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Maternal Cardiac Disease

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https://www.readbyqxmd.com/read/28100569/multiple-pregnancy-in-a-primigravida-with-uncorrected-pentalogy-of-fallot
#1
Pamela Partana, Jarrod Kah Hwee Tan, Ju Le Tan, Lay Kok Tan
Pentalogy of Fallot is a cyanotic congenital heart disease that has guarded prognosis without surgical intervention in infancy. Women with uncorrected defects rarely survive into childbearing age and pregnancy in this group is associated with a high rate of perinatal loss. Physiological cardiovascular changes in pregnancy can lead to maternal haemodynamic instability with subsequent adverse cardiac sequelae with or without fetal decompensation. Optimum management and pregnancy outcomes in mother with uncorrected Pentalogy of Fallot and twin pregnancy have not been described in the literature...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28099107/case-238-spontaneous-pneumothorax-secondary-to-intrapulmonary-necrobiotic-rheumatoid-nodule
#2
Ammar A Chaudhry, Maryam Gul, Abbas A Chaudhry, William Moore
History A 54-year-old white woman with a history of rheumatoid arthritis who was taking glucocorticoids and methotrexate presented to the emergency department in December with worsening shortness of breath and chest heaviness for 1 week. She reported additional symptoms of weakness, headache, and arthralgia primarily involving her bilateral hands, wrist, ankles, and feet. She denied experiencing fevers, syncope or presyncope, focal neurologic deficits, chest pain, nausea, vomiting, unintentional weight loss, or recent trauma...
February 2017: Radiology
https://www.readbyqxmd.com/read/28094006/salt-aldosterone-and-extrarenal-na-sensitive-responses-in-pregnancy
#3
Paula Juliet Scaife, Markus Georg Mohaupt
Outside of pregnancy excessive salt consumption is known to be harmful being linked to increased blood pressure and cardiovascular disease. However, pregnancy represents a major change to a woman's physiology resulting in an intimate adaptation to environmental conditions. It is now becoming apparent that salt is essential for a number of these changes during pregnancy including haematological, cardiac adaptations as well as directly influencing placental development and the uteroplacental immune environment...
January 10, 2017: Placenta
https://www.readbyqxmd.com/read/28054412/identifying-birth-defects-in-automated-data-sources-in-the-vaccine-safety-datalink
#4
Elyse Olshen Kharbanda, Gabriela Vazquez-Benitez, Paul A Romitti, Allison L Naleway, T Craig Cheetham, Heather S Lipkind, Shanthi Sivanandam, Nicola P Klein, Grace M Lee, Michael L Jackson, Simon J Hambidge, Avalow Olsen, Natalie McCarthy, Frank DeStefano, James D Nordin
PURPOSE: The Vaccine Safety Datalink (VSD), a collaboration between the Centers for Disease Control and Prevention and several large healthcare organizations, aims to monitor safety of vaccines administered in the USA. We present definitions and prevalence estimates for major structural birth defects to be used in studies of maternal vaccine safety. METHODS: In this observational study, we created and refined algorithms for identifying major structural birth defects from electronic healthcare data, conducted formal chart reviews for severe cardiac defects, and conducted limited chart validation for other defects...
January 4, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28051234/neonatal-lupus-erythematosus-with-congenital-heart-block-in-twins
#5
Lamia Gargouri, Faiza Safi, Bayen Maalej, Souad Mallek, Fatma Turki, Imen Majdoub, Malek Akrout, Dorra Abid, Samir Kamoun, Abdelmajid Mahfoudh
Background - Neonatal lupus erythematosus is an uncommon acquired autoimmune disease caused by transplacental passage of maternal antibodies SSA/Ro, SSB/La or U1 ribonucleoproteins. The most common clinical manifestations are skin rash, cardiac lesions, thrombocytopenia, anemia and hepatosplenomegaly. Complete congenital heart block is usually irreversible needing a pacemaker implantation in two-thirds of cases. Cases report - We report neonatal lupus erythematosus with complete congenital heart block in twins...
