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https://www.readbyqxmd.com/read/28761227/acute-kidney-injury-in-pregnancy-specific-disorders
#1
REVIEW
J Prakash, V C Ganiger
The incidence of acute kidney injury in pregnancy (P-AKI) has declined significantly over the last three decades in developing countries. However, it is still associated with significant fetomaternal mortality and morbidity. The diagnosis of P-AKI is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate (GFR) are not validated in this population. The incidence of P-AKI with respect to total AKI cases has decreased in the last three decades from 25% in 1980s to 9% in 2000s at our centre...
July 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28760134/life-threatening-bleeding-from-gastric-dieulafoy-s-lesion-in-a-pregnant-woman-with-hellp-syndrome-a-case-report-and-literature-review
#2
Chen Si, Zhu Xiuli, Xie Li, Jia Yong, Zhou Ying, Zhang Kaiguang
BACKGROUND: Dieulafoy's lesion (DL) is one of the rare causes of upper gastrointestional bleeding. This disease is characterized by small sub-mucosal arteriole that eroded the stomach mucosa and cause severe upper GI bleeding without obvious ulceration. The most common location is fundus area of stomach and usually affects patients over 50 years of age with multiple comorbidities. CASE PRESENTATION: We report a case of life-threatening bleeding from DL during late pregnancy 31 weeks...
July 31, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28737473/association-between-the-high-soluble-fms-like-tyrosine-kinase-1-to-placental-growth-factor-ratio-and-adverse-outcomes-in-asymptomatic-women-with-early-onset-fetal-growth-restriction
#3
Satoshi Shinohara, Yuzo Uchida, Mayuko Kasai, Rei Sunami
OBJECTIVE: To assess whether the high soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio is associated with adverse outcomes (e.g., HELLP syndrome [hemolysis, elevated liver enzymes, and low platelets], severe hypertension uncontrolled by medication, non-reassuring fetal status, placental abruption, pulmonary edema, growth arrest, maternal death, or fetal death) and a shorter duration to delivery in early-onset fetal growth restriction (FGR). METHODS: Thirty-four women with FGR diagnosed at <34...
July 24, 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/28720086/pregnancy-outcomes-in-patients-with-acute-kidney-injury-during-pregnancy-a-systematic-review-and-meta-analysis
#4
Youxia Liu, Xinxin Ma, Jie Zheng, Xiangchun Liu, Tiekun Yan
BACKGROUND: Presently, the matter of pregnancy outcomes of patients with pregnancy related AKI (PR-AKI) were disputed. Thus, we conducted a meta-analysis to evaluate the impact of PR-AKI on pregnancy outcomes. METHOD: We systematically searched MEDLINE, Embase, VIP, CNKI and Wanfang Databases for cohort or case-control studies in women with PR-AKI and those without AKI as a control group to assess the influence of PR-AKI on pregnancy outcomes and kidney outcome...
July 18, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28711077/acute-kidney-injury-in-pregnancy
#5
Belinda Jim, Vesna D Garovic
Pregnancy-related acute kidney injury (AKI) has declined in incidence in the last three decades, although it remains an important cause of maternal and fetal morbidity and mortality. Pregnancy-related causes of AKI such as preeclampsia, acute fatty liver of pregnancy, HELLP (Hemolysis, Elevated Liver function tests, Low Platelets) syndrome, and the thrombotic microangiopathies (thrombotic thrombocytopenic purpura, atypical hemolytic-uremic syndrome [HUS]) exhibit overlapping features and often present as diagnostic dilemmas...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711073/lupus-nephritis-and-pregnancy-concerns-and-management
#6
Liz Lightstone, Michelle A Hladunewich
Pregnancy associated with lupus, especially lupus nephritis, is often fraught with concern for both the mother and fetus. Thus, it is paramount that care begins preconception so that proper planning in terms of optimizing the medical regimen, discontinuation of fetotoxic agents, and treatment of active disease can occur. It is well known that active nephritis at the time of conception is associated with poor outcomes. Even with quiescent disease, recent data indicate that being lupus anticoagulant-positive, nonwhite or Hispanic, and using antihypertensive medications were all predictors of worse pregnancy outcomes...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28704180/placental-protein-13-pp13-in-combination-with-papp-a-and-free-leptin-index-fli-in-first-trimester-maternal-serum-screening-for-severe-and-early-preeclampsia
#7
Carin P De Villiers, Paula L Hedley, Sophie Placing, Karen R Wøjdemann, Anne-Cathrine Shalmi, Anting L Carlsen, Line Rode, Karin Sundberg, Ann Tabor, Michael Christiansen
BACKGROUND: Placental protein-13 (PP13) is involved in placental invasion and has been suggested as a maternal serum marker of preeclampsia (PE) development. However, the discriminatory ability of PP13 in first trimester has not been completely clarified. METHODS: PP13 was measured in first trimester (week 10+3-13+6) maternal serum from 120 PE pregnancies and 267 control pregnancies and was correlated with clinical parameters. The population screening performance of PP13 in combination with the PE markers pregnancy associated plasma protein A (PAPPA) and free leptin index (fLI) was assessed by Monte Carlo simulation...
