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https://www.readbyqxmd.com/read/29761476/comparison-of-materno-fetal-predictors-and-short-term-outcomes-between-early-and-late-onset-pre-eclampsia-in-the-low-income-setting-of-douala-cameroon
#1
Charlotte Tchente Nguefack, Annabel Ako Mangwi, Anastase Dzudie Tamdja, Théophile Nana Njamen, Paul Nkemtendong Tolefack, Emile Mboudou
OBJECTIVE: To describe and compare materno-fetal predictors and short-term outcomes of early onset pre-eclampsia (EOPE) and late onset pre-eclampsia (LOPE) in Douala, Cameroon. METHODS: The present prospective hospital-based cross-sectional study included women with pre-eclampsia attending obstetric units at four hospitals in Douala between December 1, 2016, and April 30, 2017. To determine maternal predictors, sociodemographic and medical data were recorded using a pretested questionnaire...
May 14, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29725629/acute-kidney-injury-in-pregnancy-the-changing-landscape-for-the-21st-century
#2
REVIEW
Swati Rao, Belinda Jim
Pregnancy-related acute kidney injury (Pr-AKI) remains a large public health problem, with decreasing incidences in developing countries but seemingly increasing incidences in the United States and Canada. These epidemiologic changes are reflective of the advances in medical and obstetric care, as well as changes in underlying maternal risk factors. The risk factors associated with advanced maternal age, such as hypertension, diabetes, chronic kidney disease, and those associated with reproductive technologies such as multiple gestations, are increasing...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29717384/the-complement-alternative-pathway-and-preeclampsia
#3
REVIEW
Layan Alrahmani, Maria Alice V Willrich
PURPOSE OF REVIEW: Significant and intricate immune adaptations are essential for the establishment and maintenance of normal pregnancy. Preeclampsia is a morbid, potentially life-threatening disease for both mother and neonate that occurs uniquely in pregnancy, at least in part, due to maternal immune maladaptation. We aim to review the literature that focuses on case reports, diagnostic approaches, and treatment strategies for disorders of the complement alternative pathway (CAP) as related to preeclampsia...
May 1, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29699420/analysis-of-preventability-of-hypertensive-disorder-in-pregnancy-related-maternal-death-using-the-nationwide-registration-system-of-maternal-deaths-in-japan
#4
Shinji Katsuragi, Hiroaki Tanaka, Junichi Hasegawa, Masamitsu Nakamura, Naohiro Kanayama, Masahiko Nakata, Takeshi Murakoshi, Jun Yoshimatsu, Kazuhiro Osato, Kayo Tanaka, Akihiko Sekizawa, Isamu Ishiwata, Tomoaki Ikeda
OBJECTIVE: Hypertensive disorder of pregnancy (HDP) is a major cause of maternal death. The goal of this study was to investigate factors associated with maternal death due to HDP. STUDY DESIGN: HDP-related maternal deaths in Japan reported to the Committee of the Ministry of Health, Labor and Welfare from 2010 to 2015 were examined. RESULTS: Out of 47 cases of HDP, 30 were identified as the major cause of maternal death. The median maternal age was 34 years (range 24-45) and the mortality in women aged ≥40 years was seven times higher that than in women aged <34 years...
April 26, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29697379/-hypertension-of-pregnancy-associated-with-hypergomocysteinemia-of-the-first-trimester-of-pregnancy
#5
Ak Tussupkaliyev, A Gaiday, S Bermagambetova, R Aniuliene
In this study, the association of high homocysteine concentrations (>10 μmol/L) of pregnant women with hypertensive disorders during pregnancy was studied, as well as other complications of pregnancy, such as loss of pregnancy in the first half, premature birth, intrauterine growth retardation, congenital malformations development of the fetus. A single-center prospective cohort study was conducted. Depending on the concentration of homocysteine detected by the immunoenzyme assay with monoclonal antibodies Homocysteine EIA ELISA (Axis-Shield Diagnostics Ltd, Scotland), for a period of up to 14 weeks, the subjects were divided into 2 groups: with high concentrations (>10 μmol/L) and normal levels (<10 μmol/L)...
March 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29691249/hypertensive-pregnancy-complications-in-women-with-epilepsy-and-antiepileptic-drugs-a-population-based-cohort-study-of-first-pregnancies-in-norway
#6
Kim Christian Danielsson, Ingrid Borthen, Nils-Halvdan Morken, Nils Erik Gilhus
OBJECTIVES: To estimate the risk of hypertensive pregnancy complications in women with epilepsy, with and without antiepileptic drugs, and assess the risk associated with the four most common antiepileptic drugs. DESIGN: A population-based cohort study using linked data from the Medical Birth Registry of Norway and the Norwegian Prescription Database. Women with epilepsy with and without antiepileptic drugs were compared with women without epilepsy. SETTING: Norway, 2004-2012...
