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https://www.readbyqxmd.com/read/28176472/suspected-atypical-haemolytic-uraemic-syndrome-in-two-post-partum-patients-with-foetal-death-in-utero-responding-to-eculizumab
#1
REVIEW
Justin Chua, Kathy Paizis, Simon Z He, Peter Mount
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) is a rare condition with the triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Other conditions that present in a similar manner peri-partum include thrombotic thrombocytopaenic purpura, and pregnancy associated conditions including HELLP syndrome (haemolysis, elevated liver enzymes and low platelets), severe pre-eclampsia and less commonly acute fatty liver of pregnancy. CASE REPORTS: We describe two cases of suspected aHUS, who presented post-partum with foetal death-in-utero at 33 and 37 weeks respectively...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28155100/posterior-reversible-encephalopathy-syndrome-in-pregnancy-a-retrospective-series-of-36-patients-from-mainland-china
#2
Y Wen, B Yang, Q Huang, Y Liu
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is associated with variable predisposing risk factors including preeclampsia and eclampsia since it proposed. However, studies of large case series focusing on pregnancy-related PRES are still limited. We performed a large retrospective study of patients with pregnancy-related PRES admitted to our institution. METHODS: This was a single-center, 2010-2015 retrospective cohort study of patients with pregnancy-related PRES who underwent neuroimaging via magnetic resonance imaging or computerized tomography from mainland China...
February 2, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28136130/integrin-%C3%AE-8-is-abundant-in-human-rat-and-mouse-trophoblasts
#3
Sebastian Herdl, Hanna Huebner, Gudrun Volkert, Ines Marek, Carlos Menendez-Castro, Stephanie C Noegel, Matthias Ruebner, Wolfgang Rascher, Andrea Hartner, Fabian B Fahlbusch
OBJECTIVE: Integrins exert regulatory functions in placentogenesis. Null mutation of certain integrin α subunits leads to placental defects with subsequent fetal growth restriction or embryonic lethality in mice. So far, the placental role of α8 integrin remains to be determined. METHODS: Localization of α8 integrin and its ligands, fibronectin (FN) and osteopontin (OPN), was studied by immunohistochemistry in human, rat, and mouse placenta. The vascularization of the placental labyrinth layer of α8 integrin-deficient mice was determined by CD31 staining...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28132012/use-of-magnesium-sulfate-before-32%C3%A2-weeks-of-gestation-a-european-population-based-cohort-study
#4
H T Wolf, L Huusom, T Weber, A Piedvache, S Schmidt, M Norman, J Zeitlin
OBJECTIVES: The use of magnesium sulfate (MgSO4) in European obstetric units is unknown. We aimed to describe reported policies and actual use of MgSO4 in women delivering before 32 weeks of gestation by indication. METHODS: We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort study of births before 32 weeks of gestation in 19 regions in 11 European countries. Data were collected from April 2011 to September 2012 from medical records and questionnaires...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28130929/use-of-antenatal-corticosteroids-in-special-circumstances-a-comprehensive-review
#5
Everett F Magann, Kjell Haram, Songthip Ounpraseuth, Jan Helge Mortensen, Horace J Spencer, John C Morrison
OBJECTIVE: To determine in pregnancies complicated by preterm premature rupture of membranes (PPROM), hypertension, intrauterine growth restriction, multi-fetal gestations and pregnancies 23- 26 weeks≥ 34 weeks gestation whether antenatal corticosteroids benefit the fetus. DATA SOURCES: Literature review using PubMed, Web of Science, Clinical trials. gov, Cochrane Database of Systematic Reviews (1990 - 2015). METHODS OF STUDY SELECTION: Search terms linked special circumstances with corticosteroids...
