with PAH are basically advised to avoid pregnancy. Recently, several reports have described pregnant women with PAH who were treated with pulmonary vasodilators during pregnancy and delivered safely. However, the efficacy of this treatment during pregnancy is still not clear. Here we report on the short-term outcomes of three primiparous women with PAH who were prescribed pulmonary vasodilator therapy during their pregnancies...
February 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28188773/maternal-buprenorphine-treatment-and-fetal-neurobehavioral-development
#7
Lauren M Jansson, Martha Velez, Krystle McConnell, Nancy Spencer, Michelle Tuten, Hendree E Jones, Van L King, Neeraj Gandotra, Lorraine A Milio, Kristin Voegtline, Janet A DiPietro
BACKGROUND: Gestational opioid use/misuse is escalating in the United States, however, little is understood about the fetal effects of medications used to treat maternal opioid use disorders. OBJECTIVE: The purpose of this study was to determine the effect of maternal buprenorphine administration on longitudinal fetal neurobehavioral development. STUDY DESIGN: Forty-nine buprenorphine-maintained women attending a substance use disorder treatment facility with generally uncomplicated pregnancies underwent fetal monitoring for 60 minutes at times of trough and peak maternal buprenorphine levels...
February 7, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28186601/-analysis-of-the-cause-of-pregnancy-failure-with-combined-mlpa-assay-for-subtelomeric-regions-and-ultrasonography
#8
Ying Zhao, Jiwu Lou, Manna Sun, Youqing Fu, Yanhui Liu
OBJECTIVE: To explore the value of multiplex ligation-dependent probe amplification (MLPA) for the detection of chromosome abnormalities in miscarriage tissues, and to correlate the result with ultrasound findings. METHODS: A total of 421 cases of spontaneous abortions and fetal deaths were detected with the MLPA method. RESULTS: Among the 421 samples, 232 (55.11%) had an abnormal MLPA result. For the 286 cases derived from < 13 weeks pregnancy, 206 (72...
February 10, 2017: Zhonghua Yi Xue Yi Chuan Xue za Zhi, Zhonghua Yixue Yichuanxue Zazhi, Chinese Journal of Medical Genetics
https://www.readbyqxmd.com/read/28186593/-prenatal-diagnosis-of-a-case-with-46-xx-del-4-dup-21
#9
Lin Zhang, Meihong Ren, Guining Song, Xuexia Liu, Jing Zhang, Xiaohong Zhang
OBJECTIVE: To investigate the genetic cause and prognosis of a fetus with a rare karyotype. METHODS: Fluorescence in situ hybridization (FISH) was used for verifying a structural chromosomal abnormality detected by conventional karyotyping analysis. Whole genome DNA microarray was used to analyze copy number variations carried by the fetus. RESULTS: The fetus was found to have a 46,XX,dup(21)(?q21q22) karyotype, which was verified by FISH analysis as repetition of chromosome 21 region, namely nuc ish 21q22×3...
February 10, 2017: Zhonghua Yi Xue Yi Chuan Xue za Zhi, Zhonghua Yixue Yichuanxue Zazhi, Chinese Journal of Medical Genetics
https://www.readbyqxmd.com/read/28177551/the-significance-of-a-prenatal-diagnosis-of-right-aortic-arch
#10
Anna Wójtowicz, Maria Respondek-Liberska, Maciej Słodki, Paulina Kordjalik, Joanna Płużańska, Anna Knafel, Hubert Huras
OBJECTIVES: To analyze a population of fetuses with prenatally diagnosed right aortic arch (RAA). METHODS: Retrospective study of fetuses with RAA diagnosed prenatally between 2011 and 2015 in 2 referral centers. RESULTS: RAA was found in 4.4% (46/1036) of fetuses with cardiovascular abnormalities (CVA). As an isolated anomaly, RAA was present in 30.4% of cases; in 32.6%, other CVA were detected; in 23.9%, CVA and extracardiac anomalies; and in 13...
