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https://www.readbyqxmd.com/read/28333552/treatment-of-multiple-sclerosis-during-pregnancy-safety-considerations
#1
Jan Thone, Sandra Thiel, Ralf Gold, Kerstin Hellwig
Women with multiple sclerosis (MS) are treated early in the disease course with disease modifying therapies (DMT). Updated information is needed on pregnancy outcomes of DMT-exposed pregnancies and the effect of the drug withdrawal on MS disease activity. Areas covered: In this review, we will cover the most important updated management strategies in planning a pregnancy when having MS. Expert opinion: MS itself does not increase the risk of adverse pregnancy outcomes and does not negatively influence the long-term course of the disease...
March 23, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28331377/management-of-systemic-lupus-erythematosus-during-pregnancy-challenges-and-solutions
#2
REVIEW
Caroline L Knight, Catherine Nelson-Piercy
Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal-neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28325856/prevalence-of-undiagnosed-asymptomatic-bacteriuria-and-associated-risk-factors-during-pregnancy-a-cross-sectional-study-at-two-tertiary-centres-in-cairo-egypt
#3
Mohamed Abdel-Aziz Elzayat, Ashton Barnett-Vanes, Mohamed Farag Elmorsy Dabour, Feng Cheng
BACKGROUND: The prevalence of asymptomatic bacteriuria (ASB) during pregnancy is poorly understood in Egypt-a country with a high birth rate. OBJECTIVES: To determine the prevalence of ASB among pregnant women booking at El Hussein and Sayed Galal Hospitals in Al-Azhar University in Egypt; and to observe the relationship between ASB prevalence and risk factors such as socioeconomic level and personal hygiene. SETTING: Obstetrics and gynaecology clinics of 2 university hospitals in the capital of Egypt...
March 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28323748/serum-aminotransferase-flares-in-pregnant-and-postpartum-women-with-current-or-prior-treatment-for-chronic-hepatitis-b
#4
Christine Y Chang, Natali Aziz, Mugilan Poongkunran, Asad Javaid, Huy N Trinh, Daryl T Lau, Mindie H Nguyen
BACKGROUND AND AIMS: Antiviral therapy is recommended for pregnant women with chronic hepatitis B (CHB) and hepatitis B virus (HBV) DNA>200,000 IU/mL, but there is less consensus on management of women who discontinue therapy in anticipation of pregnancy or who become pregnant while on therapy. The goal of this study was to describe flares in alanine aminotransferase (ALT) during pregnancy and postpartum in CHB women with current and/or prior treatment. METHODS: This was a multicenter, retrospective study of 67 pregnancies in 56 CHB women treated before and/or during pregnancy...
March 20, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28317489/ankylosing-spondylitis-and-pregnancy-a-literature-review
#5
Eirini Giovannopoulou, Grigorios Gkasdaris, Stylianos Kapetanakis, Emmanuel Kontomanolis
Ankylosing Spondylitis (AS) is the prototype of a group of systemic rheumatic diseases collectively referred to as Spondyloarthitides (SpA). It is has recently become clear that AS is not as rare as previously thought and, although it has an early onset in life affecting patients in their reproductive years, it has not been proved to adversely affect fertility in females. Furthermore, new pharmaceutical agents have been introduced for its therapeutical management. The interaction between systematic rheumatic diseases and pregnancy has been under investigation with the majority of studies focusing on systemic lupus erythematosus and rheumatoid arthritis (RA)...
March 17, 2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28316849/spontaneous-pneumomediastinum-in-labor
#6
Mohamed Adnane Berdai, Said Benlamkadem, Smael Labib, Mustapha Harandou
Spontaneous pneumomediastinum and subcutaneous emphysema also known as Hamman's syndrome is a very rare complication of labor that is often related to the valsalva maneuver during the labor. In most case, Hamman's syndrome is a self-limiting condition, rarely complicated unless there are underlying respiratory diseases. Chest X-ray can be a useful early diagnostic technique in severe clinical presentation. We report an uneventful pregnancy in a primigravid parturient, which was complicated in the late second stage of labor by the development of subcutaneous emphysema, pneumomediastinum, and mild pneumothorax...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28315411/extrauterine-choriocarcinoma-in-the-fallopian-tube-following-infertility-treatment-implications-for-the-management-of-early-detected-ectopic-pregnancies
#7
Seung Chik Jwa, Shigeru Kamiyama, Hisako Takayama, Yoshimitsu Tokunaga, Tetsuro Sakumoto, Masahiro Higashi
Extrauterine choriocarcinoma in the fallopian tube is highly rare and is often diagnosed and treated as an ectopic tubal pregnancy. A 34-year old woman who initially became pregnant after infertility treatment using ovulation induction with clomiphene citrate and intrauterine insemination was later diagnosed as having an extrauterine choriocarcinoma in the left fallopian tube. Because of a suspicion of left ectopic tubal pregnancy by ultrasonographic findings and high levels of beta human chorionic gonadotropin (β-hCG; 7054...
