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https://www.readbyqxmd.com/read/28217686/pregnancy-related-osteoporosis-and-spinal-fractures
#1
Ka Yeong Yun, Si Eun Han, Seung Chul Kim, Jong Kil Joo, Kyu Sup Lee
Pregnancy-related osteoporosis is a very rare condition characterized by the occurrence of fracture during pregnancy or the puerperium. Despite its relative rarity, it can be a dangerous condition that causes severe back pain, height loss and disability. Normal physiologic changes during pregnancy, genetic or racial difference, obstetrical history and obstetrical disease, such as preterm labor or pregnancy-induced hypertension, are presumed risk factors of pregnancy-related osteooporosis. However, exact etiology and pathogenesis are uncertain...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28208950/cerebral-venous-thrombosis-in-pregnancy-a-poignant-allegory-of-an-unusual-case
#2
Sheeba Marwah, Gaikwad Harsha Shailesh, Sumedha Gupta, Manjula Sharma, Pratima Mittal
Cerebral Venous Thrombosis (CVT), also known as cortical venous, cerebral sinus, cerebral venous sinus, or dural sinus thrombosis, is an infrequent grave condition affecting pregnant females, resulting from clot formation in one of the many outflow tracts of the brain. Although pregnancy-associated stroke or CVT is uncommon, the risk of stroke is greatly increased above the low baseline rate in young patients during late pregnancy and, even more so, during the puerperium. Haemorrhagic infarction can occur in the acute stage of CVT...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28175111/p284-ulcerative-colitis-presentation-during-pregnancy-or-puerperium
#3
P Sousa, D Martins, J Pinho, E Cancela, R Cardoso, R Araújo, A Castanheira, A Silva, P Ministro
No abstract text is available yet for this article.
February 1, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28168066/management-of-venous-thromboembolism-in-patients-with-hereditary-antithrombin-deficiency-and-pregnancy-case-report-and-review-of-the-literature
#4
Mohammad Refaei, Lydia Xing, Wendy Lim, Mark Crowther, Kochawan Boonyawat
Background. Hereditary antithrombin deficiency is a thrombogenic disorder associated with a 50-90% lifetime risk of venous thromboembolism (VTE), which is increased during pregnancy and the puerperium in these patients. We present a case of a woman with antithrombin (AT) deficiency who presented with a VTE despite therapeutic low molecular weight heparin (LMWH). Though the pregnancy was deemed unviable, further maternal complications were mitigated through the combined use of therapeutic anticoagulation and plasma-derived antithrombin concentrate infusions to normalize her functional antithrombin levels...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28141956/bell-s-facial-nerve-palsy-in-pregnancy-a-clinical-review
#5
Ahsen Hussain, Charles Nduka, Philippa Moth, Raman Malhotra
Bell's facial nerve palsy (FNP) during pregnancy and the puerperium can present significant challenges for the patient and clinician. Presentation and prognosis can be worse in this group of patients. This article reviews the background, manifestation and management options of FNP. In particular, it focuses on the controversies that exist regarding corticosteroid use during pregnancy and outlines approaches to diagnosis and treatment. Based on this review, we recommend an early evidence-based approach using guidelines derived from non-pregnant populations...
January 31, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28129658/-dying-at-life-s-beginning
#6
Franziska Frank, Franziska Maurer, Jessica Pehlke-Milde, Valerie Fleming
Aim: When parents-to-be are faced with a terminal prenatal diagnosis, they are confronted with the decision either to continue the pregnancy or to terminate it at an advanced stage. This difficult decision is intimately affected by the experience of the inevitability of loss, and ethical dilemmas posed in this usually completely unexpected situation. Studies indicate that perinatal child loss due to lethal foetal anomalies is a major life event and a source of serious psychological issues, which can last for many years after the experience...
January 27, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28125624/clonidine-versus-captopril-for-severe-postpartum-hypertension-a-randomized-controlled-trial
#7
Carlos Noronha Neto C, Sabina S B Maia, Leila Katz, Isabela C Coutinho, Alex R Souza, Melania M Amorim
BACKGROUND: Changes during the puerperium are still unclear, particularly in women with hypertension. The choice of antihypertensives, both to control very high blood pressure episodes and to keep blood pressure stable, also requires further elucidation. Currently, there are no clear data to guide the decision for the choice of postpartum antihypertensives. Captopril plays an important role in the treatment of very high blood pressure episodes and may be used postpartum. Clonidine has been used as an alternative in pregnant or postpartum women with contraindications to captopril, with satisfactory effect...
