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https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#1
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28618730/possible-triggering-factors-and-comorbidities-in-newly-diagnosed-autoimmune-bullous-diseases
#2
Sevgi Akarsu, Özlem Özbağçivan, Necla Dolaş, Şebnem Aktan
BACKGROUND/AIM: The distribution and the demographic, etiological, and clinical features of autoimmune bullous diseases (ABDs) vary according to geographic regions of the world. The limited number of reported studies in Turkey are mostly retrospective and generally include only pemphigus. The aim of our study was to evaluate the demographic data, clinical features, associated triggering factors, and comorbidities in patients newly diagnosed with ABDs. MATERIALS AND METHODS: In this descriptive and prospective study, the demographic data, inhabited regions, smoking and drinking habits, presence of comorbidities, and specific and general potential triggering factors of ABDs considered by the patients were examined...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28609179/maternal-distress-and-the-development-of-hypertensive-disorders-of-pregnancy
#3
Idalia Garza-Veloz, Claudia Castruita-De la Rosa, Yolanda Ortiz-Castro, Virginia Flores-Morales, Maria E Castañeda-Lopez, Edith Cardenas-Vargas, Gloria P Hernandez-Delgadillo, Vicente Ortega-Cisneros, Martha Luevano, Iram P Rodriguez-Sanchez, Fabiola Trejo-Vazquez, Ivan Delgado-Enciso, Miguel A Cid-Baez, Perla M Trejo-Ortiz, Maria G Ramos-Del Hoyo, Margarita L Martinez-Fierro
Despite the implementation of programmes to improve maternal health, maternal and foetal mortality rates still remain high. The presence of maternal distress and its association with the development of pregnancy hypertensive disorders is not well established. The aim of this study was to evaluate the association between maternal distress and the development of hypertensive disorders in pregnancy in a prospective cohort of 321 Mexican women. Symptoms of maternal distressing were evaluated at week 20th of gestation using the General Health Questionnaire...
June 13, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28609171/myocardial-performance-index-in-hypertensive-disorders-of-pregnancy-the-relationship-between-blood-pressures-and-angiogenic-factors
#4
Hadi Ramadan, Sarosh Rana, Ariel Mueller, Surichhya Bajracharya, Dongsheng Zhang, Saira Salahuddin, Rabab Nasim, Joana Lopes Perdigao, Mohammed Minhaj, Avery Tung, Zolt Arany, Sajid Shahul
OBJECTIVE: To study the association between cardiac function measured by myocardial performance index (MPI), blood pressures and angiogenic factors measured at the time of echocardiography in patients with and without hypertensive disorders of pregnancy (HDP). METHODS: We prospectively studied 189 pregnant women and evaluated whether changes in cardiac function observed on echocardiography were correlated with higher blood pressures and whether higher blood pressures were associated with antiangiogenic proteins (soluble fms-like tyrosine kinase, sFlt1; soluble endoglin, sEng)...
May 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/28607124/placental-vesicles-carry-active-endothelial-nitric-oxide-synthase-and-their-activity-is-reduced-in-preeclampsia
#5
Carolina Motta-Mejia, Neva Kandzija, Wei Zhang, Vuyane Mhlomi, Ana Sofia Cerdeira, Alexandra Burdujan, Dionne Tannetta, Rebecca Dragovic, Ian L Sargent, Christopher W Redman, Uday Kishore, Manu Vatish
Preeclampsia, a multisystem hypertensive disorder of pregnancy, is associated with increased systemic vascular resistance. Placentae from patients with preeclampsia have reduced levels of endothelial nitric oxide synthase (eNOS) and, thus, less nitric oxide (NO). Syncytiotrophoblast extracellular vesicles (STBEV), comprising microvesicles (STBMV) and exosomes, carry signals from the syncytiotrophoblast to the mother. We hypothesized that STBEV-bound eNOS (STBEV-eNOS), capable of producing NO, are released into the maternal circulation...