July 12, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28696852/imaging-of-pregnancy-related-vascular-complications
#8
R Scooter Plowman, Cylen Javidan-Nejad, Constantine A Raptis, Douglas S Katz, Vincent M Mellnick, Sanjeev Bhalla, Patricia Cornejo, Christine O Menias
Pregnancy results in substantial hemodynamic and prothrombotic changes that form the foundation for downstream vascular complications, both during pregnancy and in the postpartum period. In addition, several important risk factors, including older patient age, diabetes, and smoking, can increase the risk for vascular-related pregnancy complications. Because radiologists often play an important role in evaluation of the pregnant patient, understanding the pathophysiology of vascular-related complications in pregnancy and their imaging appearances is essential for diagnostic accuracy...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28676729/-spontaneous-hepatic-haematoma-in-a-pregnant-woman-during-labour
#9
M Polo Gil, E Uriarte Rosquil, I Plaja Martí, J Del Río Manterola, T Lánderer Vázquez, M Remón Izquieta
Spontaneous hepatic rupture during labour is a rare condition. Because of the difficulty in diagnosing hepatic rupture in pregnant women, it is often associated with a high mortality rate. Although pregnant women with HELLP syndrome are more prone to hepatic rupture, it can also occur with other liver pathologies and even in healthy women. We should be vigilant in case of suspicious clinical signs even if we have no evidence of preeclampsia. An early diagnosis will be the key to reducing the mortality and morbidity rate...
June 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28643875/prediction-of-severe-pre-eclampsia-by-a-combination-of-sflt-1-ct-pro-et1-and-blood-pressure-exploratory-study
#10
Anne Lind Malte, Niels Uldbjerg, David Wright, Niels Tørring
OBJECTIVES: To evaluate the performance of a combination of clinical-, angiogenic- and vasoactive biomarkers to predict the development of severe preeclampsia (PE) and HELLP syndrome in the third trimester METHODS: We included 221 women with suspected- , light- , moderate - or severe PE/HELLP (mean gestational age 35(+6) weeks) attending the obstetrical outpatient clinic, and 99 with normal pregnancies. RESULTS: In a group of patients presenting with mild to moderate symptoms of preeclampsia, a combination of C-terminal Pro Endothelin 1 (CT-Pro-ET1), sFlt-1 and systolic blood pressure reached an Area under Curve (AUC) of 0...
June 23, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28602034/blood-pressure-in-adolescent-patients-with-pre-eclampsia-and%C3%A2-eclampsia
#11
Sandra X Olaya-Garay, Paula A Velásquez-Trujillo, Paulino Vigil-De Gracia
OBJECTIVE: To compare variables among adolescent and adult patients diagnosed with severe pre-eclampsia or eclampsia. METHODS: The present cross-sectional study enrolled patients with severe pre-eclampsia or eclampsia treated at an intensive care unit in Neiva, Colombia, between January 1 and November 30, 2014. Patients were stratified using age (younger than 20 years [adolescents] and aged at least 20 years [adults]) and patient variables were compared between groups...
June 11, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28593773/-hellp-syndrome-requiring-therapeutic-plasma-exchange-due-to-progression-to-multiple-organ-dysfunction-syndrome-with-predominant-encephalopathy-respiratory-and-renal-insufficiency
#12
M Trávniková, J Gumulec, Z Kořístek, M Navrátil, M Janáč, J Pelková, P Šuráň, E Doležálková, O Šimetka
OBJECTIVE: Case report of woman with twin pregnancy complicated by HELLP syndrome which progressed to multiple organ dysfunction syndrome with predominant encephalopathy, renal and respiratory insufficiency with the need to perform repeated therapeutic plasma exchange. DESIGN: Case report. SETTING: Department of gynecology and obstetrics, University Hospital in Ostrava; Departmet of hematooncology, University Hospital in Ostrava; Department of gynecology and obstetrics, Vsetín hospital; Department of hematology and transfusion, Vsetín Hospital...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28567318/hemolysis-elevated-liver-enzymes-and-low-platelets-severe-fetal-growth-restriction-postpartum-subarachnoid-hemorrhage-and-craniotomy-a-rare-case-report-and-systematic-review
#13
Shadi Rezai, Justin Faye, Alexander Hughes, Mon-Lai Cheung, Joel R Cohen, Judy A Kaia, Paul N Fuller, Cassandra E Henderson
Introduction. Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a relatively uncommon but traumatic condition occurring in the later stage of pregnancy as a complication of severe preeclampsia or eclampsia. Prompt brain computed tomography (CT) or magnetic resonance imaging (MRI) and a multidisciplinary management approach are required to improve perinatal outcome. Case. A 37-year-old, Gravida 6, Para 1-0-4-1, Hispanic female with a history of chronic hypertension presented at 26 weeks and 6 days of gestational age...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28561152/-hypercapnic-raised-intracerebral-pressure-ecmo-therapy-despite-major-intracerebral-haemorrhage
#14
Matthias Unterberg, Hartmuth Nowak, André Gottschalk
We report a case of a 29-year-old primigravida asian woman with severe peripartal HELLP-syndrome. During delivery she developed coma. HELLP syndrome, complicated by severe intracerebral hemorrhage was detected. During course of therapy with drainage of intraventricular intracerebral hemorrhage, the patient developed pneumonia followed by severe acute respiratory distress syndrome (ARDS) with critically raised ICP. After 31 days of stabilization by extracorporeal membrane oxygenation (ECMO) and lung protective ventilation the patient was weaned of ECMO therapy...