February 8, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28153548/neonatal-and-maternal-outcomes-of-pregnancy-with-maternal-cardiac-disease-the-normandy-study-years-2000-2014
#11
Vincent Bonnet, Thérèse Simonet, Fabien Labombarda, Patricia Dolley, Paul Milliez, Michel Dreyfus, Jean-Luc Hanouz
Pregnancies complicated by congenital or acquired heart diseases are at high risk of maternal, obstetrical and neonatal poor outcomes. During the period 2000-2014, 197 pregnancies occurring in 147 women with heart disease were managed in our institution. A maternal cardiac event complicated 13 pregnancies. Obstetrical and neonatal complications occurred respectively in 35.0 % (95 % CI [28.3 - 41.7]) and 37.0 % (95 % CI [30.3 - 43.7]) of pregnancies. All complications were more frequent amongst cardiomyopathies or obstructive and conotruncal lesions, whereas left-to-right shunts were less prone to present with complications...
January 30, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28152279/pulmonary-vein-stenosis-of-ex-premature-infants-with-pulmonary-hypertension-and-bronchopulmonary-dysplasia-epidemiology-and-survival-from-a-multicenter-cohort
#12
Linda Mahgoub, Tarek Kaddoura, A Rebecca Kameny, Paloma Lopez Ortego, Rachel D Vanderlaan, Ashok Kakadekar, Frank Dicke, Ivan Rebeyka, Christopher A Calderone, Andrew Redington, Maria Jesus Del Cerro, Jeff Fineman, Ian Adatia
BACKGROUND: Pulmonary vein stenosis is emerging as an important clinical problem in ex-premature infants. METHODS: We sought to describe the epidemiology of pulmonary vein stenosis affecting ex-premature infants by a multicenter retrospective cohort study of patients from seven children's hospitals diagnosed between 2000-2014. RESULTS: We identified 39 ex-premature patients (26 males, median gestational age 28 weeks range 22-36 weeks, birth weight 1...
February 2, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28151819/epidemiology-of-cardiac-arrest-during-hospitalization-for-delivery-in-canada-a-nationwide-study
#13
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/28151494/relationship-between-maternal-hemodynamics-and-plasma-natriuretic-peptide-concentrations-during-pregnancy-complicated-by-preeclampsia-and-fetal-growth-restriction
#14
S R Giannubilo, A Pasculli, E Tidu, A Biagini, V Boscarato, A Ciavattini
OBJECTIVE: A proper maternal cardiovascular adaptation to the pregnancy plays a key role for promoting an adequate uteroplacental perfusion, for ensuring normal fetal development and for preventing gestational hypertensive complications such as preeclampsia. This study aims to evaluate hemodynamic measurements obtained by noninvasive methods among preclamptic women with and without fetal growth restriction (FGR) and the relationship with plasma levels of natriuretic peptides. STUDY DESIGN: The study compared 98 pregnant women (n=48 with preeclampsia; n=50 normotensive pregnant women) and 50 nonpregnant normotensive control subjects undergoing anultrasonic cardiac output monitor (USCOM) and plasma assessment of atrial N-terminal pro B-type natriuretic peptide (NT-proBNP)...
February 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28150433/impaired-maternal-hemodynamics-in-morbidly-obese-women-a-case-control-study
#15
D Vinayagam, J Gutierrez, J Binder, E Mantovani, B Thilaganathan, A Khalil
AIM: Maternal obesity is associated with significant pregnancy complications and is a risk factor for the development of hypertensive disorders of pregnancy as well as other adverse outcomes. There are few data regarding the hemodynamic aberrations observed in maternal obesity. The aim of this study was to investigate maternal hemodynamics in morbidly obese pregnant women. METHODS: This was a prospective, case-control study of morbidly obese women (BMI >40 kg/m(2) ) and controls (BMI 20-29...
