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https://www.readbyqxmd.com/read/28647939/non-criteria-or-seronegative-obstetric-antiphospholipid-syndrome
#1
REVIEW
Luis J Jara, Gabriela Medina, Polita Cruz-Cruz, Javier Olivares-Rivera, Carolina Duarte-Salazar, Miguel A Saavedra
Obstetric antiphospholipid syndrome (Obs-APS) is one of the most commonly identified causes of recurrent pregnancy loss and its accurate diagnosis is a requirement for optimal treatment. Some patients do not fulfill the revised Sapporo classification criteria, the original APS classification criteria, and are considered to be non-criteria Obs-APS. In these patients with non-criteria, there is controversy about their inclusion within the spectrum of APS and eventually their treatment as having Obs-APS. A subset of patients may also have clinical characteristics of Obs-APS even though lupus anticoagulant (LA), anticardiolipin antibodies, and anti-β2-glycoprotein I (aβ2GPI) antibodies are consistently negative...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28618257/is-a-therapeutic-anticoagulation-window-needed-for-delivery-when-using-prophylactic-low-molecular-weight-heparin-during-pregnancy-a-retrospective-monocentric-study
#2
Assila Roueli, Elsa Cesario, Julien Amsellem, Antoine Agman, Danièle Vauthier-Brouzes, Jacky Nizard
OBJECTIVES: The aim of the study was to evaluate the usefulness of therapeutic window for delivery for patients under prophylactic anticoagulation by low molecular weight heparin (LMWH) by comparing those who had a planned delivery versus those who delivered spontaneously. STUDY DESIGN: This retrospective monocentric study included pregnant patients with prophylactic anticoagulation (one injection per day of enoxaparin 4000UI), who delivered after 24 weeks of gestation...
June 1, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28607783/intramural-hematoma-of-the-esophagus-complicating-severe-preeclampsia
#3
Simone Garzon, Giovanni Zanconato, Nicoletta Zatti, Giuseppe Chiarioni, Massimo Franchi
Intramural hematoma of the esophagus is a rare injury causing esophageal mucosal dissection. Forceful vomiting and coagulopathy are common underlying causes in the elderly population taking antiplatelets or anticoagulation agents. Acute retrosternal pain followed by hematemesis and dysphagia differentiates the hematoma from other cardiac or thoracic emergencies, including acute myocardial infarction or aortic dissection. Direct inspection by endoscopy is useful, but chest computed tomography best assesses the degree of obliteration of the lumen and excludes other differential diagnoses...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28605659/trimester-specific-coagulation-and-anticoagulation-reference-intervals-for-healthy-pregnancy
#4
Chanjuan Cui, Shuo Yang, Jie Zhang, Guojing Wang, Shengkai Huang, Aiwei Li, Yuncong Zhang, Rui Qiao
BACKGROUND: Due to the normal physiological need of pregnancy and childbirth, the haemostatic system of pregnant women is different from that of healthy non-pregnant women. The aim of this study was to establish trimester-specific reference intervals of coagulation screening tests and thrombophilia markers in pregnancies without complications of females with Han ethnicity from North China. METHODS: In total 744 Han healthy pregnant women (first trimester 207 cases, second trimester 222 cases and third trimester 315 cases) and 121 healthy non-pregnant women were recruited in North China...
May 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28588653/renal-cell-carcinoma-with-inferior-vena-cava-thrombus-extending-to-the-right-atrium-diagnosed-during-pregnancy
#5
REVIEW
Efe C Ghanney, Jaime A Cavallo, Matthew A Levin, Ramachandra Reddy, Jeffrey Bander, Maria Mella, Joanne Stone, Myron Schwartz, Kenneth Haines, Umesh Gidwani, Reza Mehrazin
Only one case of renal cell carcinoma (RCC) with inferior vena cava (IVC) tumor thrombus diagnosed and treated during pregnancy has been reported in the literature. In that report, the tumor thrombus extended to the infrahepatic IVC (level II tumor thrombus). In the present case, a 37-year-old woman with lupus anticoagulant antibodies was diagnosed with RCC and IVC tumor thrombus extending to the right atrium (level IV tumor thrombus) at 24 weeks of pregnancy. The fetus was safely delivered by cesarean section at 30 weeks of gestation...