January 28, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28128518/maternal-and-neonatal-outcomes-in-women-with-severe-early-onset-pre-eclampsia-before-26-weeks-of-gestation-a-case-series
#6
M F van Oostwaard, L van Eerden, M W de Laat, J J Duvekot, Jjhm Erwich, Kwm Bloemenkamp, A C Bolte, Jpf Bosma, S V Koenen, R F Kornelisse, B Rethans, P van Runnard Heimel, Hcj Scheepers, W Ganzevoort, Bwj Mol, C J de Groot, Ipm Gaugler-Senden
OBJECTIVE: To describe the maternal and neonatal outcomes and prolongation of pregnancies with severe early onset pre-eclampsia before 26 weeks of gestation. DESIGN: Nationwide case series. SETTING: All Dutch tertiary perinatal care centres. POPULATION: All women diagnosed with severe pre-eclampsia who delivered between 22 and 26 weeks of gestation in a tertiary perinatal care centre in the Netherlands, between 2008 and 2014...
January 27, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28109137/color-vision-abnormality-as-the-sole-manifestation-of-posterior-reversible-encephalopathy-due-to-post-partum-hellp-syndrome
#7
Hironori Takahashi, Teppei Matsubara, Shinji Makino, Kenji Horie, Shigeki Matsubara
Posterior reversible encephalopathy syndrome (PRES) is associated with several symptoms; of those, visual acuity loss, light oversensitivity (photophobia), and light flashes (photopsia) are known as PRES-related eye symptoms. We report a post-partum woman with PRES associated with hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP), in whom color vision abnormality (achromatopsia) was the sole manifestation. Cesarean section was performed at 28 weeks due to headache, epigastralgia, and severe hypertension...
January 21, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28106904/planned-early-delivery-versus-expectant-management-for-hypertensive-disorders-from-34-weeks-gestation-to-term
#8
REVIEW
Catherine Cluver, Natalia Novikova, Corine M Koopmans, Helen M West
BACKGROUND: Hypertensive disorders in pregnancy are significant contributors to maternal and perinatal morbidity and mortality. These disorders include well-controlled chronic hypertension, gestational hypertension (pregnancy-induced hypertension) and mild pre-eclampsia. The definitive treatment for these disorders is planned early delivery and the alternative is to manage the pregnancy expectantly if severe uncontrolled hypertension is not present, with close maternal and fetal monitoring...
January 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28092247/-emergency-obstetric-causes-and-immediate-response-team-in-a-secondary-hospital
#9
Luis Rafael López-Ocaña, Norma Angélica Hernández-Pineda, Polita Rocío Cruz-Cruz, Manuel Ramiro-H, Víctor Octavio Pérez Del Valle-Ibarra
BACKGROUND: The aim of this work is to describe the causes of the obstetric emergency, which motivates the activation of the Immediate Response Team at a second level hospital of the Instituto Mexicano del Seguro Social, which has not an Intensive Care Unit for Adult Patients. METHODS: Retrospective observational study of the causes of obstetric emergency that occurred in the domains of Admission, Hospitalization, Labor, Delivery Room, Operating Room and Recovery of the Hospital General de Zona 53 of the IMSS, during the years 2014 and 2015...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28068990/risk-factors-for-severe-postpartum-hemorrhage-a-case-control-study
#10
Lill Trine Nyfløt, Irene Sandven, Babill Stray-Pedersen, Silje Pettersen, Iqbal Al-Zirqi, Margit Rosenberg, Anne Flem Jacobsen, Siri Vangen
BACKGROUND: In high-income countries, the incidence of severe postpartum hemorrhage (PPH) has increased. This has important public health relevance because severe PPH is a leading cause of major maternal morbidity. However, few studies have identified risk factors for severe PPH within a contemporary obstetric cohort. METHODS: We performed a case-control study to identify risk factors for severe PPH among a cohort of women who delivered at one of three hospitals in Norway between 2008 and 2011...
