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https://www.readbyqxmd.com/read/28068990/risk-factors-for-severe-postpartum-hemorrhage-a-case-control-study
#1
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/28068787/ventricular-endomyocardial-fibrosis-in-a-pregnant-female-with-beh%C3%A3-et-s-disease
#2
Zahra Mirfeizi, Bahram Memar, Hoorak PourZand, Mohammad Hadi Molseghi, Arash Rezaei Shahmirzadi, Nafiseh Abdolahi
A 32-year-old pregnant woman, diagnosed with Behçet's disease 6 months earlier, presented with recent mild hemoptysis and exertional dyspnea. Transthoracic echocardiography showed an enlarged dysfunctional right ventricle. A large hypoechoic triangular-shaped mass was seen attached to the inner right ventricular wall, filling the cavity. No change in the size of the mass was noted after anticoagulant administration, and right heart failure progressed. Surgery was performed to remove the mass and repair the tricuspid valve...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28056758/thrombotic-management-of-antiphospholipid-syndrome-towards-novel-targeted-therapies
#3
Md Asiful Islam, Fahmida Alam, Kah Keng Wong, Mohammad Amjad Kamal, Siew Hua Gan
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombosis and/or pregnancy morbidity with persistent levels of antiphospholipid antibodies (aPLs). The development of thrombosis in APS is mediated by aPLs and contributes to the high mortality rate in APS patients. However, although APS has been reported for more than 30 years, there has been no optimal regimen for its prevention or for the management of thrombosis, mainly because the mainstay treatment strategies for managing APS are not targeted towards aPL-mediated thrombotic pathophysiology...
5, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28050648/diagnostic-value-of-antibodies-to-phosphatidylserine-prothrombin-complex-for-antiphospholipid-syndrome-in-chinese-patients
#4
Lei Zhu, Chun Li, Na Liu, Xin Yang, R L Jia, Rong Mu, Yin Su, Z G Li
To evaluate the diagnosis value of antibodies to phosphatidylserine/prothrombin complex (aPS/PT) in patients with antiphospholipid syndrome (APS) and to determine the clinical features of APS patients with avidity of aPS/PT. Serum samples were collected from 108 APS patients. Sixty patients with pregnancy morbidity, 37 patients with thrombosis without a history of autoimmune diseases, and 89 healthy blood donors were included as the control group. The enzyme-linked immunosorbent assay (ELISA) test was performed to detect the concentration of aPS/PT, including IgG/M, IgG, and IgM forms, in the same serum sample...
January 3, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28019065/pregnancy-outcomes-in-women-with-mechanical-prosthetic-heart-valves-a-prospective-descriptive-population-based-study-using-the-united-kingdom-obstetric-surveillance-system-ukoss-data-collection-system
#5
S Vause, B Clarke, C L Tower, Crm Hay, M Knight
OBJECTIVE: To describe the incidence of mechanical prosthetic heart valves (MPHV) in pregnancy in the UK; rates of maternal and fetal complications in this group of women, and whether these vary with the anticoagulation used during pregnancy. DESIGN: Prospective descriptive population-based study. SETTING: All consultant-led maternity units in the UK. POPULATION: All women with an MPHV who were pregnant between 1 February 2013 and 31 January 2015...
December 26, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28017976/acute-abdomen-in-the-17th-week-of-twin-pregnancy-due-to-ovarian-torsion-a-late-complication-of-ivf
#6
D Habek, R Bauman, L Rukavina Kralj, T Hafner, T Turudic, S Vujisic
Background: A 32-year-old woman with tubal factor infertility due to bilateral laparoscopic salpingectomy conceived twins with in vitro fertilization (IVF). She developed moderate ovarian hyperstimulation syndrome which was treated with anticoagulant therapy. The subsequent course of the twin pregnancy was normal until the 17th week of gestation when she presented to hospital because of a sharp pain in the right lower abdomen which ceased after admission. Case: Except for a single incident of vomiting, patient had no other subjective symptoms...
December 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/28009646/lupus-anticoagulant-hypoprothrombinemia-syndrome-a-rare-cause-of-intracranial-bleeding
#7
Sreejesh Sreedharanunni, Jasmina Ahluwalia, Narender Kumar, Sunil K Bose, Rishi Dhawan, Pankaj Malhotra
We report a 14-year-old girl who presented with subdural hematoma and a deranged coagulation profile suggestive of an inhibitor. Investigations revealed prothrombin deficiency along with positivity for antiphospholipid antibodies, which improved with steroid therapy. Bleeding diathesis in children and adolescents commonly results from thrombocytopenia, platelet function disorders, or coagulation factor deficiency; whereas bleeding because of coagulation factor inhibitors are extremely rare in this age group...