December 2017: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/28584200/efficacy-of-different-treatment-regimens-for-antiphospholipid-syndrome-related-recurrent-spontaneous-abortion
#6
Sheng-Long Ye, Xun-Ke Gu, Li-Yuan Tao, Ji-Mei Cong, Yong-Qing Wang
BACKGROUND: Antiphospholipid syndrome (APS)-related immune factors are considered as an important cause of recurrent spontaneous abortion (RSA). Anticoagulant and anti-inflammatory treatments are believed to effectively improve adverse pregnancy outcomes by affecting the abnormal autoimmune response of the maternal-fetal interface. The aim of this study was to observe the clinical characteristics and treatment outcomes of anticoagulant regimens and anti-inflammatory plus anticoagulation regimens for APS-related RSA...
June 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28580572/the-impact-of-low-molecular-weight-heparin-on-obstetric-outcomes-among-unexplained-recurrent-miscarriages-complicated-with-methylenetetrahydrofolate-reductase-gene-polymorphism
#7
Orkun Cetin, Erbil Karaman, Numan Cim, Deniz Dirik, Hanim Guler Sahin, Erdal Kara, Ramazan Esen
OBJECTIVES: The association between methylenetetrahydrofolate reductase gene polymorphisms and unexplained recurrent miscarriage is elusive. The recommendations for improving pregnancy outcomes in these patients keep changing based on the available evidence. The aim of this study is to analyze the impact of low molecular weight heparin on obstetric outcomes of recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphism. MATERIAL AND METHODS: We reviewed medical records of 121 patients with a history of recurrent miscarriage complicated by methylenetetrahydrofolate reductase gene polymorphisms, retrospectively...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28578446/unilateral-adrenal-infarction-in-pregnancy-secondary-to-elevated-factor-viii
#8
Khaled Y Aljenaee, Sulaiman A Ali, Seong K Cheah, Moudhi J Alroomi
Adrenal infarction in pregnancy is an extremely rare event. We report a case of a 29-year-old pregnant woman at the twenty-fourth week of gestation that presented with an acute episode of severe localized right upper quadrant pain. Her preliminary blood investigations and abdominal ultrasonography were essentially unremarkable. A diagnosis of right adrenal infarction was subsequently established on the basis of a non-enhanced swollen right adrenal gland on CT scanning of the abdomen with contrast, consistent with the clinical presentation...
June 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28572466/longterm-outcome-of-patients-with-primary-antiphospholipid-syndrome-a-retrospective-multicenter-study
#9
Mara Taraborelli, Rossella Reggia, Francesca Dall'Ara, Micaela Fredi, Laura Andreoli, Maria Gerosa, Ariela Hoxha, Laura Massaro, Marta Tonello, Nathalie Costedoat-Chalumeau, Patrice Cacoub, Franco Franceschini, Pier Luigi Meroni, Jean Charles Piette, Amelia Ruffatti, Guido Valesini, Eon Nigel Harris, Angela Tincani
OBJECTIVE: To assess the longterm frequency of thrombotic recurrences, obstetrical complications, organ damage, severe comorbidities, and evolution toward connective tissue disease (CTD) in primary antiphospholipid syndrome (PAPS). METHODS: Medical records of patients with PAPS followed in 6 centers for ≥ 15 years were retrospectively reviewed. RESULTS: One hundred fifteen patients were studied: 88% women, followed between 1983 and 2014 with a mean (± SD) age at diagnosis of 33 (± 10) years...
June 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28571631/maternal-and-fetal-outcomes-of-anticoagulation-in-pregnant-women-with%C3%A2-mechanical-heart%C3%A2-valves
#10
Zachary L Steinberg, Clara P Dominguez-Islas, Catherine M Otto, Karen K Stout, Eric V Krieger
BACKGROUND: Anticoagulation for mechanical heart valves during pregnancy is essential to prevent thromboembolic events. Each regimen has drawbacks with regard to maternal or fetal risk. OBJECTIVES: This meta-analysis sought to estimate and compare the risk of adverse maternal and fetal outcomes in pregnant women with mechanical heart valves who received different methods of anticoagulation. METHODS: Studies were identified using a Medline search including all publications up to June 5, 2016...