January 10, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28067720/swept-source-optical-coherence-tomography-evaluation-of-chorioretinal-changes-in-hypertensive-choroidopathy-related-to-hellp-syndrome
#11
Daniel Velazquez-Villoria, Pablo Marti Rodrigo, Maria L DeNicola, Miguel A Zapata Vitori, Antonio Segura García, Jose García-Arumí
PURPOSE: To report a case of hypertensive choroidopathy with detailed chorioretinal images obtained using swept source optical coherence tomography. METHODS: We report the case of a 36-year-old pregnant woman who presented with extensive bilateral exudative retinal detachments (visual acuity of hands movement bilaterally), high blood pressure, and severe alteration of the laboratory test results resulting in the diagnosis of HELLP syndrome. The baby was delivered by emergency cesarean section and the patient was hospitalized in the intensive care unit...
January 6, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28028148/strokes-associated-with-pregnancy-and-puerperium-a-nationwide-study-by-the-japan-stroke-society
#12
Kazumichi Yoshida, Jun C Takahashi, Yohei Takenobu, Norihiro Suzuki, Akira Ogawa, Susumu Miyamoto
BACKGROUND AND PURPOSE: The incidence and cause of strokes associated with pregnancy and the puerperium are still not fully understood. The aim of this study was to characterize pregnancy-related strokes in Japan using a large-scale survey with current imaging techniques. METHODS: A retrospective analysis was conducted based on clinical chart reviews in 736 stroke teaching hospitals certified by the Japan Stroke Society between 2012 and 2013, using a web-based questionnaire requesting the detailed clinical course without any personally identifying information...
December 27, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28005587/diagnosis-and-management-of-hellp-syndrome-complicated-by-liver-hematoma
#13
Agnès Ditisheim, Baha M Sibai
Subcapsular liver hematoma is a rare but potentially life-threatening complication of preeclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome. It may present with nonspecific signs and symptoms, none of which are diagnostic, and can mimic pulmonary embolism of cholecystitis. There is no consensus on the management of subcapsular liver hematoma. Unruptured liver hematoma can be conservatively managed. When rupture occurs, surgical, endovascular approaches and, rarely, liver transplantation, may be required...
March 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28004456/maternal-endothelial-function-and-vascular-stiffness-after-hellp-syndrome-a-case-control-study
#14
Rossana Orabona, Edoardo Sciatti, Enrico Vizzardi, Ivano Bonadei, Federico Prefumo, Adriana Valcamonico, Marco Metra, Tiziana Frusca
OBJECTIVES: To assess endothelial function and arterial stiffness in women with a previous pregnancy complicated by haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, and compare them with women with a previous preeclampsia (PE) without HELLP and controls with uncomplicated pregnancies. METHODS: Women who have had a singleton pregnancy complicated by PE with (n = 49) or without (n = 60) HELLP syndrome and controls (n = 60) underwent peripheral arterial tonometry (EndoPAT method) and pulse wave velocity (PWV) assessment at 6 months-4 years after delivery...
December 22, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27939487/cerebrospinal-fluid-levels-of-tau-and-phospho-tau-181-proteins-during-pregnancy
#15
Wolfgang Lederer, Cristina Alomar Dominguez, Marina Popovscaia, Günther Putz, Christian Humpel
OBJECTIVES: During pregnancy various interactions occur between structural alterations of the maternal brain and placental metabolism. The aim of the present study was to investigate whether cerebrospinal fluid concentrations of tau and phospho-tau-181 protein vary during normal pregnancy and in women with preeclampsia and HELLP syndrome. STUDY DESIGN: We measured cerebrospinal fluid biomarkers, tau and phospho-tau-181 protein levels in 90 pregnant women electively assigned for regional anaesthesia during pregnancy or for cesarean section using enzyme-linked immunosorbent assays...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27935907/eclampsia-feto-maternal-outcomes-in-a-tertiary-care-centre-in-eastern-nepal
#16
S Ghimire
INTRODUCTION: Eclampsia is a preventable and treatable cause of maternal morbidity and mortality with poor feto-maternal outcome in developing countries. Despite development in the level of health education expertise in human resources and institutional obstetric care in our country, the delay in early recognition of the problem, transportation to proper health facility and getting proper expert care are major hurdles to reduce complications. Therefore, we decided to study feto-maternal outcomes in our setting...