March 14, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28314387/twin-pregnancy-complicated-by-esophageal-atresia-duodenal-atresia-gastric-perforation-and-hypoplastic-left-heart-structures-in-one-twin-a-case-report-and-review-of-the-literature
#8
Mohamad K Abou Chaar, Mariana L Meyers, Bethany D Tucker, Henry L Galan, Kenneth W Liechty, Timothy M Crombleholme, Ahmed I Marwan
BACKGROUND: The antenatal diagnosis of a combined esophageal atresia without tracheoesophageal fistula and duodenal atresia with or without gastric perforation is a rare occurrence. These diagnoses are difficult and can be suspected on ultrasound by nonspecific findings including a small stomach and polyhydramnios. Fetal magnetic resonance imaging adds significant anatomical detail and can aid in the diagnosis of these complicated cases. Upon an extensive literature review, there are no reports documenting these combined findings in a twin pregnancy...
March 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28302138/congenital-giant-left-atrial-appendage-aneurysm-a-case-report
#9
Yan Chen, Yun Mou, Li-Jun Jiang, Shen-Jiang Hu
BACKGROUND: Congenital left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with potentially serious complications, including life-threatening systemic thromboembolism, atrial tachyarrhythmia, and cardiac dysfunction. Currently, early surgical intervention is generally recommended to prevent these complications. CASE PRESENTATION: We present a case of congenital giant LAAA in a female patient who successfully completed pregnancy and underwent caesarean section with no obvious complications...
March 16, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28301336/sepsis-in-obstetrics-clinical-features-and-early-warning-tools
#10
Sheryl E Parfitt, Mary L Bogat, Sandra L Hering, Charlotte Ottley, Cheryl Roth
Morbidity and mortality associated with sepsis has gained widespread attention on a local, state, and national level, yet, it remains a complicated disorder that can be difficult to identify in a timely manner. Sepsis in obstetric patients further complicates the diagnosis as alterations in physiology related to pregnancy can mask sepsis indicators normally seen in the general population. If early signs of sepsis go unrecognized, septic shock can develop, leading to organ dysfunction and potential death. Maternal early warning tools have been designed to assist clinicians in recognizing early indications of illness...
March 15, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28292926/management-of-endocrine-disease-acromegaly-and-pregnancy-a-contemporary-review
#11
Julio Abucham, M D Bronstein, Monike Lourenço Dias
Although fertility is frequently impaired in women with acromegaly, pregnancy is apparently becoming more common due to improvement in acromegaly treatment as well as in fertility therapy. As a result, several studies on pregnancy in patients with acromegaly have been published in recent years adding new and relevant information to the preexisting literature. Also, new GH assays with selective specificities and the knowledge of the expression of the various GH genes have allowed a better understanding of somatotrophic axis function during pregnancy...
March 14, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28291126/strategies-to-reduce-blood-product-utilization-in-obstetric-practice
#12
Holger Neb, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management (PBM) aims to improve patient outcome and safety by reducing the number of unnecessary RBC transfusions and vitalizing patient-specific anemia reserves. Although PBM is increasingly recognized as best clinical practice in elective surgery, implementation of PBM is restrained in the setting of obstetrics. This review summarizes recent findings to reduce blood product utilization in obstetric practice. RECENT FINDINGS: PBM-related evidence-based benefits should be urgently adopted in the field of obstetric medicine...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28288882/clinical-outcomes-of-patients-with-heterotopic-pregnancy-after-surgical-treatment
#13
Yiqi Guan, Caihong Ma
STUDY OBJECTIVE: This study aimed to review surgical management and clinical outcomes of patients with heterotopic pregnancy (HP) who underwent in vitro fertilization and embryo transfer (IVF-ET) and surgical treatment at the Assisted Reproductive Technology Center of Peking University Third Hospital from January 2010 to December 2015. DESIGN: We retrospectively analyzed 56 patients' general characteristics, diagnostic features, surgical management, and clinical outcomes according to medical records and follow-up telephone interviews...
March 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28287945/gestational-trophoblastic-disease-clinical-and-imaging-features
#14
Akram M Shaaban, Maryam Rezvani, Reham R Haroun, Anne M Kennedy, Khaled M Elsayes, Jeffrey D Olpin, Mohamed E Salama, Bryan R Foster, Christine O Menias
Gestational trophoblastic disease (GTD) is a spectrum of both benign and malignant gestational tumors, including hydatidiform mole (complete and partial), invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. The latter four entities are referred to as gestational trophoblastic neoplasia (GTN). These conditions are aggressive with a propensity to widely metastasize. GTN can result in significant morbidity and mortality if left untreated. Early diagnosis of GTD is essential for prompt and successful management while preserving fertility...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28285426/fetal-growth-restriction-current-knowledge
#15
REVIEW
Luciano Marcondes Machado Nardozza, Ana Carolina Rabachini Caetano, Ana Cristina Perez Zamarian, Jaqueline Brandão Mazzola, Carolina Pacheco Silva, Vivian Macedo Gomes Marçal, Thalita Frutuoso Lobo, Alberto Borges Peixoto, Edward Araujo Júnior
BACKGROUND: Fetal growth restriction (FGR) is a condition that affects 5-10% of pregnancies and is the second most common cause of perinatal mortality. This review presents the most recent knowledge on FGR and focuses on the etiology, classification, prediction, diagnosis, and management of the condition, as well as on its neurological complications. METHODS: The Pubmed, SCOPUS, and Embase databases were searched using the term "fetal growth restriction". RESULTS: Fetal growth restriction (FGR) may be classified as early or late depending on the time of diagnosis...