June 6, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28569919/elevated-plasma-tfpi-activity-causes-attenuated-tf-dependent-thrombin-generation-in-early-onset-preeclampsia
#11
Karl Egan, Hugh O'Connor, Barry Kevane, Fergal Malone, Aine Lennon, Amani Al Zadjali, Sharon Cooley, Cathy Monteith, Patricia Maguire, Paulina Szklanna, Seamus Allen, Naomi McCallion, Fionnuala Ní Áinle
Early onset preeclampsia (EOP) is a pregnancy-specific proinflammatory disorder that is characterised by competing thrombotic and bleeding risks. It was the aim of this study to characterise thrombin generation, a major determinant of thrombotic and bleeding risk, in order to better understand the haemostatic balance in patients with EOP. Patients with EOP were recruited at the Rotunda Hospital, Dublin. Twenty-six cases of EOP were recruited over a 21-month period, out of 15,299 deliveries at the Rotunda. Blood samples were collected into sodium citrate plus corn trypsin inhibitor anticoagulated vacutainers, platelet-poor plasma was prepared, and calibrated automated thrombography was used to assess thrombin generation...
June 1, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28553146/recurrent-pregnancy-loss-current-perspectives
#12
REVIEW
Hady El Hachem, Vincent Crepaux, Pascale May-Panloup, Philippe Descamps, Guillaume Legendre, Pierre-Emmanuel Bouet
Recurrent pregnancy loss is an important reproductive health issue, affecting 2%-5% of couples. Common established causes include uterine anomalies, antiphospholipid syndrome, hormonal and metabolic disorders, and cytogenetic abnormalities. Other etiologies have been proposed but are still considered controversial, such as chronic endometritis, inherited thrombophilias, luteal phase deficiency, and high sperm DNA fragmentation levels. Over the years, evidence-based treatments such as surgical correction of uterine anomalies or aspirin and heparin for antiphospholipid syndrome have improved the outcomes for couples with recurrent pregnancy loss...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28538012/antiphospholipid-syndrome-an-update-for-clinicians-and-scientists
#13
Andrew P Vreede, Paula L Bockenstedt, Jason S Knight
PURPOSE OF REVIEW: Antiphospholipid syndrome (APS) is a leading acquired cause of thrombosis and pregnancy loss. Upon diagnosis (which is unlikely to be made until at least one morbid event has occurred), anticoagulant medications are typically prescribed in an attempt to prevent future events. This approach is not uniformly effective and does not prevent associated autoimmune and inflammatory complications. The goal of this review is to update clinicians and scientists on mechanistic and clinically relevant studies from the past 18 months, which have especially focused on inflammatory aspects of APS pathophysiology...
May 22, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28536761/-anticoagulation-direct-oral-anticoagulants
#14
B Kemkes-Matthes
Since direct oral anticoagulants (DOAC) have become available, use of anticoagulant treatment has become easier and safer-for patients suffering from thromboembolic diseases as well as for patients with atrial fibrillation: Because of constant bioavailability, fixed dose regimen treatment is possible, monitoring not necessary and severe bleeding complications-particularly intracranial hemorrhages-rare in comparison to vitamin K anticoagulants. To gain all these advantages, it is essential to give DOAC in the correct dosage...
May 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28532221/antiphospholipid-antibodies-are-associated-with-positive-screening-for-common-mental-disorders-in-women-with-previous-pregnancy-loss-the-noha-psy-observational-study
#15
Jean-Christophe Gris, Fabienne Cyprien, Sylvie Bouvier, Eva Cochery-Nouvellon, Géraldine Lavigne-Lissalde, Erick Mercier, Jean-Pierre Balducchi
OBJECTIVES: Case reports describe neuropsychiatric manifestations associated with antiphospholipid antibodies (aPlAbs). In patients sharing the same symptoms fulfilling the antiphospholipid syndrome (APS) clinical criteria, the prevalence of common mental disorders has, however, never been studied. METHODS: We observed women with three consecutive abortions before the 10th week of gestation or one foetal loss at or beyond the 10th week. We compared the prevalence of common psychiatric disorders detected through screening using the Mini International Neuropsychiatric Interview, 10 years after inclusion, in women with APS (n = 506), women negative for aPlAbs but carrying the F5rs6025 or F2rs1799963 thrombogenic polymorphism (n = 269), and women with negative thrombophilia screening results as controls (n = 764)...
