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Postpartum eclampsia

Tina Djernis Gundersen, Lone Krebs, Ellen Christine Leth Loekkegaard, Steen Christian Rasmussen, Julie Glavind, Tine Dalsgaard Clausen
OBJECTIVES: To examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: All live births in Denmark between 2004 and 2010 (n=450 856). Births were classified by intended caesarean delivery (n=45 053) or intended vaginal delivery (n=405 803), and by actual mode of delivery: spontaneous vaginal delivery, operative vaginal delivery, emergency or planned caesarean delivery in labour or prelabour...
March 14, 2018: BMJ Open
Tiong Y Lim, Enoka Gonsalkorala, Mary D Cannon, Stella Gabeta, Leonie Penna, Nigel D Heaton, Michael A Heneghan
BACKGROUND: Liver transplantation (LT) is a successful treatment for both acute liver failure and end-stage liver disease. The number of women of reproductive age undergoing LT is increasing. Pregnancy outcomes are favourable but there is still a lack of prognostic markers. We aimed to identify factors predictive of adverse pregnancy outcomes in LT recipients. METHODS: An analysis of all pregnancies occurring in LT recipients from 1989-2016 at King's College Hospital was performed...
March 14, 2018: Liver Transplantation
Paras Ali, Sofia Butt, Nazli Hossain
OBJECTIVE: To evaluate the practice of Eclampsia management at a tertiary care public sector hospital. PATIENTS & METHODS: We conducted criteria based audit of 93 Eclampsia patients admitted in Gynae unit III, Civil hospital and Dow University of Health Sciences Karachi, between 1st January 2016 and 31st December 2016. Management practices were assessed using evidence-based criteria for care. A clinical criteria for standards of care were developed from Royal College of Obstetrician & Gynecologist (RCOG/NICE) guidelines, World Health Organization (WHO) manual, twelve criteria were identified for the audit purpose...
January 2018: Pregnancy Hypertension
Louise Mary Webster, Carolyn Gill, Paul T Seed, Kate Bramham, Cornelia Wiesender, Catherine Nelson-Piercy, Jenny E Myers, Lucy C Chappell
Black ethnicity is associated with worse pregnancy outcomes in women with chronic hypertension. Pre-existing endothelial and renal dysfunction, and poor placentation may contribute but pathophysiological mechanisms underpinning increased risk are poorly understood. This cohort study aimed to investigate the relationship between ethnicity, superimposed pre-eclampsia and longitudinal changes in markers of endothelial, renal and placental dysfunction in women with chronic hypertension. Plasma concentrations of placental growth factor (PlGF), syndecan-1, renin, aldosterone, and urinary angiotensinogen:creatinine ratio (AGTCR), protein:creatinine ratio (PCR) and albumin:creatinine ratio (ACR) were quantified during pregnancy and postpartum in women with chronic hypertension...
March 7, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Aivara Urbutė, Marija Paulionytė, Domicelė Jonauskaitė, Eglė Machtejevienė, Rūta J Nadišauskienė, Žilvinas Dambrauskas, Paulius Dobožinskas, Mindaugas Kliučinskas
BACKGROUND AND OBJECTIVES: There are only few training programs in obstetric emergencies currently in use and only some of them were evaluated with an adequate sample of participants. Therefore, we present the evaluation of the novel Standardized Trainings in Obstetrical Emergencies (STrObE), conducted in Lithuania. The aim of this study was to analyze whether participants' self-reported knowledge and confidence increased after the trainings, and whether the impact of the trainings was long-lasting...
February 8, 2018: Medicina
María Fernanda Escobar Vidarte, Daniela Montes, Alejandra Pérez, Sara Loaiza-Osorio, Albaro José Nieto Calvache
BACKGROUND: Hepatic rupture is a complication during pregnancy that, although rare, accounts for high morbidity and mortality rates. It is mainly associated with severe preeclampsia and HELLP syndrome. Incidence is estimated to be at one per 67 000 births or one per 2000 patients with preeclampsia/eclampsia/HELLP, mainly in multiparous women; women in their 40s; after 32 weeks of gestation; and during the first 15 hours postpartum Cases: This article exposes the institutional experience at Fundación Valle del Lili in Cali, Colombia, in managing and treating hepatic rupture associated with severe preeclampsia and HELLP syndrome in three patients in the 30th, 26th and 27th week of gestation, not resulting in maternal death...
