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https://www.readbyqxmd.com/read/28208940/neurological-disorders-complicating-pregnancy-focus-on-obstetric-outcome
#1
Sandya Renukesh, Lavanya Rai
INTRODUCTION: Neurological disorders in pregnancy can be pregnancy related or can be caused by exacerbation of a pre-existing neurological condition or sometimes may even be detected for the first time during pregnancy in which it might be an incidental finding. The diagnosis and management of the neurological disorders in pregnancy is always a challenging task due to varied symptomatology and risks to the fetus. The evaluation and management should be performed in a stepwise fashion and requires multidisciplinary approach...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28202184/high-prevalence-of-same-sex-twins-in-patients-with-cloacal-exstrophy-support-for-embryological-association-with-monozygotic-twinning
#2
Brenna S Fullerton, Eric A Sparks, Amber M Hall, Cristine S Velazco, Biren P Modi, Dennis P Lund, Tom Jaksic, W Hardy Hendren
PURPOSE: Previous studies have hypothesized that cloacal exstrophy may be caused by errors early in embryological development related to monozygotic twinning. This study reports the prevalence of twins in a large cohort of patients with cloacal exstrophy. METHODS: Patients with cloacal exstrophy treated 1974-2015 were reviewed for reports of multiple gestation or conjoined twinning. The genetic sex of the patient and their twin, and any mention of anomaly in the twin were recorded...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28183709/consequences-of-delivery-at-home-in-a-woman-without-prenatal-care
#3
Nakul Kumar, Lisa Gilbert, Terry Ellis, Sandeep Krishnan
This is a case report of a 39-year-old multigravida woman without allopathic prenatal care who, after three previous caesarean sections, attempted to deliver her fourth child at home with the help of a direct entry midwife. During labour, fetal movement and fetal heart tones became undetectable, at which time the patient was referred by the midwife to the hospital. The patient was diagnosed with uterine rupture, bladder rupture and fetal demise; she was rushed to emergency surgery. The patient's lack of allopathic prenatal care, attempt of vaginal birth after three previous caesarean sections, coupled with her desire for delivery at home, led to her complicated course...
February 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28178739/methamphetamine-consumption-during-pregnancy-effects-on-child-health
#4
Jürgen Dinger, Patricia Hinner, Jörg Reichert, Mario Rüdiger
Methamphetamine abuse during pregnancy represents an emerging health care problem. The consequences are not only of relevance to the pregnant women, but also their unborn child. It is associated with an increased risk of preeclampsia and hypertension, fetal demise, preterm delivery, and intrauterine growth restriction. The deleterious effects of prenatal methamphetamine exposure on the developing fetal brain may lead to long-term neuro-developmental and behavioral problems.Given the current evidence, abuse of methamphetamine during pregnancy must be of utmost concern to health care professionals and to policy-makers...
February 8, 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28178055/pulmonary-hypertension-in-pregnancy-a-report-of-49-cases-at-four-tertiary-north-american-sites
#5
Marie-Louise Meng, Ruth Landau, Olof Viktorsdottir, Jennifer Banayan, Tamila Grant, Brian Bateman, Richard Smiley, Elena Reitman
OBJECTIVE: To identify whether pregnancy outcomes vary by etiology and severity of pulmonary hypertension and whether contemporary therapies influence outcomes. METHODS: A retrospective review of medical records at four academic institutions was conducted to identify pregnant women with pulmonary hypertension (2001-2015). International Classification of Diseases, 9th Revision codes for pulmonary hypertension and pregnancy were used to identify potential participants...
February 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28166604/smith-lemli-opitz-syndrome-carrier-frequency-and-estimates-of-in-utero-mortality-rates
#6
Gabriel A Lazarin, Imran S Haque, Eric A Evans, James D Goldberg
OBJECTIVE: To tabulate individual allele frequencies and total carrier frequency for Smith-Lemli-Opitz syndrome (SLOS) and compare expected versus observed birth incidences. METHODS: 262,399 individuals with no known indication or increased probability of SLOS carrier status, primarily US-based, were screened for SLOS mutations as part of an expanded carrier screening panel. Results were retrospectively analyzed to estimate carrier frequencies in multiple ethnic groups...
February 6, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28163434/aortic-and-pulmonary-artery-calcification-an-unusual-manifestation-of-twin-to-twin-transfusion-syndrome
#7
Sumitra Venkatesh, J Sanyukta, S Jain, S S Prabhu, S Kulkarni
Twin-to-twin transfusion syndrome (TTTS) at times complicates monochorionic twin gestations, resulting in conditions ranging from discordant sizes to fetal demise of one baby. Various types of cardiac defects have been described in the recipient twin of this syndrome. Isolated great artery calcification, i.e. aortic and pulmonary artery calcification is one such uncommon condition associated with TTTS. Calcification of the walls of great vessels may be due to chronic vascular injury sustained as a result of circulatory volume overload in the recipient twin...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28161068/distribution-and-potential-significance-of-intravillous-and-intrafibrinous-particulate-microcalcification
#8
Jennifer Zeng, Alan Marcus, Tatiana Buhtoiarova, Khushbakhat Mittal
Radiologic studies indicate that placental calcifications seen at 28-32 weeks' gestation are associated with adverse fetal outcome. One type of placental calcification is typically located at the basement membrane of chorionic villi. It has a fine particulate appearance and can only be seen microscopically. We have designated these calcifications as Intravillous and Intrafibrinous Particulate MicroCalcification (IPMC). In this study we examined the distribution and potential significance of IPMC. Placentas from 14 groups of fetal and maternal outcomes are examined histologically for IPMC...