June 19, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28514122/-is-anti-thrombotic-prophylaxis-warranted-in-fertility-and-in-vitro-fertilization-treatments
#16
REVIEW
Enav Yefet, Amir Weiss
INTRODUCTION: Assisted reproductive technology (ART) treatments are potential risk factors for thromboembolism (TE) due to excessive estrogen levels. Recently, several studies have shed new light on this matter. AIMS: To review the literature to assess the risk for TE during ART and to establish guidelines regarding thrombophylaxis. METHODS: A search was conducted of PubMed, Medline, Cochrane and clinicaltrials.gov. The search terms were fertility, assisted reproductive technology, IVF, thromboembolism, thrombosis and anticoagulation...
July 2016: Harefuah
https://www.readbyqxmd.com/read/28501283/assessment-of-annexin-a5-and-annexin-a2-levels-as-biomarkers-for-pre-eclampsia-a-pilot-study
#17
Marwa Abd El-Latif, Hanan Azzam, Maha Othman, Osama Warda, Solafa El-Sharawy, Hayam Ghoneim
Deficient anticoagulant activity of annexin A5 and deficient profibrinolytic activity of annexin A2 have been linked to increased risk of thrombotic events. Placental dysfunction due to fibrin deposition/microthrombi has been implicated in the pathogenesis of pre-eclampsia (PE). In this study, we aimed to assess serum levels of annexin A5 and annexin A2 in a cohort of PE patients and investigate their role as biomarkers for the development of the disease. We examined 80 women in total; 40 healthy pregnant women and 40 pregnant women with PE after 20weeks of pregnancy...
April 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/28498066/atrial-fibrillation-in-pregnancy-a-growing-challenge
#18
Vasiliki Katsi, Georgios Georgiopoulos, Maria Marketou, Dimitrios Oikonomou, Fragiskos Parthenakis, Thomas Makris, Petros Nihoyannopoulos, P Vardas, Dimitris Tousoulis
BACKGROUND: Atrial fibrillation (AF) constitutes a relatively infrequent pregnancy complication, which may be a therapeutic Gordian knot. Indeed, sparse data exist regarding the prevalence, prognosis, and management of AF during pregnancy. In general, AF occurs as a benign, self-limited arrhythmia, but occasionally may have severe hemodynamic consequences in pregnant patients suffering from heart failure, congenital heart disease, or other comorbidities. Extra-cardiac causes of AF should always be meticulously excluded...
June 8, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28483615/severe-mesenteric-ischemia-in-a-pregnant-woman-with-antiphospholipid-syndrome
#19
Andrea Padricelli, Anna Maria Giribono, Doriana Ferrara, Flavia Spalla, Umberto Bracale, Luca Del Guercio, Giuseppe Servillo, Carlo Ruotolo, Umberto Marcello Bracale
The antiphospholipid syndrome (APS), either primary or secondary form, is considered an autoimmune disease with presence of at least one clinical and one laboratory abnormalities as defined by The Sydney criteria. Clinical criteria include vascular thrombosis of venous, artery, small vessel in any organ and recurrent pregnancy pathologies. Mesenteric ischemia is a rare and threatening manifestation of APS. We herein report a case of 34-years old pregnant woman referred to our Emergency Room with thoracic and abdominal acute pain...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28483284/after-deep-vein-thrombosis-which-patients-refer-to-vascular-specialist-for-anticoagulant-withdrawal-a-delphi-study-results-between-general-practitioners-and-vascular-specialists
#20
Antonin Zoubian, Laurent Bertoletti, Paul Frappé
AIM: Deep vein thrombosis (DVT) is a potential serious common disease. Its management is, except in particular cases, on an outpatient basis. General practitioner's (GP) role usually includes the treatment risk/benefit reassessment. The treatment duration can vary and is difficult to define. The national and international guidelines do not explain clearly when to refer, or not, to a vascular specialist in order to stop treatment. The study's objective was to identify, for DVT, when a GP has to refer or not to a vascular specialist, for anticoagulant withdrawal...
May 2017: La Presse Médicale
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