March 11, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28284197/case-review-of-perinatal-deaths-at-hospitals-in-kigali-rwanda-perinatal-audit-with-application-of-a-three-delays-analysis
#16
Aimable Musafili, Lars-Åke Persson, Cyprien Baribwira, Jessica Påfs, Patrick Adam Mulindwa, Birgitta Essén
BACKGROUND: Perinatal audit and the three-delays model are increasingly being employed to analyse barriers to perinatal health, at both community and facility level. Using these approaches, our aim was to assess factors that could contribute to perinatal mortality and potentially avoidable deaths at Rwandan hospitals. METHODS: Perinatal audits were carried out at two main urban hospitals, one at district level and the other at tertiary level, in Kigali, Rwanda, from July 2012 to May 2013...
March 11, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28282781/fetal-brain-anomalies-detection-during-the-first-trimester-expanding-the-scope-of-antenatal-sonography
#17
Eldad Katorza, Itai Gat, Nir Duvdevani, Nir Meller, Noam Pardo, Eran Barzilay, Reuven Achiron
PURPOSE: The purpose of this study was to describe fetal brain anomalies identified during nuchal translucency (NT) examination and their clinical management. MATERIALS AND METHODS: In this retrospective study, we evaluated charts of pregnant women performed the first trimester scan (FTS) between 1.1.2011 and 31.12.14 in a tertiary referral center. Study population consisted of 952 patients scheduled for routine NT scan for aneuploidy screening between 11.0 and 13...
February 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277805/intrauterine-transfusion-and-non-invasive-treatment-options-for-hemolytic-disease-of-the-fetus-and-newborn-review-on-current-management-and-outcome
#18
Carolien Zwiers, Inge van Kamp, Dick Oepkes, Enrico Lopriore
Hemolytic disease of the fetus and newborn (HDFN) remains a serious pregnancy complication which can lead to severe fetal anemia, hydrops and perinatal death. Areas covered: This review focusses on the current prenatal management, treatment with intrauterine transfusion (IUT) and promising non-invasive treatment options for HDFN. Expert commentary: IUTs are the cornerstone in prenatal management of HDFN and have significantly improved perinatal outcome in the past decades. IUT is now a relatively safe procedure, however the risk of complications is still high when performed early in the second trimester...
March 20, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28274949/management-of-endocrine-disease-subclinical-thyrotoxicosis-prevalence-causes-and-choice-of-therapy
#19
Allan Carle, Stine Linding Andersen, Kristien Boelaert, Peter Laurberg
Subclinical thyrotoxicosis is a condition affecting up to 10% of the population in some studies. We have reviewed literature and identified studies describing prevalences, causes and outcomes of this condition. Treatment should be considered in all subjects if this biochemical abnormality is persistent, especially in case of symptoms of thyrotoxicosis or in the presence of any complication. In particular, treatment should be offered in those subclinically thyrotoxic patients with a sustained serum TSH below 0...
March 8, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28274270/the-effects-of-dietary-and-lifestyle-interventions-among-pregnant-women-who-are-overweight-or-obese-on-longer-term-maternal-and-early-childhood-outcomes-protocol-for-an-individual-participant-data-ipd-meta-analysis
#20
Jodie M Dodd, Rosalie M Grivell, Jennie Louise, Andrea R Deussen, Lynne Giles, Ben W Mol, Christina Vinter, Mette Tanvig, Dorte Moller Jensen, Annick Bogaerts, Roland Devlieger, Riitta Luoto, Fionnuala McAuliffe, Kristina Renault, Emma Carlsen, Nina Geiker, Lucilla Poston, Annette Briley, Shakila Thangaratinam, Ewelina Rogozinska, Julie A Owens
BACKGROUND: The aim of this individual participant data meta-analysis (IPDMA) is to evaluate the effects of dietary and lifestyle interventions among pregnant women who are overweight or obese on later maternal and early childhood outcomes at ages 3-5 years. METHODS/DESIGN: We will build on the established International Weight Management in Pregnancy (i-WIP) IPD Collaborative Network, having identified researchers who have conducted randomised dietary and lifestyle interventions among pregnant women who are overweight or obese, and where ongoing childhood follow-up of participants has been or is being undertaken...
March 9, 2017: Systematic Reviews
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