December 22, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/27988438/detection-of-lupus-anticoagulant-in-the-era-of-direct-oral-anticoagulants
#8
REVIEW
Ariela Hoxha, Alessandra Banzato, Amelia Ruffatti, Vittorio Pengo
Lupus anticoagulant (LAC) is an in vitro phenomenon determining a phospholipid-dependent elongation of clotting times. The presence of LAC associated with anticardiolipin (aCL) and anti-β2 glycoprotein I (anti-β2GPI) antibodies is strongly associated with thrombosis and pregnancy morbidity. Direct oral anticoagulants (DOACs) targeting thrombin and factor Xa are currently widely use to prevent and treat venous and arterial thromboembolism. Some concern has, however, been expressed about the possibility of false laboratory results during LAC assessment in patients taking these drugs...
December 15, 2016: Autoimmunity Reviews
https://www.readbyqxmd.com/read/27981745/assisted-reproductive-technology-and-severe-postpartum-haemorrhage-a-case-control-study
#9
L T Nyfløt, I Sandven, N B Oldereid, B Stray-Pedersen, S Vangen
OBJECTIVE: To investigate the association between assisted reproductive technology and severe postpartum haemorrhage. DESIGN: Case-control study. SETTING: The study was conducted in Norway; Division of Gynaecology and Obstetrics at Oslo University Hospital and Department of Obstetrics and Gynaecology at Drammen Hospital. POPULATION: A source population including all women admitted for delivery at Oslo University Hospital and Drammen Hospital during the time period 1 January 2008 to 31 December 2011...
December 16, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27965311/accurate-diagnosis-of-iliac-vein-thrombosis-in-pregnancy-with-magnetic-resonance-direct-thrombus-imaging-mrdti
#10
Charlotte E A Dronkers, Alexandr Srámek, Menno V Huisman, Frederikus A Klok
A pregnant woman aged 29 years, G1P0 at 21 weeks of gestation of a dichorionic diamniotic twin, presented with suspected deep vein thrombosis (DVT) of the left leg. Repeated (compression) ultrasonography was not diagnostic for DVT but showed reduced flow over the left external iliac vein, common femoral vein and superficial femoral vein. In pursue of a definite diagnosis, magnetic resonance direct thrombus imaging was performed showing a clear high signal in the left common iliac vein which is diagnostic for acute thrombosis in this venous segment...
December 13, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27917690/pharmacological-management-of-pulmonary-embolism
#11
Bobby Gouin, Helia Robert-Ebadi, Marc Righini, Marc Blondon
Pulmonary embolism (PE) is a common and potentially severe manifestation of venous thromboembolism. Its management has relied on anticoagulation by vitamin K antagonists (VKA) for the past fifty years. Recently, new alternative drugs have been developed and dramatically modified both the treatment of acute PE and its secondary prevention. Areas covered: This review discusses the contemporary pharmacological treatment for PE, with a focus on anticoagulation options for non-high risk PE. In particular, the advent of direct oral anticoagulants (rivaroxaban, apixaban, edoxaban and dabigatran) and modalities for long-term prevention will be described...
January 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27913550/prevention-of-thrombosis-in-antiphospholipid-syndrome
#12
Wendy Lim
Antiphospholipid syndrome (APS) is an acquired autoimmune condition characterized by thrombotic events, pregnancy morbidity, and laboratory evidence of antiphospholipid antibodies (aPL). Management of these patients includes the prevention of a first thrombotic episode in at-risk patients (primary prevention) and preventing recurrent thrombotic complications in patients with a history of thrombosis (secondary prevention). Assessment of thrombotic risk in these patients, balanced against estimated bleeding risks associated with antithrombotic therapy could assist clinicians in determining whether antithrombotic therapy is warranted...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913507/diagnosis-of-suspected-venous-thromboembolism
#13
Clive Kearon
The primary goal of diagnostic testing for venous thromboembolism (VTE) is to identify all patients who could benefit from anticoagulant therapy. Test results that identify patients as having a ≤2% risk of VTE in the next 3 months are judged to exclude deep vein thrombosis (DVT) or pulmonary embolism (PE). Clinical evaluation, with assessment of: (1) clinical pretest probability (CPTP) for VTE; (2) likelihood of important alternative diagnoses; and (3) the probable yield of D-dimer and various imaging tests, guide which tests should be performed...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913455/inherited-thrombophilia-a-double-edged-sword
#14
Saskia Middeldorp
Inherited thrombophilia is a blood coagulation disorder that increases the risk for venous thromboembolism (VTE). During the last decades, the practice of testing has evolved from testing selected populations, leading to high perceived risks, to broad testing for various conditions that included VTE, arterial thrombosis, and pregnancy complications. Because results of such tests usually do not guide treatment decisions, not testing patients with VTE for inherited thrombophilia is on the "Choosing Wisely" list endorsed by multiple specialty societies, including ASH...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27889133/-venous-thromboembolism-prevention-in-pregnancy-and-the-postpartum-period-in-primary-and-specialized-care
#15
J L Gallo-Vallejo, M Naveiro-Fuentes, A Puertas-Prieto, F J Gallo-Vallejo
After noting that there are a number of risk factors for venous thromboembolism disease during pregnancy, it emphasizes primary prevention and treatment of this serious condition during pregnancy and the postpartum period are essential to reduce maternal morbidity and mortality. Low molecular-weight heparins are under the anticoagulant of choice in pregnancy. Your prescription may make both the primary care physician, as the hematologist and obstetrician. As for prescribing terms, an application protocol in both primary and specialized, multidisciplinary care, based on the existing literature on the subject is presented, which indicated that the hypercoagulable disorders associated with some of the risk factors, forced to do thromboprophylaxis with low molecular-weight heparins throughout pregnancy and the postpartum period presented...