2017: PloS One
https://www.readbyqxmd.com/read/28078172/gastric-rupture-in-pregnancy-case-series-from-a-tertiary-institution-in-rwanda-and-review-of-the-literature
#8
David Ntirushwa, Stephen Rulisa, Febronie Muhorakeye, Lisa Bazzett-Matabele, Theogene Rurangwa, Maria Small
Background Gastric rupture is a rare, life-threatening condition during pregnancy. Case study We present three cases of gastric perforation during pregnancy and the puerperium. The first patient presented with gastric perforation 4 days following an uncomplicated cesarean delivery for obstetric indications. She initially complained of epigastric pain; however, those symptoms resolved. She later demonstrated worsening abdominal distension, intra-abdominal free fluid, and signs of peritonitis. At laparotomy, an ascariasis-associated gastric rupture was diagnosed...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28074994/-normoglycemic-diabetic-ketoacidosis-in-pregnancy-report-of-one-case
#9
Margarita Rivas M, Pamela Belmar Z, Pilar Durruty A, Lilian Sanhueza M, Gloria López S
Normoglycemic diabetic ketoacidosis should be suspected in pregnant women presenting nausea, vomiting, abdominal pain and anorexia. We report a 39 years old woman with a 32 weeks pregnancy who sought emergency care due to hyperemesis. She was hospitalized with the following diagnoses: pregnancy hypertension syndrome, gestational diabetes, morbid obesity and poor prenatal control. The evaluation of the feto-placental unit showed perception of fetal movements, non-reactive non-stress baseline record and a biophysical profile of 6/8...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28071837/use-of-tnf-inhibitors-and-ustekinumab-for-psoriasis-during-pregnancy-a-patient-series
#10
Tamara Lund, Simon Francis Thomsen
From 2002 to 2016 a total of seven women with severe refractory psoriasis were exposed to the TNF-inhibitors infliximab and adalimumab or to the IL12/23 inhibitor ustekinumab during one or more pregnancies. Maternal, fetal or teratogenic toxicity were not detected during pregnancy and puerperium. All pregnancies were uneventful and resulted in delivery of 10 healthy children in total, one of the women is due February 2017. Postpartum, five of the women were lactating, but none of the women or newborns developed adverse reactions...
January 10, 2017: Dermatologic Therapy
https://www.readbyqxmd.com/read/28034599/neuraxial-analgesia-in-a-pregnant-woman-with-fowler-s-syndrome-and-sacral-neuromodulation
#11
M Ansó, L Veiga-Gil, J De Carlos, A Hualde, J Pérez-Cajaraville
We report the anesthetic management of a 16-year-old woman with Fowler's syndrome who became pregnant three years after sacral neuromodulation was initiated for treatment of the condition. Multidisciplinary consensus was to switch off the neurostimulator during pregnancy, and attempt vaginal delivery with a neuraxial block. When the patient was admitted for labor, an epidural catheter was placed successfully. The patient had a normal vaginal delivery. Sacral neuromodulation was restarted uneventfully in the early puerperium and the Fowler's syndrome remains well controlled...
December 5, 2016: International Journal of Obstetric Anesthesia
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/27938868/antenatal-and-postnatal-risk-factors-of-postpartum-depression-symptoms-in-thai-women-a-case-control-study
#13
Chutima Roomruangwong, Sinaporn Withayavanitchai, Michael Maes
OBJECTIVE: To examine the effects of different predictors on the incidence and severity of postpartum depression (PPD) symptoms in a Thai population. METHODS: In this case control study we delineate the clinical, demographic and socio-economic risk factors associated with PPD symptoms. We used the Edinburgh Postnatal Depression Scale (EPDS) 4-6 weeks postpartum to divide parturients into those with (n = 53) and without (n = 260) PPD using a cutoff score of 11...
December 2016: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/27914274/the-adaptive-psychological-changes-of-elective-induction-of-labor-in-breastfeeding-women
#14
Vincenzo Zanardo, Martina Bertin, Laura Sansone, Laura Felice
BACKGROUND: Labor induction has been associated with breastfeeding suppression, but reasons for why this association exists have not been well determined. METHODS: We examined the influence of elective labor induction by vaginal prostaglandin at gestational week 41(+3)days on affective, cognitive, and behavioural adaptations early in puerperium and on breastfeeding pattern at 1 and 3months. RESULTS: One hundred and eighty consecutive puerperae were assigned to two groups: mothers having received vaginal prostaglandin E2 gel (Prepidil®, dinoprostone) before labor (PGE group, n=90) and mothers having received no treatment (unmedicated group, n=90)...