April 24, 2018: BMJ Open
https://www.readbyqxmd.com/read/29674195/thrombotic-microangiopathies-of-pregnancy-differential-diagnosis
#7
REVIEW
M Gupta, B B Feinberg, R M Burwick
Thrombotic microangiopathy (TMA) disorders are characterized by microangiopathic hemolytic anemia, thrombocytopenia and end-organ injury. In pregnancy and postpartum, TMA is most commonly encountered with HELLP (hemolysis, elevated liver enzymes, low platelet count syndrome) or preeclampsia with severe features, but rarely TMA is due to thrombotic thrombocytopenic purpura (TTP) or atypical hemolytic uremic syndrome (aHUS). Due to overlapping clinical and laboratory features, TTP and aHUS are often mistaken for preeclampsia or HELLP...
February 16, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29673002/incidence-of-and-risk-factors-for-severe-maternal-complications-associated-with-hypertensive-disorders-after-36-weeks-gestation-in-uncomplicated-twin-pregnancies-a-prospective-cohort-study
#8
Ryo Yamamoto, Keisuke Ishii, Haruka Muto, Shiyo Ota, Haruna Kawaguchi, Shusaku Hayashi, Nobuaki Mitsuda
AIM: To elucidate the incidence of and risk factors for severe hypertensive disorders (HD) and related maternal complications in uncomplicated twin pregnancies that reached 36 weeks' gestation. METHODS: We conducted a prospective cohort study of twin pregnancies delivered after 36 weeks' gestation. Cases of twin-twin transfusion syndrome, twin anemia-polycythemia sequence, malformed fetuses, monoamniotic twins, selective reduction, fetal therapy and HD or fetal death before 35 weeks' gestation were excluded...
April 19, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29662967/maternal-serum-uric-acid-level-and-maternal-and-neonatal-complications-in-preeclamptic-women-a-cross-sectional-study
#9
Maryam Asgharnia, Fariba Mirblouk, Soudabeh Kazemi, Davood Pourmarzi, Mina Mahdipour Keivani, Seyedeh Fatemeh Dalil Heirati
Background: Preeclampsia is associated with maternal and neonatal complications. It has been indicated that increased uric acid might have a predictive role on preeclampsia. Objective: We aimed to investigate the relationship between the level of uric acid with maternal and neonatal complications in women with preeclampsia. Materials and Methods: In this cross-sectional study, 160 singleton preeclamptic women at more than 28 wk gestational age were included...
September 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/29644153/acute-fatty-liver-of-pregnancy-a-thorough-examination-of-a-harmful-obstetrical-syndrome-and-its-counterparts
#10
Joshua Ronen, Shahzeb Shaheen, David Steinberg, Kevin R Justus
Diagnosed in one of every 20,000 deliveries, acute fatty liver of pregnancy (AFLP) was considered to be a deadly disease for many years. However, advancements in the clinical and surgical management of pregnant mothers have lead to a drastic decrease in maternal morbidity and mortality. The corresponding case recounts a 23-year-old gravida 2 para 1 (G2P1) at 38 weeks gestational age (GA) with no relevant past medical or family medical history that presented to the emergency department (ED) with a five-day history of nausea, protracted vomiting, hypertension, and new-onset headache...
February 6, 2018: Curēus
https://www.readbyqxmd.com/read/29563339/germline-mutations-in-the-alternative-pathway-of-complement-predispose-to-hellp-syndrome
#11
Arthur J Vaught, Evan M Braunstein, Jagar Jasem, Xuan Yuan, Igor Makhlin, Solange Eloundou, Andrea C Baines, Samuel A Merrill, Shruti Chaturvedi, Karin Blakemore, C John Sperati, Robert A Brodsky
BACKGROUND: HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome is a severe variant of hypertensive disorders of pregnancy affecting approximately 1% of all pregnancies, and has significant maternal and fetal morbidity. Previously, we showed that upregulation of the alternative pathway of complement (APC) plays a role in HELLP syndrome. We hypothesize that HELLP syndrome follows a 2-hit disease model similar to atypical hemolytic uremic syndrome (aHUS), requiring both genetic susceptibility and an environmental risk factor...
March 22, 2018: JCI Insight
https://www.readbyqxmd.com/read/29478361/hepatic-rupture-associated-with-preeclampsia-report-of-three-cases-and-literature-review
#12
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
https://www.readbyqxmd.com/read/29466901/modified-isth-pregnancy-specific-dic-score-in-parturients-with-liver-rupture-population-based-case-series
#13
Ranit Hizkiyahu, Anat Rabinovich, Jecko Thachil, Eyal Sheiner, Gad Shaked, Gilbert Sebbag, Eli Maymon, Offer Erez
OBJECTIVES: Liver rupture and hematoma are rare life-threatening complications of pregnancy. The aims of the current study are to: (1) characterize in a population-based study all cases of liver hematoma and/or rupture; and (2) validate the utility of the International Society on Thrombosis and Haemostasis (ISTH) modified pregnancy specific disseminated intravascular coagulation (DIC) score in those cases. STUDY DESIGN: A retrospective cohort study including all patients with liver subcapsular hematoma or rupture between the years 1996 and 2012 was conducted...