May 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28555168/a-case-of-sevoflurane-use-during-pregnancy-in-the-management-of-persistent-status-asthmaticus
#15
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/28553148/severe-preeclampsia-and-eclampsia-incidence-complications-and-perinatal-outcomes-at-a-low-resource-setting-mpilo-central-hospital-bulawayo-zimbabwe
#16
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
https://www.readbyqxmd.com/read/28545408/importance-of-correctly-interpreting-magnetic-resonance-imaging-to-diagnose-posterior-reversible-encephalopathy-syndrome-associated-with-hellp-syndrome-a-case-report
#17
Syuichi Tetsuka, Hiroaki Nonaka
BACKGROUND: Severe haemolysis, elevated liver enzyme levels, and low platelet count (HELLP) syndrome in pregnancy are possible underlying trigger factors for posterior reversible encephalopathy syndrome (PRES). Magnetic resonance imaging (MRI) shows diffuse signal abnormalities involving the subcortical white matter in the parieto-occipital lobes. Although the diagnosis of RPES was clearly established by the distinctive reversibility of clinical and radiological abnormalities, it is difficult to distinguish from differential diagnosis...
May 25, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28541089/decreased-frequency-of-peripheral-blood-cd8-cd25-foxp3-regulatory-t-cells-correlates-with-il-33-levels-in-pre-eclampsia
#18
Jianxiu Yu, Lei Qian, Fenghui Wu, Ming Li, Wei Chen, Hongyou Wang
OBJECTIVE: We aimed to investigate the role of CD8(+)CD25(+)Foxp3(+)regulatory T (Treg) cells in pre-eclampsia (PE). METHODS: This was a cross-sectional study of 46 patients with PE and 24 normotensive women within the third trimester of gestation. We analyzed the percentages of CD8(+)CD25(+)Foxp3(+)Treg cells in peripheral blood using flow cytometry and the serum levels of interleukin (IL)-6, IL-17A, IL-10, TGF-β1, IL-1β, and IL-33 by Luminex 200. RESULTS: We found that patients with PE had lower percentages of CD8(+)CD25(+)Foxp3(+)Treg cells than normotensive pregnant women...
May 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/28532255/outpatient-versus-inpatient-management-for-superimposed-preeclampsia-without-severe-features-a-retrospective-multicenter-study
#19
Corina N Schoen, Sindy C Moreno, Gabriele Saccone, Nora M Graham, Lauren C Hand, Giuseppe M Maruotti, Pasquale Martinelli, Vincenzo Berghella, Amanda Roman
PURPOSE: To determine if women with preterm superimposed preeclampsia without severe features can be successfully and safely triaged to outpatient management. MATERIALS AND METHODS: This was a multicenter, retrospective, cohort study of singleton pregnancies with superimposed preeclampsia without severe features diagnosed before 37 weeks managed outpatient versus inpatient at Thomas Jefferson University (Philadelphia, PA) and at University of Naples (Naples, Italy) from January 2008 to July 2015...
June 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28503510/a-case-report-of-the-nutrition-support-for-a-patient-with-hellp-syndrome
#20
Seo Eun Yeon, Sun Jung Kim, Ju Hee Kim, Hae-Yun Chung, Se Hee Na, Song Mi Lee
A 30-year-old female patient, 18 weeks gestational age, with no prior medical history was admitted to hospital complaining severe right upper quadrant pain. The patient was admitted to intensive care unit (ICU) after emergency surgery to treat intraperitoneal hemorrhage caused by rupture of liver hematoma. Despite the absence of high blood pressure, the patient was diagnosed with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome on the basis of abnormal levels of blood aspartate aminotransferase/alanine aminotransferase, lactate dehydrogenase, total bilirubin, direct bilirubin, C-reactive protein (CRP) and platelet along with liver damage and proteinuria...
April 2017: Clinical Nutrition Research
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