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renal failure in postpartum preeclampsia

N Gopalakrishnan, J Dhanapriya, C Padmakumar, T Dineshkumar, A A Kurien, R Sakthirajan, T Balasubramaniyan
Collapsing glomerulopathy (CG) is a distinct histopathologic pattern of glomerular injury characterized by global/segmental wrinkling of the glomerular basement membrane with podocyte hyperplasia and hypertrophy along with tubulointerstitial changes. There is no specific treatment for CG due to etiological heterogeneity, and newer insights into the pathogenesis may lead to the development of targeted therapy. The most common form of CG is the primary or idiopathic followed by secondary (due to viral infections, autoimmune disease, drugs, etc...
March 2018: Indian Journal of Nephrology
Gamaliel Mc Lean, Osvaldo Reyes, Rodrigo Velarde
OBJECTIVE: To evaluate if postpartum uterine curettage improved the clinical and laboratory parameters in patients with preeclampsia or eclampsia. METHODS: A total of 442 patients with preeclampsia/eclampsia were randomized to postpartum curettage (223) or no procedure (219). Systolic and diastolic blood pressure were recorded and analyzed at hours 6, 12, 24 and 48. Also, several laboratory values and diuresis were evaluated. RESULTS: No statistical differences were found between groups (curettage vs...
October 2017: Pregnancy Hypertension
Richard M Burwick, Rachel A Pilliod, Stephanie E Dukhovny, Aaron B Caughey
OBJECTIVE: To assess the incidence and severity of preeclampsia in pregnancies complicated by fetal hydrops. METHODS: We performed a retrospective cohort study of singleton gestations from 2005 to 2008 in California. The primary predictor was fetal hydrops and the primary outcome was preeclampsia. Selected adverse maternal and neonatal events were assessed as secondary outcomes. Potential confounders examined included fetal anomalies, polyhydramnios, race/ethnicity, nulliparity, chronic hypertension, and gestational or pregestational diabetes mellitus...
November 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
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 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Nina D Paauw, Jaap A Joles, José T Drost, Marianne C Verhaar, Arie Franx, Gerjan Navis, Angela H E M Maas, A Titia Lely
Women with a history of preeclampsia have a 5- to 12-fold increased risk to develop end-stage kidney disease. Previous observations in small cohorts suggest that former preeclamptic (fPE) women have subtle abnormalities in renal hemodynamics and renal function, which might predispose them to renal failure in later life. In this study, we analyzed renal function in a cross-sectional cohort consisting of former early-onset preeclamptic (fPE, n=339) and former healthy pregnant women (fHP, n=332), overall with a mean age of 39 years at 10 years postpartum...
December 2016: Hypertension
Kathryn J Sharma, Tania F Esakoff, Alyson Guillet, Richard M Burwick, Aaron B Caughey
OBJECTIVE: To determine whether adverse outcomes were more common in late preterm pregnancies complicated by preeclampsia and growth restriction compared to those affected by preeclampsia alone. METHODS: This was a retrospective cohort study of 8927 singleton pregnancies with preeclampsia. Pregnancies with small for gestational age (SGA) neonates (birth weight <10th percentile) were compared to those appropriate for gestational age (AGA) neonates. Maternal outcomes included cesarean delivery (CD) rate, CD for fetal heart rate (FHR) abnormalities, abruption, postpartum hemorrhage (PPH), maternal transfusion, acute renal failure, and peripartum cardiomyopathy...
October 2017: Journal of Maternal-fetal & Neonatal Medicine
Eriseida Ndoni, Redi Hoxhallari, Astrit Bimbashi
BACKGROUND: Preeclampsia is a hypertensive multisystem disorder of pregnancy that complicates up to 10% of pregnancies worldwide and is one of the leading causes of maternal and perinatal morbidity and mortality. AIM: To evaluate maternal complications associated with severe preeclampsia. METHODS: This is a retrospective cross-sectional study conducted in the UHOG "Koço Gliozheni", in Tirana. Primary outcomes evaluated: maternal death, eclampsia, stroke, HELLP syndrome, and pulmonary edema...
March 15, 2016: Open Access Macedonian Journal of Medical Sciences
Saowapark Chumpathong, Somkiet Sirithanetbhol, Bhurinud Salakij, Shusee Visalyaputra, Sudta Parakkamodom, Tuangsit Wataganara
OBJECTIVE: This study is aiming to determine an actual incidence and characteristics of complications in cesarean section for severe pre-eclampsia (PE) by analysis of a large cohort from a single tertiary care center according to two choices of anesthesia. METHODS: Electronic medical records of pregnant women complicated with severe PE delivered by cesarean section from January 2002 to December 2011 were retrospectively reviewed. Medical records of their corresponding neonates were also identified and reviewed...