February 21, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29450378/ocular-posterior-pole-pathological-modifications-related-to-complicated-pregnancy-a-review
#14
REVIEW
Vanessa Andrada Păun, Zamfir-Radu Ionescu, Liliana Voinea, Monica Cîrstoiu, Alexandru Baroș, Ștefan Pricopie, Radu Ciuluvică
Ocular posterior pole modification are a pathological manifestation in complicated pregnancies, especially when pregnancy induced hypertension is present (PIH), as well as in preeclampsia (PE) or eclampsia. Nonetheless, as the pregnancy evolves, the possibility for an aggravated evolution with HELLP syndrome, disseminated intravascular coagulation, and idiopathic thrombocytopenic purpura may have an ocular manifestation that, mainly, implies a loss of visual field or acuity, that, left unattended, may constitute a permanent impairment...
April 2017: Romanian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29430625/hellp-syndrome-risk-factors-in-first-and-second-pregnancy-a-population-based-cohort-study
#15
Ola Malmström, Nils-Halvdan Morken
INTRODUCTION: HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) may have specific risk factors and risk factors varying from first to second pregnancy. The aims of the study were to estimate the risk of HELLP syndrome by potential risk factors in first and second pregnancy, respectively. MATERIAL AND METHODS: A population-based cohort study including all women in Norway having their first baby (≥22 gestational weeks) during 1999 to 2014, registered in the Medical Birth Registry (n = 418 897)...
February 11, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29403592/management-of-retinal-diseases-in-pregnant-patients
#16
REVIEW
Julie M Rosenthal, Mark W Johnson
Pregnancy leads to significant changes in the body, which potentially affect the retina. Pregnancy can induce disease, such as that seen in hypertensive retinopathy and choroidopathy. It can cause exudative retinal detachments in the HELLP syndrome (hemolysis, elevated liver enzymes and low platelets), disseminated intravascular coagulation (DIC), and thrombotic thrombocytopenic purpura (TTP), and provoke arterial and venous retinal occlusive disease. Pregnancy may also exacerbate pre-existing retinal disease, such as idiopathic central serous chorioretinopathy (ICSC) and diabetic retinopathy...
January 2018: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/29348275/microangiopathies-in-pregnancy
#17
Jailan Elayoubi, Kavitha Donthireddy, Divyesh Reddy Nemakayala
Thrombotic thrombocytopenic purpura (TTP) is a potentially reversible, life-threatening medical emergency. We present a case of a 21-year-old female with evidence of haemolytic anaemia based on the presence of positive markers of haemolysis. Negative Coomb's test, thrombocytopenia and placental infarcts raised suspicion for a thrombotic microangiopathy. She was diagnosed with TTP and managed with emergency plasma exchange. Her recovery was immediate.A presumptive diagnosis of TTP should be based on the presence of microangiopathic haemolytic anaemia with thrombocytopenia and plasma exchange should be initiated while complete work up is pending...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29345041/serum-amyloid-a-procalcitonin-highly-sensitive-c-reactive-protein-and-tumor-necrosis-factor-alpha-levels-and-acute-inflammatory-response-in-patients-with-hemolysis-elevated-liver-enzymes-low-platelet-count-hellp-and-eclampsia
#18
Kazım Uckan, Hanım Guler Sahin
AIM: The aim of this study was to determine the relationship between serum amyloid A (SAA), procalcitonin (ProC), highly sensitive C reactive protein (hsCRP) and tumor necrosis factor (TNF) alpha activity in patients with pre-eclampsia, eclampsia and hemolysis, elevated liver enzymes, low platelet count (HELLP), and the pathogenesis and severity of the disease. METHOD: Ninety patients at ≥ 32 gestational weeks, according to the last date of menstruation and ultra-sonographic measurements, diagnosed with pre-eclampsia (30 patients), eclampsia (30 patients) or HELLP syndrome (30 patients) were included in the study...
March 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29331477/atypical-presentation-of-pregnancy-related-hemolytic-uremic-syndrome
#19
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
https://www.readbyqxmd.com/read/29321548/role-and-mechanism-of-at1-aa-in-the-pathogenesis-of-hellp-syndrome
#20
Shurui Bu, Yuxian Wang, Shuqing Sun, Yanqian Zheng, Zhu Jin, Jianming Zhi
HELLP syndrome remains a leading cause of maternal and neonatal mortality and morbidity worldwide, which symptoms include hemolysis, elevated liver enzymes and low platelet count. The objective of this study was to determine whether HELLP is associated with AT1-AA. The positive rate and titer of AT1-AA in plasma from pregnant women were determined, and the correlation of AT1-AA titer with the grade of HELLP was analyzed. A HELLP rat model established by intravenous injection of AT1-AA. Our experimental results show the AT1-AA titer and positive rate were significantly higher in HELLP group, and AT1-AA titer were positively correlated with the level of TNF-α and ET-1 in plasma and the grade of HELLP syndrome...
January 10, 2018: Scientific Reports
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