June 12, 2017: Hypertension
https://www.readbyqxmd.com/read/28602444/abducens-nerve-palsy-in-gestational-hypertension-a-case-report-and-review-of%C3%A2-the%C3%A2-literature
#6
Albaro J Nieto-Calvache, Sara Loaiza-Osorio, José Casallas-Carrillo, María F Escobar-Vidarte
BACKGROUND: Headache, blurring of vision, and confusion are common neurologic symptoms of hypertensive disorders of pregnancy, whereas abducens nerve palsy during pregnancy is an extremely rare condition. CASE: A 28-year-old woman with gestational hypertension presented isolated sixth cranial nerve palsy after delivery. Neither simple resonance nor angioresonance showed alterations. No other specific pathology was found. Symptoms of abducens nerve palsy resolved spontaneously...
June 8, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28602020/techniques-of-monitoring-blood-glucose-during-pregnancy-for-women-with-pre-existing-diabetes
#7
REVIEW
Foong Ming Moy, Amita Ray, Brian S Buckley, Helen M West
BACKGROUND: Self-monitoring of blood glucose (SMBG) is recommended as a key component of the management plan for diabetes therapy during pregnancy. No existing systematic reviews consider the benefits/effectiveness of various techniques of blood glucose monitoring on maternal and infant outcomes among pregnant women with pre-existing diabetes. The effectiveness of the various monitoring techniques is unclear. OBJECTIVES: To compare techniques of blood glucose monitoring and their impact on maternal and infant outcomes among pregnant women with pre-existing diabetes...
June 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28600043/placenta-associated-pregnancy-complications-in-pregnancies-complicated-with-placenta-previa
#8
Yael Baumfeld, Reli Herskovitz, Zehavi Bar Niv, Salvatore Andrea Mastrolia, Adi Y Weintraub
OBJECTIVES: The purpose of our study was to examine the hypothesis that pregnancies complicated with placenta previa have an increased risk of placental insufficiency associated pregnancy complications (IUGR, preeclampsia, placental abruption and perinatal mortality). MATERIALS AND METHODS: Our study included all deliveries that occurred at Soroka University Medical Center (Beer Sheva, Israel) between January 1998 and December 2013. Of them 1,249 were complicated by placenta previa and represented our study group...
June 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28599896/objectively-measured-short-sleep-duration-and-later-sleep-midpoint-in-pregnancy-are-associated-with-a-higher-risk-of-gestational-diabetes
#9
Francesca L Facco, William A Grobman, Kathryn J Reid, Corette B Parker, Shannon M Hunter, Robert M Silver, Robert C Basner, George R Saade, Grace W Pien, Shalini Manchanda, Judette M Louis, Chia-Ling Nhan-Chang, Judith H Chung, Deborah A Wing, Hyagriv N Simhan, David M Haas, Jay Iams, Samuel Parry, Phyllis C Zee
BACKGROUND: Experimental and epidemiologic data suggest that among non-pregnant adults, sleep duration may be an important risk factor for chronic disease. Although pregnant women commonly complain of poor sleep, few studies have objectively evaluated the quality of sleep in pregnancy or have explored the relationship between sleep disturbances and maternal and perinatal outcomes. OBJECTIVES: Our objective was to examine the relationship between objectively assessed sleep duration, timing and continuity (measured via wrist actigraphy) and maternal cardiovascular and metabolic morbidity specific to pregnancy...
June 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28597481/peripartum-cardiomyopathy-in-denmark-a-retrospective-population-based-study-of-incidence-management-and-outcome
#10
Anne S Ersbøll, Marianne Johansen, Peter Damm, Steen Rasmussen, Niels G Vejlstrup, Finn Gustafsson
AIM: Population-based European studies of peripartum cardiomyopathy (PPCM) are few. We aimed to estimate the nationwide incidence and outcome of PPCM in Denmark during 2005-2014. METHODS AND RESULTS: The Danish National Birth Register and the Danish National Patient Register were linked and searched for cardiomyopathy and heart failure ICD-10 diagnoses in a period of nine months before to 12 months after a delivery from 1 January 2005 through 31 December 2014. Diagnoses were validated and additional data were extracted from patient charts...