December 2016: Journal of Maternal-fetal & Neonatal Medicine
A Tan, J Ma, X Deng, G Tang
UNLABELLED: Previous studies show that HELLP syndrome occurring in postpartum period was more dangerous to both fetus and the mother than if presented before delivery. So far, there is a lack of screening or predictive tests for postpartum HELLP syndrome in clinical practice. CASE: Here the authors report a rare case of postpartum HELLP syndrome with severe ascites as the primary symptom. The patient was diagnosed with severe preeclampsia and fetal growth retardation at 34+2 weeks gestation and received anti-hypertensive therapy...
2015: Clinical and Experimental Obstetrics & Gynecology
G Dias, F Caeiro, A V Santos, E Landim, I Santos, T Matos, A Nazaré
INTRODUCTION: Hypertension affects 10% of all pregnancies and accounts for approximately a quarter of all antenatal admissions. Hypertension in pregnancy includes a wide spectrum of conditions, including pre-eclampsia, eclampsia, pre-eclampsia superimposed on chronic hypertension, chronic hypertension, and gestational hypertension. Pregnancies complicated by hypertension are associated with increased risk of adverse fetal, neonatal and maternal outcomes, including preterm birth, fetal growth restriction, perinatal death, acute renal or hepatic failure, ante partum haemorrhage, postpartum haemorrhage and maternal death...
July 2012: Pregnancy Hypertension
O Nakamoto, R Tasaka, C Motohisa
INTRODUCTION: Eclampsia is MRI-radiologically defined as posterior reversible encephalopathy syndrome (PRES), which indicate cases with eclampsia might improve spontaneously and reversibly. On the other hand the central nervous system is the main target organ affected by the disease of severe preeclampsia. Eclampsia is thought to be one of the severe states of this disease. We should recognise some eclamptic cases to grow worse resulting in disastrous stroke or poor prognosis. Especially the symptoms of long lasting unconsciousness or repeating seizures, or the sings with cerebrovascular vasospasms or brain stem lesion are considered as the progressing disease among the disease of eclampsia...
July 2012: Pregnancy Hypertension
Ainslie M Hildebrand, Kuan Liu, Salimah Z Shariff, Joel G Ray, Jessica M Sontrop, William F Clark, Michelle A Hladunewich, Amit X Garg
Acute kidney injury (AKI) is a rare complication of pregnancy, but may be associated with significant morbidity and mortality in young and often otherwise healthy women. We conducted a retrospective population-based cohort study of all consecutive pregnancies over a 15-year period (1997-2011) in Ontario, Canada, and describe the incidence and outcomes of AKI treated with dialysis during pregnancy or within 12 weeks of delivery. Of 1,918,789 pregnancies, 188 were complicated by AKI treated with dialysis (incidence: 1 per 10,000 [95% confidence interval, 0...
December 2015: Journal of the American Society of Nephrology: JASN
Erica L Berry, Sara N Iqbal
HELLP syndrome is a collection of symptoms described as hemolysis, elevated liver enzymes and low platelets. HELLP syndrome complicates 0.01-0.6% of pregnancies and can be considered a severe variant of preeclampsia. The occurrence of HELLP syndrome diagnosed before the 20th week of gestation has been most commonly reported in association with antiphospholipid antibody syndrome (APS) or triploid chromosomal anomalies. A 41-year-old primigravida was admitted at 17 weeks and 6 days gestation with hypertension, proteinuria, hemolytic anemia and acute renal injury...
December 2014: Journal of Clinical Gynecology and Obstetrics
Munire Erman Akar, Murat Ozekinci, Cem Sanhal, Nilgun Kececioglu, Inanc Mendilcioglu, Yesim Senol, Kerem Dirican, Huseyin Kocak, Ayhan Dinckan, Gultekin Suleymanlar
BACKGROUND: We reported pregnancy outcomes after kidney transplantation in a single transplant center. METHODS: We reviewed the perinatal outcomes of female kidney transplant patients of reproductive age (18-40 years) from 1987 to 2011. RESULTS: A total of 246 patients were reviewed. Of these, 43 women registered a pregnancy following kidney transplantation. The mean patient age was 31.3 ± 4.2 years (range 24-40). The mean transplant-conception interval was 35...