February 2017: Placenta
https://www.readbyqxmd.com/read/28150444/the-influence-of-chorionicity-and-gestational-age-at-single-fetal-loss-on-the-risk-of-preterm-birth-in-twin-pregnancies-analysis-of-the-stork-multiple-pregnancy-cohort
#9
Francesco D'Antonio, Basky Thilaganathan, Tiran Dias, Asma Khalil
BACKGROUND: Single intrauterine death (sIUD) in twin pregnancies is associated with a significant risk of co-twin demise and preterm birth (PTB), especially in monochorionic (MC) twins. However, it is yet to be established whether the gestational age at loss may influence the pregnancy outcome. The aim of this study was to explore the risk of PTB according to the gestational age at the diagnosis of sIUD. METHODS: A cohort study of all twin pregnancies from a large regional network of 9 hospitals over a ten-year period...
February 2, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28116109/a-case-of-a-surviving-co-twin-diagnosed-with-porencephaly-and-renal-hypoplasia-after-a-single-intrauterine-fetal-death-at-21-weeks-of-gestation-in-a-monochorionic-monoamniotic-twin-pregnancy
#10
Hidenori Machino, Takayuki Iriyama, Toshio Nakayama, Atsushi Komatsu, Takeshi Nagamatsu, Yutaka Osuga, Tomoyuki Fujii
Monochorionic monoamniotic (MM) twin pregnancy carries a high risk of intrauterine fetal death (IUFD). Single IUFD in an MM twin pregnancy prior to 22 weeks of gestation has been reported to be strongly correlated with double twin demise. To our knowledge, there are no case reports on the natural course of a surviving co-twin in an MM twin pregnancy resulting in live birth after a single IUFD prior to 22 weeks of gestation. Here, we report a case of a surviving co-twin, after a single IUFD at 21 weeks of gestation in a MM twin pregnancy, with an antenatal diagnosis of renal hypoplasia and severe neurological damage leading to porencephaly, and live birth at 36 weeks of gestation...
January 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28081020/sonographic-findings-and-diagnostic-pitfalls-in-evaluation-for-uterine-rupture-in-a-case-of-fetal-demise-and-prior-cesarean-delivery-of-unknown-type
#11
James Andrew Spain, Shehbaz Shaikh, Sharon A Sandberg
A 38-week pregnant patient with history of cesarean delivery was admitted to the hospital for induction of labor after diagnosis of fetal demise. When the clinical picture became concerning for uterine scar dehiscence, an ultrasound was ordered. After targeted ultrasound of the lower uterine segment, the sonographer initially reported thin but intact lower uterine segment and normal positioning of the fetus. By keeping a high level of suspicion, the radiologist analyzed the images submitted and found other clues suggesting possible dehiscence or rupture...
January 9, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28079573/medically-assisted-withdrawal-detoxification-considering-the-mother-infant-dyad
#12
Hendrée E Jones, Mishka Terplan, Marjorie Meyer
Recommendations for opioid agonist pharmacotherapy and against medically assisted withdrawal were based upon early reports that associated withdrawal with maternal relapse and fetal demise. Data from recent case series have called these recommendations into question. Although these data do not support an association between medically assisted withdrawal and fetal demise, relapse remains a significant clinical concern with reported rates ranging from 17% to 96% (average 48%). Given the high loss to follow-up in these studies, the actual relapse rate is likely even greater...
January 11, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28076991/type-2-diabetes-mellitus-does-prenatal-care-affect-outcomes-suggested-running-head-treatment-of-t2dm-and-perinatal-outcomes
#13
Allison J Allen, Jonathan M Snowden, Bernard Lau, Yvonne Cheng, Aaron B Caughey
OBJECTIVE: To determine if prenatal care affects adverse perinatal outcomes in pregnant women with Type-2 Diabetes Mellitus. STUDY DESIGN: This was a retrospective cohort study of pregnant women with pregestational diabetes mellitus pregnancies in the state of California between 1997 and 2006, using vital statistics data linked to birth certificates. Women were stratified by time of presentation to care and we compared those who presented in the first trimester, third trimester, and those who had no prenatal care prior to delivery...
January 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28058487/fetal-surgery-a-critical-review
#14
REVIEW
H Kitagawa, K C Pringle
Therapeutic fetal surgical procedures are predicated upon the ability to make an accurate fetal diagnosis. The earliest open fetal surgical procedures were introduced in the 1960s to treat Rh isoimmunisation. They were introduced when it became possible to predict impending fetal demise. Open procedures were abandoned when percutaneous approaches proved superior. The introduction of fetal ultrasound allowed the diagnosis of other congenital anomalies, some being amenable to fetal interventions. Open fetal surgical procedures were initially utilised, with significant maternal morbidity...