November 30, 2016: Early Human Development
https://www.readbyqxmd.com/read/27914160/infectious-postpartum-sacroiliitis-the-importance-and-difficulty-of-early-diagnosis
#15
Emídio Vale-Fernandes, Fedra Rodrigues, Carla Monteiro, Luís Carvalho
The sacroiliitis accounts for about 1.5% - 10% of all cases of septic arthritis and it is strongly associated with gynaecological infections, pelvic trauma or drug abuse (3.4% - 12.8% of cases occur during the postpartum period). Early diagnosis is difficult because the symptoms are nonspecific in pregnancy and in the postpartum period, making the delay of treatment a serious risk of irreversible damage to the joint and development of post-infectious complications. The authors describe the case of a 37-year-old puerperal woman presented to hospital, weeks after urgent caesarean section, with endometritis, post-anesthetic epidural hematoma and secondary infectious postpartum sacroiliitis...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27908330/sepsis-in-special-populations
#16
REVIEW
Matthew P Borloz, Khalief E Hamden
Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present. Baseline changes in vital signs and chronic medications often mask clues to the severity of illness. The physiologic, hematologic, and biochemical adjustments that accompany pregnancy and the puerperium introduce similar challenges...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27901174/metrics-for-electronic-nursing-record-based-narratives-cross-sectional-analysis
#17
Kidong Kim, Suyeon Jeong, Kyogu Lee, Hyeoun-Ae Park, Yul Ha Min, Joo Yun Lee, Yekyung Kim, Sooyoung Yoo, Gippeum Doh, Soyeon Ahn
OBJECTIVES: We aimed to determine the characteristics of quantitative metrics for nursing narratives documented in electronic nursing records and their association with hospital admission traits and diagnoses in a large data set not limited to specific patient events or hypotheses. METHODS: We collected 135,406,873 electronic, structured coded nursing narratives from 231,494 hospital admissions of patients discharged between 2008 and 2012 at a tertiary teaching institution that routinely uses an electronic health records system...
November 30, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27896248/uterine-artery-pulsatility-index-in-hypertensive-pregnancies-when-does-the-index-normalize-in-the-puerperium
#18
Seung Mi Lee, Jong Kwan Jun, Su Jin Sung, Sung Il Choo, Jeong Yeon Cho, Hye Jin Yang, Chan-Wook Park, Joong Shin Park, Hee Chul Syn
OBJECTIVE: To investigate whether the uterine artery pulsatility index (UtA PI) of hypertensive pregnancies is higher than that of normal pregnancies in the puerperium, as well as in the antepartum period. METHODS: The UtA PI was measured in hypertensive (group 1) and normal pregnancies (group 2) during antepartum, immediate postpartum or late postpartum periods. Using the transvaginal approach, the bilateral uterine artery indices were measured. RESULTS: One hundred twenty-two women were enrolled: group 1, hypertensive disease in pregnancy (11 cases in antepartum, 13 cases in immediate postpartum and 10 cases in late postpartum period); group 2, normal pregnancies (32 cases in antepartum, 29 cases in immediate postpartum and 27 cases in late postpartum)...
November 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27887785/thromboelastography-teg%C3%A2-demonstrates-that-tinzaparin-4500-international-units-has-no-detectable-anticoagulant-activity-after-caesarean-section
#19
S Griffiths, C Woo, V Mansoubi, A Riccoboni, A Sabharwal, S Napier, M Columb, M Laffan, G Stocks
BACKGROUND: Low molecular weight heparin is routinely used for thromboprophylaxis in pregnancy and the puerperium. Consensus guidelines recommend waiting 10-12h after administration of a thromboprophylactic dose of low molecular weight heparin before performing a neuraxial block or removing an epidural catheter. Thromboelastography (TEG®) has been reported to be sensitive to the effects of enoxaparin 4h after administration. The purpose of this study was to use TEG to examine coagulation changes in the first 10h after a thromboprophylactic dose of tinzaparin in an attempt to ratify the current consensus guidelines about timing of neuraxial blockade and epidural catheter removal...
February 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27867409/the-postpartum-ultrasound-scan
#20
REVIEW
Aslı Üçyiğit, Jemma Johns
Ultrasound assessment of the postpartum uterus has a significant role to play in the evaluation of a large proportion of symptomatic puerperal women. Often the imaging modality of choice for excluding retained placental tissue, correct application of postpartum ultrasound could enable more accurate identification of women requiring surgical intervention, with consequent reduction in patient morbidity and clinical workload. This article aims to review the current understanding and application of ultrasound in the puerperium and evaluate the current evidence investigating the physiological and pathological findings of the postpartum uterus and its contents...
August 2016: Ultrasound: Journal of the British Medical Ultrasound Society
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