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stroke in pregnant women

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https://www.readbyqxmd.com/read/29657057/ventricular-efficiency-in-pregnant-women-with-congenital-heart-disease
#1
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
#2
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...
April 12, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29623416/agreement-between-preload-reserve-measured-by-impedance-cardiography-and-echocardiography-during-pregnancy
#3
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
#4
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...
March 24, 2018: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29477223/vitamin-b-12
#5
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
#6
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
#7
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
#8
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...
January 29, 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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/29124903/relationship-between-the-left-ventricular-size-and-the-amount-of-trabeculations
#14
Bruno Paun, Bart Bijnens, Constantine Butakoff
Contemporary imaging modalities offer noninvasive quantification of myocardial deformation; however, they make gross assumptions about internal structure of the cardiac walls. Our aim is to study the possible impact of the trabeculations on the stroke volume, strain, and capacity of differently sized ventricles. The cardiac left ventricle is represented by an ellipsoid and the trabeculations by a tissue occupying a fixed volume. The ventricular contraction is modeled by scaling the ellipsoid whereupon the measurements of longitudinal strain, end-diastolic, end-systolic, and stroke volumes are derived and compared...
March 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29120921/pregnancy-and-ischemic-stroke-a-practical-guide-to-management
#15
Mayte E van Alebeek, Roel de Heus, Anil M Tuladhar, Frank-Erik de Leeuw
PURPOSE OF REVIEW: Ischemic stroke during pregnancy or the puerperium is a devastating disease during a crucial period in life and warrants a specific approach. To date, current practice is mainly based on expert opinion because of a lack of randomized controlled trials and high-quality observational studies. The present review is intended as a practical guide to (acute) management of ischemic stroke during pregnancy and puerperium. RECENT FINDINGS: Recent findings showed that the incidence of stroke during pregnancy is rising...
February 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29111146/medical-contraindications-to-estrogen-and-contraceptive-use-among-women-veterans
#16
Colleen P Judge, Xinhua Zhao, Florentina E Sileanu, Maria K Mor, Sonya Borrero
BACKGROUND: Women veterans have high rates of medical comorbidities and may be particularly vulnerable to adverse health outcomes associated with unintended pregnancy. OBJECTIVES: The objective of the study was to estimate the prevalence of medical contraindications to estrogen-containing combined hormonal contraception among women veterans of reproductive age and to evaluate the relationship between contraindications and contraceptive use. STUDY DESIGN: This was a secondary analysis of data from a cross-sectional, telephone-based survey with a national sample of 2302 female veterans, aged 18-45 years, who use the Veterans Administration Healthcare System for primary care...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29089251/longitudinal-study-to-assess-changes-in-arterial-stiffness-and-cardiac-output-parameters-among-low-risk-pregnant-women
#17
Mohamed Waseem Osman, Mintu Nath, Asma Khalil, David R Webb, Thompson G Robinson, Hatem A Mousa
AIM: A single-centre, prospective longitudinal study to assess changes in maternal arterial stiffness and cardiac output parameters among low-risk healthy pregnant women. METHODOLOGY: Thirty low-risk, healthy, pregnant women attending their routine antenatal dating ultrasound scan were recruited. Non-invasive assessment of arterial stiffness and cardiac output was undertaken at five gestational windows from 11 to 40 weeks of pregnancy. Data were analysed using a linear mixed model incorporating time and other relevant predictors as fixed effects, and patient as a random effect...
October 16, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29066439/pulmonary-hypertension-and-pregnancy-outcomes-insights-from-the-national-inpatient-sample
#18
Erin Thomas, Jie Yang, Jianjin Xu, Fabio V Lima, Kathleen Stergiopoulos
BACKGROUND: Pregnant women with pulmonary hypertension (PH) are at risk for adverse cardiac outcomes, particularly at the time of labor and delivery. The purpose of this study is to define the impact of PH on pregnancy outcomes and the risk of major adverse cardiac events (MACE). METHODS AND RESULTS: The National Inpatient Sample was screened for hospital admissions of women delivering during the years 2003 to 2012. The primary outcome was MACE, a composite of death, cardiac arrest, cardiogenic shock, myocardial infarction, respiratory failure, arrhythmia, stroke, and embolic event...
October 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28926807/ambient-temperature-and-risk-of-cardiovascular-events-at-labor-and-delivery-a-case-crossover-study
#19
Sandie Ha, Kelly Nguyen, Danping Liu, Tuija Männistö, Carrie Nobles, Seth Sherman, Pauline Mendola
BACKGROUND: Extreme ambient temperatures are linked to cardiac events in the general population, but this relationship is unclear among pregnant women. We estimated the associations and attributable risk between ambient temperature and the risk of cardiovascular event at labor/delivery, and investigated whether these associations vary by maternal race/ethnicity. METHODS: We identified 680 women with singleton deliveries affected by cardiovascular events across 12 US sites (2002-2008)...
November 2017: Environmental Research
https://www.readbyqxmd.com/read/28803230/revised-reference-values-for-potassium-intake
#20
Daniela Strohm, Sabine Ellinger, Eva Leschik-Bonnet, Friederike Maretzke, Helmut Heseker
BACKGROUND: The nutrition societies of Germany, Austria and Switzerland have revised the reference values for potassium intake in January 2017. METHODS: For adults, the estimated value was based on the 24-h urinary potassium excretion and on preventive considerations regarding hypertension and stroke. The estimated values for children and adolescents were extrapolated from the adult estimated value considering differences in body mass. For infants aged 0 to under 4 months, the estimated value was set based on the potassium intake via breast milk...
2017: Annals of Nutrition & Metabolism
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