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stroke in pregnant women

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https://www.readbyqxmd.com/read/29909951/-anticoagulation-s-problematic-during-pregnancy-in-carriers-of-mechanical-heart-prosthesis
#1
N F Benatta, D D Batouche, M A Djazouli
INTRODUCTION: The heart prosthesis pregnant women are becoming more frequent due to the persistence of rheumatic fever in the country sends developments. OBJECTIVE: To propose management strategies from preconception to pregnancy and postpartum. MATERIALS AND METHODS: Prospective study from 2009-2014 about parturientes followed in cardiology and maternity on center Hospitalo University Oran. RESULTS: Thirty patients were followed, ejection fraction was equal to 60% in 29 cases...
June 14, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29898711/maternal-cardiovascular-hemodynamics-in-normotensive-versus-preeclamptic-pregnancies-a-prospective-longitudinal-study-using-a-noninvasive-cardiac-system-nicas%C3%A2
#2
Anat Lavie, Maya Ram, Shaul Lev, Yair Blecher, Uri Amikam, Yael Shulman, Tomer Avnon, Eran Weiner, Ariel Many
BACKGROUND: Preeclampsia is among the most common medical complications of pregnancy. The clinical utility of invasive hemodynamic monitoring in preeclampsia (e.g., Swan-Ganz catheter) is controversial. Thoracic impedance cardiography (TIC) and Doppler echocardiography are noninvasive techniques but they both have important limitations. NICaS™ (NI Medical, PetachTikva, Israel) is a noninvasive cardiac system for determining cardiac output (CO) that utilizes regional impedance cardiography (RIC) by noninvasively measuring the impedance signal in the periphery...
June 14, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29886492/pancreatic-cancer-in-pregnancy-presenting-with-thromboembolic-events-case-report-and-review-of-the-literature
#3
Brian W Wakefield, Crystal M C Masterson, Manuel T Borges, K Joseph Hurt
Stroke and hepatic vein thrombosis are highly associated with neoplasia but are extremely rare events in young, pregnant women. Rare and recurrent thrombotic events in pregnancy increase the suspicion for occult malignancy. We describe the case of a healthy 31-year-old G2P1 who presented with visual changes and dysarthria during pregnancy. Imaging showed cerebral infarcts. Her thrombophilia evaluation was negative. During delivery, she was diagnosed with fulminant Budd-Chiari Syndrome. Hepatic ultrasound suggested malignancy or metastasis, and postpartum CT scan and biopsy confirmed the diagnosis of Stage IV pancreatic cancer...
June 8, 2018: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/29878938/cardiac-structure-and-function-in-morbidly-obese-parturients-an-echocardiographic-study
#4
Bigna S Buddeberg, Nicole L Fernandes, Adri Vorster, Blanche J Cupido, Carl J Lombard, Justiaan L Swanevelder, Thierry Girard, Robert A Dyer
BACKGROUND: The increasing prevalence of obesity worldwide is a major threat to global health. Cardiac structural and functional changes are well documented for obesity as well as for pregnancy, but there is limited literature on morbidly obese parturients. We hypothesized that there are both cardiac structural and functional differences between morbidly obese pregnant women and pregnant women of normal body mass index (BMI). METHODS: This prospective cross-sectional study was performed in 2 referral maternity units in Cape Town, South Africa, over a 3-month period...
June 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29844145/modeling-superimposed-preeclampsia-using-ang-ii-angiotensin-ii-infusion-in-pregnant-stroke-prone-spontaneously-hypertensive-rats
#5
Hannah L Morgan, Elaine Butler, Shona Ritchie, Florian Herse, Ralf Dechend, Elisabeth Beattie, Martin W McBride, Delyth Graham
Hypertensive disorders of pregnancy are the second leading cause of maternal deaths worldwide. Superimposed preeclampsia is an increasingly common problem and often associated with impaired placental perfusion. Understanding the underlying mechanisms and developing treatment options are crucial. The pregnant stroke-prone spontaneously hypertensive rat has impaired uteroplacental blood flow and abnormal uterine artery remodeling. We used Ang II (angiotensin II) infusion in pregnant stroke-prone spontaneously hypertensive rats to mimic the increased cardiovascular stress associated with superimposed preeclampsia and examine the impact on the maternal cardiovascular system and fetal development...