July 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28049534/case-report-maternal-mosaicism-resulting-in-inheritance-of-a-novel-gata6-mutation-causing-pancreatic-agenesis-and-neonatal-diabetes-mellitus
#6
Daphne Yau, Elisa De Franco, Sarah E Flanagan, Sian Ellard, Miriam Blumenkrantz, John J Mitchell
BACKGROUND: Haploinsufficiency of the GATA6 transcription factor gene was recently found to be the most common cause of pancreatic agenesis, a rare cause of neonatal diabetes mellitus. Although most cases are de novo, we describe three siblings with inherited GATA6 haploinsufficiency and the rare finding of parental mosaicism. CASE PRESENTATION: The proband was born at term with severe intrauterine growth restriction, the first child of non-consanguineous parents...
January 3, 2017: Diagnostic Pathology
https://www.readbyqxmd.com/read/28045917/impact-of-pregestational-weight-and-weight-gain-during-pregnancy-on-long-term-risk-for-diseases
#7
Ulrika Moll, Håkan Olsson, Mona Landin-Olsson
OBJECTIVE: The aim of this study was to analyse the impact of maternal BMI at start of pregnancy and maternal weight gain during pregnancy on the risk of various diseases later in life. METHODS: In a population-based cohort from southern Sweden, women with at least one delivery registered in the Swedish Medical Birth Register ten or more years before answering a health questionnaire were identified (n = 13,608). Complete data were found in 3,539 women. RESULTS: Women with BMI >25 at start of pregnancy had increased risk of developing obesity (OR 21...
2017: PloS One
https://www.readbyqxmd.com/read/28027841/kawasaki-disease-with-coronary-artery-aneurysms-psychosocial-impact-on-parents-and-children
#8
Nita Chahal, Ahlexxi Jelen, Janet Rush, Cedric Manlhiot, Katherine M Boydell, Renee Sananes, Brian W McCrindle
INTRODUCTION: For those living with Kawasaki disease and coronary artery aneurysms, little is known about the psychosocial burden faced by parents and their children. METHODS: Exploratory, descriptive, mixed-methods design examining survey and interview data about health-related uncertainty, intrusiveness, and self-efficacy. RESULTS: Parents' uncertainty was associated with missed diagnosis, higher income, and maternal education. Higher uncertainty scores among children were associated with absence of chest pain and lower number of echocardiograms...
December 24, 2016: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28006009/mode-of-delivery-and-pregnancy-outcome-in-women-with-congenital-heart-disease
#9
Joris Hrycyk, Harald Kaemmerer, Nicole Nagdyman, Moritz Hamann, Ktm Schneider, Bettina Kuschel
BACKGROUND: Advances in cardiac surgery and congenital cardiology have led to an increasing number of women with congenital heart disease (CHD) reaching childbearing age. In general, cardiologists recommend vaginal delivery for women with CHD to avoid complications from Caesarean section as many women with CHD tolerate vaginal delivery well. METHODS AND RESULTS: This is a single-center study comparing mode of delivery, pregnancy outcome, indications for Caesarean section and induction of labor between women with and without CHD...
2016: PloS One
https://www.readbyqxmd.com/read/28005272/prophylactic-versus-selective-blood-transfusion-for-sickle-cell-disease-in-pregnancy
#10
REVIEW
Babasola O Okusanya, Olufemi T Oladapo
BACKGROUND: Pregnant women with sickle cell disease (HbSS, HbSC and HbSβThal) may require blood transfusion to prevent severe anaemia or to manage potential medical complications. Preventive blood transfusion in the absence of complications starting from the early weeks of pregnancy or blood transfusion only for medical or obstetric indications have been used as management policies. There is currently no consensus on the blood transfusion policy that guarantees optimal clinical benefits with minimal risks for such women and their babies...
22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28002851/prenatal-ultrasonographic-diagnosis-of-cataract-in-utero-manifestations-of-cryptic-disease
#11
Eran Ashwal, Asaf Achiron, Yinon Gilboa, Michal Berkenstadt, Mordecai Rosner, Reuven Achiron
Purpose To report and review our experience with antenatal evaluation for fetuses diagnosed with congenital cataract. Materials and Methods We retrospectively identified pregnancies diagnosed with fetal cataract during antenatal ultrasound. Evaluation of fetal eyes included intraocular anatomy and biometry. Data on fetal malformations, serology and fetal karyotype were collected. Results 8 cases, identified over the course of 10 years, were reviewed. Week 15 was the mean time for diagnosis (range 11 - 34)...