February 2, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28145980/oral-healthcare-and-cardiovascular-disease-a-scoping-review-of-current-strategies-and-implications-for-nurses
#16
Paula Sanchez, Bronwyn Everett, Yenna Salamonson, Shilpi Ajwani, Ajesh George
BACKGROUND: There is epidemiological evidence showing an association between periodontal disease and cardiovascular disease (CVD). Despite this evidence* no comprehensive review has been undertaken to identify strategies to improve the oral health of people with CVD. OBJECTIVES: The aim of this review is to identify current evidence relating to the oral healthcare and management of patients with CVD. METHODS: A scoping review was undertaken focusing on 4 key areas, namely, the impact of periodontal treatment on CVD, current recommendations regarding oral health and CVD, the role of nurses in promoting oral health, and available resources to support them...
January 31, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28143885/does-first-trimester-screening-modify-the-natural-history-of-congenital-heart-disease-%C3%A2-analysis-of-outcome-of-regional-cardiac-screening-at-two-different-time-periods
#17
Hana Jicinska, Pavel Vlasin, Michal Jicinsky, Ilga Grochova, Viktor Tomek, Julia Volaufova, Jan Skovranek, Jan Marek
BACKGROUND: -The study analyzed the impact of first trimester screening on the spectrum of congenital heart defects (CHD) later in pregnancy, and on the outcome of fetuses and children born alive with CHD. METHODS: -The spectrum of CHD, associated comorbidities and outcome of fetuses either diagnosed with CHD in the first trimester (Group I, 127 fetuses), or only in the second trimester screening (Group II, 344 fetuses), were analyzed retrospectively between 2007 and 2013...
January 31, 2017: Circulation
https://www.readbyqxmd.com/read/28139946/multiple-sclerosis-in-pregnancy-prevalence-sociodemographic-features-and-obstetrical-outcomes
#18
Alex Fong, Cindy T Chau, Cara Quant, Jennifer Duffy, Deyu Pan, Dotun A Ogunyemi
OBJECTIVE: We sought to describe the prevalence, sociodemographic features, and antenatal/peripartum outcomes of multiple sclerosis (MS) in pregnancy. STUDY DESIGN: A retrospective cohort study was performed using deliveries in California from 2001-2009. Cases of MS as well as other morbidities were identified via ICD-9-CM code. Logistic regression was performed to adjust for potential confounders. RESULTS: 1,185 out of 4,424,049 deliveries were complicated by MS...
January 31, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28138914/obstetric-and-perinatal-outcome-in-anti-ro-ssa-positive-pregnant-women-a-prospective-cohort-study
#19
Nuria Martínez-Sánchez, Sergio Pérez-Pinto, Ángel Robles-Marhuenda, Francisco Arnalich-Fernández, María Martín Cameán, Edurne Hueso Zalvide, Jose Luis Bartha
: Anti-Ro/SS-A is one specific type of antinuclear antibodies. They are in the majority of cases associated with primary Sjögren syndrome (SS) but also in Systemic Lupus Erythematosus (SLE), rheumatoid arthritis (RA), and in healthy people. During pregnancy, they are mainly associated to congenital heart block (CHB) and neonatal lupus (NL). The aim of this study was to compare the rate of maternal and fetal complications between a series of anti-Ro/SS-A positive pregnant women prospectively followed...
January 30, 2017: Immunologic Research
https://www.readbyqxmd.com/read/28133695/rupture-rudimentary-horn-pregnancy-at-31-week
#20
Abdullah A Al Qarni, Nawal Al-Braikan, Moh'd M Al-Hanbali, Abdullah H Alharmaly
Rudimentary horn could be a rare congenital uterine anomalies result from incomplete fusion of the two Müllerian ducts throughout embryo-genesis. Pregnancy in an exceedingly rudimentary horn is rare and typically terminates in rupture throughout the late of first or second trimester of pregnancy. We tend to present a rare case of a gravida within the trimester (31 weeks) presented with complain of abdominal pain, nausea, and vomit for 3 days. On presentation, the patient was pale and irritable. Ultrasound scan showed fetus at (30 weeks) with cardiac activity...
February 2017: Saudi Medical Journal
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