November 23, 2016: Semergen
https://www.readbyqxmd.com/read/27887785/thromboelastography-teg%C3%A2-demonstrates-that-tinzaparin-4500-international-units-has-no-detectable-anticoagulant-activity-after-caesarean-section
#16
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...
October 8, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27858332/causative-genetic-mutations-for-antithrombin-deficiency-and-their-clinical-background-among-japanese-patients
#17
Akiko Sekiya, Fumina Taniguchi, Daisuke Yamaguchi, Sayaka Kamijima, Shonosuke Kaneko, Shiori Katsu, Miho Hanamura, Mao Takata, Haruka Nakano, Hidesaku Asakura, Shigeki Ohtake, Eriko Morishita
We summarize causative genetic mutations for antithrombin (AT) deficiency and their clinical background in Japanese patients. A total of 19 mutations, including seven novel mutations, were identified. We also summarize clinical symptoms of thrombosis, age at onset, family history, and contributing factors for thrombosis, and review the use of prophylactic anticoagulation in pregnant women with heterozygous type II heparin binding site defects (HBS) AT deficiency. The prevalence of thrombosis in probands with type I AT deficiency (88%) was double that observed in those with type II AT deficiency (50%)...
November 17, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27848915/heparin-monitoring-clinical-outcome-and-practical-approach
#18
Noémie Despas, Anne-Sophie Larock, Hugues Jacqmin, Jonathan Douxfils, Bernard Chatelain, Marc Chatelain, François Mullier
Traditional anticoagulant agents such as unfractionated heparin (UFH), low molecular weight heparins (LMWHs), fondaparinux, danaparoid and bivalirudine are used in the prevention and treatment of thromboembolic diseases. However, these agents have limitations: their constraining parenteral route of administration and the need for regular coagulation monitoring for HNF. The LMWHs, with their more predictable anticoagulant response, don't require a systematic monitoring. The usefulness of LMWHs monitoring in several clinical situations such as pregnancy, obesity and renal insufficiency is a matter of debate...
December 1, 2016: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/27847992/-esc-guidelines-on-atrial-fibrillation-2016-summary-of-the-most-relevant-recommendations-and-modifications
#19
L Eckardt, K G Häusler, U Ravens, M Borggrefe, P Kirchhof
The first European Society of Cardiology (ESC) guidelines on atrial fibrillation (AF) developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) were published in August 2016. These guidelines replace the revised guidelines from 2012 and contain some interesting new aspects. The topics range from the pathophysiology through diagnostics, therapy and stroke prevention up to special clinical situations, such as atrial fibrillation in cardiopathy, sport and pregnancy. Early screening, patient informed consent, individualized therapy and the modification of factors promoting atrial fibrillation are of particular importance...
December 2016: Herz
https://www.readbyqxmd.com/read/27829874/increased-unfractionated-heparin-requirements-with-decreasing-body-mass-index-in-pregnancy
#20
Avinash S Patil, Tracy Clapp, Piyamas K Gaston, David Kuhl, Eliza Rinehart, Norman L Meyer
BACKGROUND: Pregnant women receiving low-molecular-weight heparin for therapeutic anticoagulation are often converted to unfractionated heparin in anticipation of labor. We aim to characterize the impact of maternal body mass index on attainment of target anticoagulation during the conversion process. METHODS: We conducted a five-year retrospective study of a pregnancy cohort converted from low-molecular-weight heparin to unfractionated heparin in the third trimester...
December 2016: Obstetric Medicine
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