2015: Gynecologic and Obstetric Investigation
N Alpay-Kanitez, A Omma, B Erer, B Artim-Esen, A Gül, M Inanç, L Öcal, S Kamali
OBJECTIVES: Takayasu arteritis is a chronic large-vessel vasculitis in young women of reproductive age. We aimed to obtain information on pregnancy in TA retrospectively. METHODS: Takayasu arteritis patients with history of pregnancy were included in this study. The evaluations included physical findings, serum C-reactive protein, erythrocyte sedimentation rate as well as history and symptoms. Information about pregnancies, abortus, deliveries and newborns was obtained from medical records...
March 2015: Clinical and Experimental Rheumatology
Andreas Kourouklaris, Kyriakos Ioannou, Ioannis Athanasiou, Alexia Panagidou, Kiproulla Demetriou, Michalis Zavros
INTRODUCTION: Differential diagnosis of thrombotic microangiopathies can be difficult. Atypical hemolytic uremic syndrome is a rare, life-threatening disease caused by uncontrolled chronic activation of alternative complement pathway, resulting in microvascular thrombosis, organ ischemia and damage. Prognosis is poor: up to 65 percent of patients require dialysis or have kidney damage of varying severity or die despite plasma exchange/plasma infusion treatment. CASE PRESENTATION: We describe the case of a 23-year-old woman of Hellenic origin who, after a preeclampsia-induced premature delivery, developed thrombotic microangiopathy with renal failure, tonicoclonic seizures, anasarca edema and hypertension...
September 14, 2014: Journal of Medical Case Reports
Francois Folefack Kaze, Francis A Njukeng, Andre-Pascal Kengne, Gloria Ashuntantang, Robinson Mbu, Marie Patrice Halle, Tazoacha Asonganyi
BACKGROUND: Preeclampsia and eclampsia, which are the most frequent hypertensive disorders in pregnancy, are associated with renal involvements. We aimed to assess the time trend in blood pressure levels, renal function and proteinuria after delivery, and investigate their determinants in Cameroonian women with severe preeclampsia and eclampsia. METHODS: This was a prospective cohort study involving 54 women with severe preeclampsia and eclampsia, conducted between July 2010 and February 2012 at the central maternity unit of the Yaoundé Central Hospital...
April 9, 2014: BMC Pregnancy and Childbirth
Jill M Mhyre, Alexander Shilkrut, Elena V Kuklina, William M Callaghan, Andreea A Creanga, Sari Kaminsky, Brian T Bateman
OBJECTIVE: To define the frequency, risk factors, and outcomes of massive transfusion in obstetrics. METHODS: The State Inpatient Dataset for New York (1998-2007) was used to identify all delivery hospitalizations for hospitals that reported at least one delivery-related transfusion per year. Multivariable logistic regression analysis was performed to examine the relationship between maternal age, race, and relevant clinical variables and the risk of massive blood transfusion defined as 10 or more units of blood recorded...
December 2013: Obstetrics and Gynecology
Chia-Chun Wu, Sheng-Hsien Chen, Chung-Han Ho, Fu-Wen Liang, Chin-Chen Chu, Hsien-Yi Wang, Yi-Hua Lu
OBJECTIVE: The purpose of this study was to determine the long-term postpartum risk of end-stage renal disease in women with hypertensive disorders in pregnancy. Although most women with hypertensive disorders in pregnancy recover after delivery, some may experience acute renal failure. STUDY DESIGN: We searched Taiwan's National Health Insurance Research Database to identify women with hypertensive disorders in pregnancies and deliveries between 1998 and 2002. All cases were followed for a maximum of 11 years (median, 9 years; interquartile range, 7...
February 2014: American Journal of Obstetrics and Gynecology
J Prakash
The spectrum of kidney disease occurring during pregnancy includes preeclampsia, hypertensive disorders of pregnancy, urinary tract infection, acute kidney injury, and renal cortical necrosis (RCN). Preeclampsia affects approximately 3-5% of pregnancies. We observed preeclampsia in 5.8% of pregnancies, and 2.38% of our preeclamptic women developed eclampsia. Severe preeclampsia and the eclampsia or hemolysis, elevated liver enzymes levels, and low platelets count (HELLP) syndrome accounted for about 40% of cases of acute kidney injury (AKI) in pregnancy...
May 2012: Indian Journal of Nephrology
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