May 29, 2018: Hypertension
https://www.readbyqxmd.com/read/29785465/causes-and-treatment-of-acute-ischemic-stroke-during-pregnancy
#6
REVIEW
Ina Terón, Melissa S Eng, Jeffrey M Katz
PURPOSE OF REVIEW: Treatment recommendations for pregnancy associated ischemic stroke are scarce. This may be due to the fact that, in general, obstetricians tend not to make recommendations for stroke patients and neurologists are not commonly involved in the care of pregnant women. Herein, we review the multiple etiologies of ischemic stroke during pregnancy, considerations for diagnostic testing, and acute treatment and prevention options, including associated risks specific to the pregnant and puerperal state...
May 21, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29705165/the-possible-effect-of-oxytocin-in-postpartum-recovery-from-a-stroke-a-case-report
#7
Han Gil Seo, Hyun Haeng Lee, Byung-Mo Oh
Pregnancy is a risk factor for stroke in young women, but the effect of delivery on recovery and rehabilitation after stroke has not been elucidated in pregnant patients with stroke. This case report presents a pregnant patient with stroke who recovered successfully after cesarean delivery during rehabilitation. The possible effect of oxytocin is discussed as a factor promoting recovery from stroke.
April 26, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29657057/ventricular-efficiency-in-pregnant-women-with-congenital-heart-disease
#8
Jun Muneuchi, Keiko Yamasaki, Mamie Watanabe, Azusa Fukumitsu, Takeshi Kawakami, Hiromasa Nakahara, Kunitaka Joo
BACKGROUNDS: Pregnant women with congenital heart disease (CHD) are at risk of cardiovascular events during pregnancy as well as postpartum. The aim of our study is to address the feasibility of echocardiography-derived ventricular-arterial coupling during pregnancy and postpartum among women with CHD. METHODS: In 31 pregnant women with CHD, we performed serial echocardiography at the first and third trimesters, early and late postpartum. The indices of contractility (single-beat determined end-systolic elastance, Eesab ) and afterload (effective arterial elastance, Ea) were approximated on the basis of the systemic blood pressure and systemic ventricular volume...
June 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29655653/increased-risk-of-cardiovascular-disease-in-women-with-prior-gestational-diabetes-a-systematic-review-and-meta-analysis
#9
Jing Li, Chunhua Song, Changping Li, Ping Liu, Zhuoyu Sun, Xilin Yang
This study aims to investigate the effect of gestational diabetes mellitus (GDM) on the long-term risk of cardiovascular disease (CVD). PubMed and other databases were searched up to August 31, 2017. Cohort studies evaluating risk of CVD postpartum in women with and without prior GDM were included. Random-effect model was used to estimate the pooled relative risk of CVD. Sensitivity and subgroup analyses were performed to check the consistency of the effect size and to explore sources of heterogeneity. Multivariable logistic regression was used to control for high heterogeneity...
June 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29623416/agreement-between-preload-reserve-measured-by-impedance-cardiography-and-echocardiography-during-pregnancy
#10
Huan Liang, Åse Vårtun, Ganesh Acharya
PURPOSE: Accurate assessment of cardiac function is important during pregnancy. Echocardiography and impedance cardiography (ICG) are commonly used noninvasive methods to measure stroke volume (SV) and cardiac output (CO). The difference in stroke volume (ΔSV) or cardiac output (ΔCO) measured at baseline and after passive leg raising (PLR) is a measure of preload reserve that predicts volume responsiveness. However, the agreement between these two methods in measuring preload reserve during pregnancy is unclear...