June 8, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28591672/global-variation-in-pregnancy-complications-in-women-with-epilepsy-a-meta-analysis
#11
John Allotey, David Aroyo-Manzano, Patricia Lopez, Luz Viale, Javier Zamora, Shakila Thangaratinam
OBJECTIVE: Women with epilepsy are at risk of pregnancy complications. Whether these vary globally is unknown. We undertook a systematic review to assess the overall rates of obstetric outcomes in women with epilepsy, and variations in estimates across geographical region, economic status of country, and over time. STUDY DESIGN: We searched Medline, Embase, Cochrane, AMED and CINAHL, (January 1, 1990 and November 29, 2016), without any language restrictions for studies reporting core maternal and fetal outcomes in women with epilepsy...
May 30, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28578174/maternal-marijuana-use-adverse-pregnancy-outcomes-and-neonatal-morbidity
#12
Torri D Metz, Amanda A Allshouse, Carol J Rowland Hogue, Robert L Goldenberg, Donald J Dudley, Michael W Varner, Deborah L Conway, George R Saade, Robert M Silver
BACKGROUND: The Eunice Kennedy Shriver National Institute of Child Health and Human Development Stillbirth Collaborative Research Network previously demonstrated an association between stillbirth and maternal marijuana use as defined by the presence of tetrahydrocannabinol in the umbilical cord homogenate. However, the relationship between marijuana use and perinatal complications in live births is uncertain. OBJECTIVE: Our aim was to examine if maternal marijuana use is associated with increased odds of adverse pregnancy outcomes and neonatal morbidity among live-born controls in the Stillbirth Collaborative Research Network cohort...
May 31, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28577352/increased-postpartum-haemorrhage-the-possible-relation-with-serotonergic-and-other-psychopharmacological-drugs-a-matched-cohort-study
#13
Hanna M Heller, Anita C J Ravelli, Andrea H L Bruning, Christianne J M de Groot, Fedde Scheele, Maria G van Pampus, Adriaan Honig
BACKGROUND: Postpartum haemorrhage is a major obstetric risk worldwide. Therefore risk factors need to be investigated to control for this serious complication. A recent systematic review and meta-analysis revealed that the use of both serotonergic and non-serotonergic antidepressants in pregnancy are associated with a higher risk of postpartum haemorrhage. However, use of antidepressants in pregnancy is often necessary because untreated depression in pregnancy is associated with adverse maternal and neonatal outcome, such as postpartum depression, preterm birth and dysmaturity...
June 2, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28575495/maternal-smoking-a-life-course-blood-pressure-determinant
#14
Maria Cabral, Maria João Fonseca, Camila González-Beiras, Ana Cristina Santos, Liane Correia-Costa, Henrique Barros
Introduction: Exposure to maternal smoking early in life may affect blood pressure (BP) control mechanisms. We examined the association between maternal smoking (before conception, during pregnancy and 4 years after delivery) and BP in preschool children. Methods: We evaluated 4,295 of Generation XXI children, recruited at birth in 2005-2006 and re-evaluated at the age of 4. At birth, information was collected by face-to-face interview and additionally abstracted from clinical records...
May 31, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28569565/prediction-of-preeclampsia-in-primigravida-in-late-first-trimester-using-serum-placental-growth-factor-alone-and-by-combination-model
#15
Rachna Agarwal, Shweta Chaudhary, Rajarshi Kar, Gita Radhakrishnan, Anupama Tandon
We investigated a placental growth factor alone and combined clinical (mean arterial pressure, MAP), biophysical (uterine artery pulsability index, PI) and biochemical (placental growth factor, PLGF) model for predicting preeclampsia in late first trimester. The inclusion criteria was primigravida (<40 years) attending their first hospital visit with singleton pregnancy at 11-14 weeks of gestation. Of the enrolled and followed 291 subjects, 35 (12%) later developed PE (5.8%)/GH (6.2%). An equal number of randomised women with normotensive non-proteinuric course were considered as reference group...