January 5, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/27997515/zika-virus-infection-associated-with-congenital-birth-defects-in-a-hiv-infected-pregnant-woman
#15
Esaú Custódio João, Maria Isabel Fragoso da Silveira Gouvea, Maria de Lourdes Benamor Teixeira, Wallace Mendes-Silva, Juliana Silva Esteves, Edwiges Motta Santos, Leandro Augusto Ledesma, Maria Letícia Cruz
We describe a case of Zika Virus infection acquired during the first trimester in a HIV-infected pregnant woman that led to multiple fetal malformations and fetal demise in Rio de Janeiro, Brazil.
December 15, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27995289/the-fetus-with-ectopia-cordis-experience-and-expectations-from-two-centers
#16
Maria C Escobar-Diaz, Sherzana Sunderji, Wayne Tworetzky, Anita J Moon-Grady
Ectopia cordis (EC) is a rare congenital anomaly often associated with congenital heart disease (CHD). There is a lack of contemporary information on EC diagnosed prenatally. We sought to combine the experiences of two regional referral centers in order to evaluate current outcomes for EC. Clinical, echocardiographic features and perinatal outcomes of fetuses with EC managed at two large cardiac centers from 1995 to 2014 were retrospectively reviewed. Seventeen fetuses with EC were diagnosed at a median gestational age of 23 weeks (range 17-36)...
December 19, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27992943/hyperechogenic-bowel-etiologies-management-and-outcome-according-to-gestational-age-at-diagnosis-in-279-consecutive-cases-in-a-single-center
#17
Vincenzo Davide Catania, Alessandra Taddei, Marcella Pellegrino, Erika Adalgisa De Marco, Laura Merli, Carlo Manzoni, Lorenzo Nanni, Lucia Masini
Introduction The aim of the study was to investigate perinatal outcome of fetuses with hyperechogenic bowel (HB) in relation to gestational age at diagnosis. Materials and Methods This is a retrospective observational study of fetal HB cases from 2002 to 2012. Patients were divided into three groups according to trimester at diagnosis. For each group, data from fetal ultrasound examination, fetal medicine investigations, intrapartum cares, and neonatal outcome were obtained. Results A diagnosis of HB was made in 279 fetuses among them 17 (6%) during the first trimester, 186 (67%) during the second trimester, and 75 (27%) during the third trimester...
February 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27987335/gestational-choriocarcinoma-rare-spinal-metastasis-during-a-viable-pregnancy
#18
Tatsuya Ishiguro, Takehiro Serikawa, Tetsuro Yahata, Takayuki Enomoto
Gestational choriocarcinoma metastasizing to the bones, especially to the spine, is extremely rare. In addition, there are few reports of choriocarcinoma during a viable pregnancy. We report a case of gestational choriocarcinoma that metastasized to the lumbar spine during a viable pregnancy in a 41-year-old woman with a history of a missed abortion. A heterogeneous cervical mass was detected at gestational week 16. Subsequently, a metastatic lesion appeared during the pregnancy, and fetal demise in utero occurred...
December 17, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27958257/a-case-of-rudimentary-horn-pregnancy-diagnosed-after-failed-attempts-at-pregnancy-termination
#19
D Yildirim, L S Turkgeldi, N Tekiner, K D Seckin, B Yucel
We report a case of rudimentary horn pregnancy at 12 weeks gestation with fetal demise misdiagnosed ultrasonographically as an intrauterine pregnancy in a private clinic. The patient was referred to a tertiary care hospital after failed attempts at terminating her pregnancy. A definitive diagnosis was made with ultrasonography and magnetic resonance imaging (MRI) before uterine rupture ensued. Excision of the rudimentary horn and the ipsilateral fallopian tube was carried out by laparotomy. Failure to terminate pregnancy after several attempts should alert the physician about the possibility of a uterine anomaly and a pelvic MRI scan may help in the diagnosis of a suspected rudimentary horn pregnancy...
January 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/27939471/maternal-and-fetal-morbidity-following-discontinuation-of-antihypertensive-drugs-in-mild-to-moderate-chronic-hypertension-a-4-year-observational-study
#20
Mohamed Rezk, Hamid Ellakwa, Awni Gamal, Mahmoud Emara
OBJECTIVE: To assess maternal and fetal morbidity in women with mild to moderate chronic hypertension on antihypertensive drug therapy compared to cessation of therapy. METHODS: This was a prospective observational study included 222 women with mild to moderate chronic hypertension (systolic blood pressure of 140-159mmHg or diastolic blood pressure of 90-109mmHg) who were divided into two groups based on antihypertensive drug intake, treatment group (n=104) who received methyl dopa, and non-treatment group (n=118) who used only low dose aspirin...
October 2016: Pregnancy Hypertension
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