January 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27927881/brain-abscess-due-to-listeria-monocytogenes-after-hellp-syndrome-in-a-patient-with-antiphospholipid-syndrome
#17
A Fervienza, M Bodro, P Castro, S Hernández, I Teixidó, G Espinosa, R Cervera
OBJECTIVE: To illustrate an unusual case of Listeria cerebral abscess. MATERIAL AND METHODS: A 32-year-old pregnant woman with thrombotic antiphospholipid syndrome (APS) received corticotherapy for two weeks due to hemolysis, elevated liver enzymes, low platelet (HELLP) syndrome. After delivery she presented with neurological symptoms and fever. RESULTS: The MRI scan confirmed the presence of a brain abscess, and Listeria monocytogenes was isolated in blood cultures...
December 6, 2016: Lupus
https://www.readbyqxmd.com/read/27914214/antithrombin-improves-the-maternal-and-neonatal-outcomes-but-not-the-angiogenic-factors-in-extremely-growth-restricted-fetuses-at-28-weeks-of-gestation
#18
Midori Fujisaki, Ken Furuta, Masanao Ohhashi, Seishi Furukawa, Yuki Kodama, Yasuyuki Kawagoe, Hiroshi Sameshima, Tsuyomu Ikenoue
AIMS: Severe preterm fetal growth restriction (FGR) remote from term is problematic. We aimed to investigate the effect of maternally-administered antithrombin on maternal and neonatal outcomes. A prospective, one-arm, pilot study was performed in 14 women with severe FGR (≤5th centile) at <28 weeks of gestation, without hypertensive disorders. Maternal plasma concentrations of soluble Feline McDonough Sarcoma (FMS)-like trypsin kinase-1 (sFlt-1) and placental growth factor (PlGF) were measured and categorized into three groups: group 1; low sFlt-1 and high PlGF, group 2; moderate sFlt-1 and low PlGF, and group 3; high sFlt-1 and low PlGF...
December 3, 2016: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27868334/consensus-on-the-standardization-of-terminology-in-thrombotic-thrombocytopenic-purpura-and-related-thrombotic-microangiopathies
#19
M Scully, S Cataland, P Coppo, J de la Rubia, K D Friedman, J Kremer Hovinga, B Lämmle, M Matsumoto, K Pavenski, E Sadler, R Sarode, H Wu
: Essentials An international collaboration provides a consensus for clinical definitions. This concerns thrombotic microangiopathies and thrombotic thrombocytopenic purpura (TTP). The consensus defines diagnosis, disease monitoring and response to treatment. Requirements for ADAMTS-13 are given. SUMMARY: Background Thrombotic thrombocytopenic purpura (TTP) and hemolytic-uremic syndrome (HUS) are two important acute conditions to diagnose. Thrombotic microangiopathy (TMA) is a broad pathophysiologic process that leads to microangiopathic hemolytic anemia and thrombocytopenia, and involves capillary and small-vessel platelet aggregates...
November 21, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27854396/maternal-cardiac-function-after-hellp-syndrome-an-echocardiographic-study
#20
Rossana Orabona, Enrico Vizzardi, Edoardo Sciatti, Federico Prefumo, Ivano Bonadei, Adriana Valcamonico, Marco Metra, Tiziana Frusca
OBJECTIVES: To evaluate maternal hemodynamics in asymptomatic women with a pregnancy complicated by hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, and compare it with patients with a previous preeclampsia (PE) and controls with uncomplicated pregnancies. METHODS: Women with a history of PE (n = 60) or HELLP syndrome (n = 49) and matched healthy controls (n = 60) underwent an echocardiographic examination 6 months-4 years after delivery, recording left ventricular (LV) dimensions, ejection fraction (LVEF) and mass, right ventricular (RV) tricuspid annular plane systolic movement (TAPSE) and fractional area changing (FAC)...
November 10, 2016: Ultrasound in Obstetrics & Gynecology
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