June 1, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28561253/obstetric-disorders-in-the-icu
#16
Daniela N Vasquez, Lauren Plante, María N Basualdo, Gustavo G Plotnikow
Pregnant and postpartum patients represent a challenge to critical care physicians, as two patients in one have to be cared for and because specific obstetric disorders, not universally covered in formal critical care training, need to be managed. Pregnancy also alters physiologic norms, so that the critical care physician may either fail to recognize a value as abnormal in pregnancy or mistakenly identify as abnormal a value within the normal range for a pregnant woman. In this article, we will review the most frequent obstetric causes of admission of pregnant/postpartum patients to the intensive care unit (hypertensive disease of pregnancy, obstetric hemorrhage, and obstetric sepsis) along with their diagnostic criteria, clinical presentation, and recommended treatment...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28556194/assessment-of-serum-%C3%AE-hcg-and-lipid-profile-in-early-second-trimester-as-predictors-of-hypertensive-disorders-of-pregnancy
#17
Vijaya M Revankar, Lavu Narmada
OBJECTIVE: To assess and compare the ability of serum β-human chorionic gonadotropin (β-hCG) and serum lipid profile in early second trimester as predictors of hypertensive disorders of pregnancy. METHODS: The present hospital-based prospective study was conducted between November 24, 2012, and April 30, 2014, at a tertiary hospital in Mangalore, India. Women of any parity with a pregnancy of 14-20 weeks were included. Venous blood (3 mL) was collected, and serum β-hCG and lipid profile were estimated by enzyme-linked immunosorbent assay and an enzymatic colorimetric test with lipid clearing factor, respectively...
May 28, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28555168/a-case-of-sevoflurane-use-during-pregnancy-in-the-management-of-persistent-status-asthmaticus
#18
Jessica Parrott, Mitch Tener, Katie Dennis, Matthew Sharpe, Cecily Clark-Ganheart
BACKGROUND: Sevoflurane is rarely used for the treatment of status asthmaticus. We report a case of sevoflurane hepatotoxicity in pregnancy with presentation similar to HELLP syndrome. CASE: A G2P1001 at 23 weeks in status asthmaticus presented with pCO2 > 130 and pH < 7. She was nonresponsive to traditional therapy. Sevoflurane was added for a 24 hr period. Respiratory status improved. Extubation occurred on day 12. Workup for preeclampsia spectrum disorders occurred due to maternal hypertension...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28554307/hypertensive-disorders-in-pregnancy-current-practice-review
#19
Kim Turner, Afshan B Hameed
Hypertensive disorders (preeclampsia, eclampsia gestational hypertension, and chronic hypertension with superimposed preeclampsia) are common complications of pregnancy [1]. Women with chronic hypertension and gestational hypertension are at increased risk of preeclampsia. Preeclampsia is a multi-system disorder with a global prevalence of 3-5% [2] that may lead to significant maternal or fetal morbidity and even mortality. The cornerstone of management of all hypertensive disorders in pregnancy is close monitoring of blood pressure (BP) and/or end organ damage and delivery planning in select patients [3]...
May 28, 2017: Current Hypertension Reviews
https://www.readbyqxmd.com/read/28553148/severe-preeclampsia-and-eclampsia-incidence-complications-and-perinatal-outcomes-at-a-low-resource-setting-mpilo-central-hospital-bulawayo-zimbabwe
#20
Solwayo Ngwenya
BACKGROUND: Severe preeclampsia is a disorder of pregnancy characterized by high blood pressure and significant proteinuria after 20 weeks gestation. Severe preeclampsia and eclampsia have considerable adverse impacts on maternal, fetal, and neonatal health especially in low-resource countries. Hypertensive disorders of pregnancy are the third leading cause of maternal deaths in Sub-Saharan Africa. Significant avoidable maternal and neonatal morbidity and mortality may result. OBJECTIVES: This study aimed 1) to determine the incidence of severe preeclampsia/eclampsia in a low-resource setting; 2) to determine the maternal complications of severe preeclampsia/eclampsia in a low-resource setting; 3) to determine the perinatal outcomes of severe preeclampsia/eclampsia in a low-resource setting...
2017: International Journal of Women's Health
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