February 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
A Namugowa, J Iputo, J Wandabwa, A Meeme, G A B Buga, S Abura, Y Y Stofile
Women with pre-eclampsia have an increased risk of cardiovascular disease later in life. The aim of the study was to establish the presence and pattern of arterial stiffness in women previously with pre-eclampsia from a semi-rural region of South Africa. This was a prospective longitudinal study which involved 36 previously pre-eclamptic women and 86 non-pregnant controls (NPC) who had a past history of non-complicated pregnancy. Maternal wave reflection (augmentation index) and carotid-femoral pulse wave velocity were assessed noninvasively, using applanation tonometry with the SphygmoCor device...
February 23, 2018: Clinical and Experimental Hypertension: CHE
Courtney Stanley Sundin, Michelle Laurane Johnson
Posterior reversible encephalopathy syndrome (PRES) is a newly defined syndrome; therefore, this transient clinical condition is not well known and probably underdiagnosed. It develops quickly with symptoms that are usually indistinguishable from eclampsia. Nurses need to be knowledgeable and aware of identifying symptoms and appropriate treatment. The condition is thought to share pathophysiology with eclampsia, and it is suggested that endothelial dysfunction combined with hypertension causes disruption in the blood brain barrier resulting in cerebral edema...
March 2018: MCN. the American Journal of Maternal Child Nursing
Kiren Ghag, Cathy Winter, Rachna Bahl, Mary Lynch, Nayda Bautista, Rogelio Ilagan, Timothy J Draycott
OBJECTIVE: To describe the adaptation of an obstetric emergencies training program to align with local clinical practice. METHODS: A feasibility study was conducted to investigate the potential implementation of the PRactical Obstetric Multi-Professional Training (PROMPT) program at eight urban tertiary hospitals in the Philippines. Multi-professional teams attended a 2-day course on September 23 and 24, 2015, that comprised a demonstration PROMPT course (day 1) and a Train-the-Trainers session (day 2)...
February 22, 2018: International Journal of Gynaecology and Obstetrics
Surya Prasad Rimal, Pappu Rijal, Rabindra Bhatt, Kriti Thapa
INTRODUCTION: Magnesium sulfate is the drug of choice for prevention of seizures in the pre-eclamptic woman. There is no agreement in the published randomized trials regarding the optimal time to initiate magnesium sulfate, the dose to use (both loading and maintenance) as well as the duration of therapy. The objective of this study is to determine whether magnesium sulfate prophylaxis is needed for up to 24 hours postpartum in all patients with severe pre-eclampsia for the prevention of seizure...
October 2017: JNMA; Journal of the Nepal Medical Association
Martin Vanden Eede, Matthew Schroyens
OBJECTIVE AND IMPORTANCE: Late postpartum eclampsia is characterized by pre-eclampsia and tonic-clonic seizures presenting more than 48 hours postpartum. It is a rare, frightening and dangerous complication that requires rapid recognition and adequate treatment. CLINICAL PRESENTATION: We present a case of late postpartum eclampsia, initially diagnosed as right-sided heart failure, 10 days postpartum.Two days after the delivery she developed mild swelling of both feet, progressive shortness of breath on exertion and orthopnea...
February 16, 2018: Acta Clinica Belgica
Howieda Fouly, Fayza Ahmed Abdou, Ahmed M Abbas, Ayat Masoud Omar
Maternal deaths remain high, numbers at the facility level are relatively low. AIM: To evaluate effect of management guidelines on occurrence of maternal near miss in Women's Health Hospital. DESIGN: A cross-sectional study. SETTING: ICU of Women's Health Hospital's at Assiut Main University Hospital and Al-fayoum University Hospital. SUBJECTS: Convenient sample of 93 maternal near-miss cases including (Pregnancy or postpartum complications)...
February 2018: Applied Nursing Research: ANR
William R Cooke, Ulla K Hemmilä, Alison L Craik, Chimwemwe J Mandula, Priscilla Mvula, Ausbert Msusa, Gavin Dreyer, Rhys Evans
BACKGROUND: Obstetric-related acute kidney injury (AKI) is thought to be a key contributor to the overall burden of AKI in low resource settings, causing significant and preventable morbidity and mortality. However, epidemiological data to corroborate these hypotheses is sparse. This prospective observational study aims to determine the incidence, aetiology and maternal-fetal outcomes of obstetric-related AKI in Malawi. METHODS: Women greater than 20 weeks gestation or less than 6 weeks postpartum admitted to obstetric wards at a tertiary hospital in Blantyre, Malawi, and at high-risk of AKI were recruited between 21st September and 11th December 2015...