December 21, 2016: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/27994302/modern-strategy-for-identification-of-congenital-heart-defects-in-the-neonatal-period
#12
Mediha Kardasevic, Ida Jovanovic, Jelica Predojevic Samardzic
INTRODUCTION: Congenital heart defects are the most common congenital anomalies and occur with an incidence from 0.8 to 1% per 1000 live births. In recent years, the pulse oximetry has become a strong candidate for detecting cyanogen congenital heart defects and in combination with routine clinical exam can improve diagnostic of congenital heart diseases. OBJECTIVE: To apply the modern algorithm for early detection of congenital heart defects in order to improve the diagnosis in the neonatal period...
October 2016: Medical Archives
https://www.readbyqxmd.com/read/27993911/the-management-of-the-third-stage-of-labour-in-women-with-heart-disease
#13
Matthew Cauldwell, Philip J Steer, Lorna Swan, Anselm Uebing, Michael A Gatzoulis, Mark R Johnson
OBJECTIVE: In women with heart disease (HD), the third stage of labour is managed with a reduced dose of oxytocin because it can have significant adverse cardiovascular effects. However, women with HD have high rates of postpartum haemorrhage (PPH); consequently, we designed a prospective study to investigate whether higher doses of oxytocin can be given safely and would reduce rates of PPH. METHODS: We performed a single centre, prospective, cohort study comparing the standard 'low-dose' oxytocin infusion (10 U of oxytocin in 500 mL of normal saline given intravenously at 36 mL/hour for 4 hours (12 mU/min), n=29) to the low-dose infusion and an additional 2 U of oxytocin given over 10 min immediately after birth (n=30)...
December 19, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27976969/maternal-mortality-cases-from-pulmonary-embolism-a-nation-wide-study-in-turkey
#14
Sema Sanisoğlu, Dilek Uygur, Bekir Keskinkılıç, Yaprak Engin-Üstün, Hüseyin Levent Keskin, Selma Karaahmetoğlu, Ayşe Özcan, Meral Esen, Veli Ongun, Seçil Özkan
The aim of the study was to evaluate the maternal mortality cases attributed to pulmonary embolism (PE). PE constituted 7.58% of maternal deaths in 2013. Risk factors for PE were present in 15 (88.2%) of the women. Five women (29.4%) were overweight, and 5 (29.4%) were obese. Four women (23.5%) had cardiac diseases. PE occurred in the postpartum period after caesarean delivery in 9 (52.9%) patients. Eleven (64.7%) of the maternal deaths were recognised as preventable. More deaths attributed to PE occurred in the postpartum period (n = 11) than the antepartum period (n = 5)...
December 15, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27955851/-maternal-metabolic-diseases-related-to-pre-pregnancy-overweight-and-obesity-in-mexican-women-with-high-risk-pregnancy
#15
Salvador Hernández-Higareda, Omar-Alejandro Pérez-Pérez, Luz-Ma-Adriana Balderas-Peña, Brenda-Eugenia Martínez-Herrera, Ana-Leticia Salcedo-Rocha, Rosa-Emilia Ramírez-Conchas
INTRODUCTION: Pre-pregnancy obesity has been proposed as a risk factor related to gestational diabetes and hypertensive disorders during pregnancy. OBJECTIVES: Identify pregnancy related diseases associated with pre-pregnancy obesity as a risk factor ina high risk preganancy patient population. METHODS: 600 patients whose pre-pregnancy obesity had been assessed as a high risk factor were included in the study. The means, standard deviation, median, interquartile intervals, Pearson and Spearman correlation and logistic regression to estimate risk with the odds ratio and 95% confidence intervals were calculated...