April 5, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29588233/postpartum-increases-in-cerebral-edema-and-inflammation-in-response-to-placental-ischemia-during-pregnancy
#11
Ahsia M Clayton, Qingmei Shao, Nina D Paauw, Ashtin B Giambrone, Joey P Granger, Junie P Warrington
Reduced placental blood flow results in placental ischemia, an initiating event in the pathophysiology of preeclampsia, a hypertensive pregnancy disorder. While studies show increased mortality risk from Alzheimer's disease, stroke, and cerebrovascular complications in women with a history of preeclampsia, the underlying mechanisms are unknown. During pregnancy, placental ischemia, induced by reducing uterine perfusion pressure (RUPP), leads to cerebral edema and increased blood-brain barrier (BBB) permeability; however whether these complications persist after delivery is not known...
May 2018: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29477223/vitamin-b-12
#12
REVIEW
A David Smith, Martin J Warren, Helga Refsum
The biosynthesis of B12 , involving up to 30 different enzyme-mediated steps, only occurs in bacteria. Thus, most eukaryotes require an external source of B12 , and yet the vitamin appears to have only two functions in eukaryotes: as a cofactor for the enzymes methionine synthase and methylmalonylCoA mutase. These two functions are crucial for normal health in humans, and in particular, the formation of methionine is essential for providing methyl groups for over 100 methylation processes. Interference with the methionine synthase reaction not only depletes the body of methyl groups but also leads to the accumulation of homocysteine, a risk factor for many diseases...
2018: Advances in Food and Nutrition Research
https://www.readbyqxmd.com/read/29476390/spontaneous-intracranial-hemorrhage-in-pregnancy-a-systematic-review-of-the-literature
#13
Luis C Ascanio, Georgios A Maragkos, Brett C Young, Myles D Boone, Ekkehard M Kasper
Stroke in pregnant women has a mortality rate of 1.4 deaths per 100,000 deliveries. Vascular malformations are the most common cause of hemorrhagic stroke in this population; preeclampsia and other risk factors have been identified. However, nearly a quarter of strokes have an undeterminable cause. Spontaneous intracranial hemorrhage (ICH) is less frequent but results in significant morbidity. The main objective of this study is to review the literature on pregnant patients who had a spontaneous ICH. A systematic review of the literature was conducted on PubMed and the Cochrane library from January 1992 to September 2016 following the PRISMA guidelines...
February 23, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29378443/thrombolysis-in-pregnancy-a-literature-review
#14
Marina Sousa Gomes, Mariana Guimarães, Nuno Montenegro
BACKGROUND: Changes in the coagulation system during pregnancy and puerperium produce a physiological hypercoagulable state. These changes are thought to be the cause of the higher rates of deep vein thrombosis (DVT), pulmonary embolism (PE), stroke, and mechanical prosthetic valve thrombosis (PVT) during pregnancy. Thrombolysis can be a treatment option in this case. However, there are no available data from randomized controlled trials in pregnant patients and information about the security of thrombolytics in pregnancy is missing...
February 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29377071/how-i-manage-red-cell-transfusions-in-patients-with-sickle-cell-disease
#15
REVIEW
David C Rees, Susan Robinson, Jo Howard
Sickle cell disease is one of the commonest serious inherited diseases in the world, and red cell transfusion is still one of the few effective treatments for acute and chronic complications. Transfusion corrects anaemia and dilutes out the number of red cells able to cause vaso-occlusion and vascular damage. Urgent red cell transfusions are used to correct acute anaemia, treat acute chest syndrome and patients with acute neurological symptoms. We use elective transfusions preoperatively for moderate risk surgery, and in some pregnant women...
February 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29334907/hemodynamic-effects-of-lateral-tilt-before-and-after-spinal-anesthesia-during-cesarean-delivery-an-observational-study
#16
Ahmed Hasanin, Remoon Soryal, Tarek Kaddah, Sabah Abdel Raouf, Yaser Abdelwahab, Khaled Elshafaei, Mohamed Elsayad, Bassant Abdelhamid, Reham Fouad, Doaa Mahmoud, Yasmin Hassabelnaby
BACKGROUND: Post-spinal hypotension is a common maternal complication during cesarean delivery. Aortocaval compression by the gravid uterus has been assumed as a precipitating factor for post-spinal hypotension. The role of left lateral tilting position in improving maternal cardiac output after subarachnoid block (SAB) is unclear. The aim of this work is to investigate the effect of left lateral tilting on maternal hemodynamics after SAB. METHODS: A prospective observational study was conducted including 105 full term pregnant women scheduled for cesarean delivery...