February 2, 2018: BMC Nephrology
Daniel W Robinson, Michael Anana, Mary A Edens, Marc Kanter, Sorabh Khandelwal, Kaushal Shah, Todd Peterson
Introduction: Obstetrical emergencies are a high-risk yet infrequent occurrence in the emergency department. While U.S. emergency medicine (EM) residency graduates are required to perform 10 low-risk normal spontaneous vaginal deliveries, little is known about how residencies prepare residents to manage obstetrical emergencies. We sought to profile the current obstetrical training curricula through a survey of U.S. training programs. Methods: We sent a web-based survey covering the four most common obstetrical emergencies (pre-eclampsia/eclampsia, postpartum hemorrhage (PPH), shoulder dystocia, and breech presentation) through email invitations to all program directors (PD) of U...
January 2018: Western Journal of Emergency Medicine
D M Wei, Z Z Zhang, Z Wang, P Li, J F Wang, Y J Liu, J T Zhang, Y H Shi
Objective: To compare the difference in risks of obstetric complications of singleton pregnancy between women with hyperandrogenic polycystic ovary syndrome (PCOS) and women with normoandrogenic PCOS. Methods: Prospective cohort study. This study was a secondary analysis of data collected during a multicenter randomized controlled clinical trial. Women who got clinical singleton pregnancy were grouped according to whether they were diagnosed with hyperandrogenism at baseline. There were 118 women with hyperandrogenism and 366 women without hyperandrogenism...
January 25, 2018: Zhonghua Fu Chan Ke za Zhi
Vanessa L Short, Stacie E Geller, Janet L Moore, Elizabeth M McClure, Shivaprasad S Goudar, Sangappa M Dhaded, Bhalachandra S Kodkany, Sarah Saleem, Farnaz Naqvi, Omrana Pasha, Robert L Goldenberg, Archana B Patel, Patricia L Hibberd, Ana L Garces, Marion Koso-Thomas, Menachem Miodovnik, Dennis D Wallace, Richard J Derman
OBJECTIVE:  The objective of this study was to describe the relationship between early pregnancy body mass index (BMI) and maternal, perinatal, and neonatal outcomes in rural India and Pakistan. STUDY DESIGN:  In a prospective, population-based pregnancy registry implemented in communities in Thatta, Pakistan and Nagpur and Belagavi, India, we obtained women's BMI prior to 12 weeks' gestation (categorized as underweight, normal, overweight, and obese following World Health Organization criteria)...
January 24, 2018: American Journal of Perinatology
Salim Baghli, Catherine Abendroth, Umar Farooq, Jennifer A Schaub
The cause of acute kidney injury during pregnancy and in the postpartum period can be particularly challenging to diagnose, especially when it is necessary to differentiate among preeclampsia; eclampsia; hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome; and thrombotic microangiopathies (TMAs). All these disease entities can present with kidney failure, microangiopathic hemolytic anemia, and thrombocytopenia. We present a teaching case of atypical hemolytic uremic syndrome in the postpartum period in a young woman who was found to have mutations of uncertain clinical significance in the complement cascade, including in C3, CFH, and CFI...
January 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Lisbet S Lundsberg, Henry C Lee, Grace Villarin Dueñas, Kimberly D Gregory, Holly K Grossetta Nardini, Christian M Pettker, Jessica L Illuzzi, Xiao Xu
OBJECTIVE: To assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices. METHODS: Data for this study came from a statewide survey of obstetric hospitals in California regarding their organization and delivery of perinatal care. We analyzed responses from 185 hospitals that completed quality assurance sections of the survey to assess their practices in a broad spectrum of quality enhancement activities...
February 2018: Obstetrics and Gynecology
Linda M Biesty, Aoife M Egan, Fidelma Dunne, Eugene Dempsey, Pauline Meskell, Valerie Smith, G Meabh Ni Bhuinneain, Declan Devane
BACKGROUND: Gestational diabetes is a type of diabetes that occurs during pregnancy. Women with gestational diabetes are more likely to experience adverse health outcomes such as pre-eclampsia or polyhydramnios (excess amniotic fluid). Their babies are also more likely to have health complications such as macrosomia (birthweight > 4000 g) and being large-for-gestational age (birthweight above the 90th percentile for gestational age). Current clinical guidelines support elective birth, at or near term in women with gestational diabetes to minimise perinatal complications, especially those related to macrosomia...
January 5, 2018: Cochrane Database of Systematic Reviews
Katrina M Mirabito Colafella
In a recent issue of Clinical Science, Stanhewicz et al. investigated persistent microvascular dysfunction in women up to 16 months postpartum. The authors found sensitivity to the pressor effects of endothelin-1 (ET-1) was enhanced when compared with women who had a normotensive pregnancy. Importantly, the authors demonstrated that this effect was mediated via the endothelin type B (ETB) receptors. Therefore, the present study highlights the possibility that alterations in the localization of the ETB receptor contributes to the pathogenesis of pre-eclampsia and future cardiovascular disease (CVD) risk...
January 16, 2018: Clinical Science (1979-)
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