December 9, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27939485/postpartum-physiology-psychology-and-paediatric-follow-up-study-p4-study-study-protocol
#16
Gregory K Davis, Lynne Roberts, George Mangos, Amanda Henry, Franziska Pettit, Anthony O'Sullivan, Caroline S E Homer, Maria Craig, Samuel B Harvey, Mark A Brown
BACKGROUND: Women who have had hypertension in pregnancy are at greater risk of long term cardiovascular disease (CVD). Little is known about their cardiovascular risk postpartum or the effects on the woman's mental health and the outcomes of their infants. In this project we will study the physiological and psychological health of women and the physical health and development of their infants six months, two years and five years after birth. We will establish normal blood pressure (BP) and metabolic function for women who were normotensive in pregnancy and use these to assess women who had gestational hypertension (GH) or preeclampsia (PE)...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27931546/maternal-and-fetal-outcomes-in-pregnant-women-undergoing-balloon-mitral-valvotomy-for-rheumatic-mitral-stenosis
#17
Desabandhu Vinayakumar, G V Vinod, Suresh Madhavan, Mangalath Narayanan Krishnan
BACKGROUND: Rheumatic mitral stenosis constitutes a major cause of acquired heart disease complicating pregnancy in India. In the present study, we have studied the fetal and maternal outcomes of women undergoing balloon mitral valvotomy during pregnancy. METHODS AND RESULTS: 49 pregnant ladies were included in this study in whom balloon mitral valvotomy was performed. The mean age of these patients was 25.7±3.1 years. The mean gestational age was 23.5±5.2 weeks (12-36 weeks)...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27928260/emergency-redo-mitral-valve-replacement-immediately-after-caesarean-section
#18
İbrahim Duvan, Ümit Pınar Sungur, Burak Emre Onuk, Mehmet Şanser Ateş, İbrahim Sami Karacan, Murat Kurtoğlu
Surgery for heart diseases during pregnancy, especially necessitating cardiopulmonary bypass, is believed to trigger maternal and fetal risks and should be performed only when medical therapy has been unsuccessful to alleviate the cardiac decompensation. A 33-year-old pregnant woman in her 33rd week of gestation was admitted to our hospital. She had rheumatic mitral valvular stenosis and had undergone mitral valve replacement (MVR) with a mechanical prosthesis 11 years earlier in another center. Echocardiography revealed a thrombotic mass obstructing the leaflets of the mechanical mitral valve...
April 13, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27919304/green-tea-extract-intake-during-lactation-modified-cardiac-macrophage-infiltration-and-amp-activated-protein-kinase-phosphorylation-in-weanling-rats-from-undernourished-mother-during-gestation-and-lactation
#19
E Matsumoto, S Kataoka, Y Mukai, M Sato, S Sato
Maternal dietary restriction is often associated with cardiovascular disease in offspring. The aim of this study was to investigate the effect of green tea extract (GTE) intake during lactation on macrophage infiltration, and activation of adenosine monophosphate (AMP)-activated protein kinase (AMPK) and serine-threonine kinase Akt (Akt) in the hearts of weanlings exposed to maternal dietary protein restriction. Pregnant Wistar rats were fed control (C) or low-protein diets (LP) throughout gestation. Following delivery, the dams received a control or a GTE-containing control diet during lactation: control diet during gestation and lactation (CC), low-protein diet during gestation and lactation (LPC), low-protein diet during gestation and 0...
December 6, 2016: Journal of Developmental Origins of Health and Disease
https://www.readbyqxmd.com/read/27881387/intrauterine-growth-restriction-influences-vascular-remodeling-and-stiffening-in-the-weanling-rat-more-than-sex-or-diet
#20
R Blair Dodson, Thomas A Miller, Kyle N Powers, Yueqin Yang, Baifeng Yu, Kurt H Albertine, Erin K Zinkhan
Intrauterine growth restriction (IUGR) increases the incidence of adult cardiovascular disease (CVD). The sex-specific developmental mechanisms for IUGR-induced and western high fat diet (HFD) modification of CVD remain poorly understood. We hypothesized a maternal HFD in the Sprague-Dawley rat would augment IUGR-induced CVD in the offspring through decreased cardiac function and increased extracellular matrix (ECM) remodeling and stiffness in a sex-specific manner. HFD or regular diet (Reg) was given from 5 weeks prior to mating through postnatal day 21 (PND21)...
November 23, 2016: American Journal of Physiology. Heart and Circulatory Physiology
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