January 15, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29278864/stroke-volume-recruitability-during-the-third-trimester-of-pregnancy
#17
Sandra Herrera, Maggie J Kuhlmann-Capek, Sarah C Rogan, Antonio F Saad, George R Saade, Gary D V Hankins, Luis D Pacheco
OBJECTIVE:  It is unknown whether the heart operates in the ascending or flat portion of the Starling curve during normal pregnancy. Pregnant women do not respond to the passive leg-raising maneuver secondary to mechanical obstruction of the inferior vena cava by the gravid uterus. Our objective was to evaluate if administration of a fluid bolus increases baseline stroke volume (SV) among healthy pregnant patients during the third trimester. STUDY DESIGN:  Healthy pregnant women who underwent elective term cesarean sections were included...
December 26, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29201439/management-of-an-acute-ischemic-stroke-during-thrombolytic-treatment-in-a-pregnant-patient-with-prosthetic-valve-thrombosis
#18
Macit Kalçık, Mahmut Yesin, Emrah Bayam, Mustafa Ozan Gürsoy, Ahmet Güner, Sabahattin Gündüz, Mehmet Özkan
Prosthetic valve thrombosis (PVT) is a life-threatening complication in pregnant women with mechanical prosthetic heart valves. Thrombolytic therapy (TT) has evolved as an effective treatment alternative to surgery, which is associated with very high maternal and fetal mortality and morbidity in these patients. Acute ischemic stroke may rarely occur during TT for PVT. Here, we present a pregnant patient who was complicated with cerebral thromboembolism during TT for PVT and successfully managed with continuation of TT...
September 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/29187935/-haemorrhagic-stroke-of-the-brainstem-secondary-to-postpartum-eclampsia-about-a-case-and-literature-review
#19
REVIEW
Khadija Ennaqui, Assia Makayssi, Houssine Boufettal, Naima Samouh
Strokes are rare but severe accidents during pregnancy and post-partum period. They are responsible for high mortality and morbidity rates. Pre-eclampsia, eclampsia, and strokes are significantly related. Endothelial dysfunction, alteration of brain self-regulation and severe hypertension are, probably, the cause of many strokes in pregnant women and during postpartum period. We report a case of hemorrhagic stroke of the brainstem in a nonmonitored 21-year old patient at 38 weeks pregnant admitted with severe preeclampsia complicated by eclampsia and then by haemorrhagic stroke of the brainstem on the second post-operative day after cesarean section performed due to suspicion of retroplacental haematoma arisen since her admission...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29153568/maternal-obesity-and-cardiac-development-in-the-offspring-study-in-human-neonates-and-minipigs
#20
Maria Angela Guzzardi, Tiziana Liistro, Luna Gargani, Lamia Ait Ali, Gennaro D'Angelo, Silvia Rocchiccioli, Federica La Rosa, Alessandra Kemeny, Elena Sanguinetti, Nadia Ucciferri, Mariarosaria De Simone, Antonietta Bartoli, Pierluigi Festa, Piero A Salvadori, Silvia Burchielli, Rosa Sicari, Patricia Iozzo
OBJECTIVES: The aim of this study was to investigate the consequences of maternal overweight on cardiac development in offspring in infants (short term) and minipigs (short and longer term). BACKGROUND: The epidemic of overweight involves pregnant women. The uterine environment affects organ development, modulating disease susceptibility. Offspring of obese mothers have higher rates of cardiovascular events and mortality. METHODS: Echocardiography was performed in infants born to lean and overweight mothers at birth and at 3, 6, and 12 months of age...
November 10, 2017: JACC. Cardiovascular Imaging
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