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https://www.readbyqxmd.com/read/28643875/prediction-of-severe-pre-eclampsia-by-a-combination-of-sflt-1-ct-pro-et1-and-blood-pressure-exploratory-study
#1
Anne Lind Malte, Niels Uldbjerg, David Wright, Niels Tørring
OBJECTIVES: To evaluate the performance of a combination of clinical-, angiogenic- and vasoactive biomarkers to predict the development of severe preeclampsia (PE) and HELLP syndrome in the third trimester METHODS: We included 221 women with suspected- , light- , moderate - or severe PE/HELLP (mean gestational age 35(+6) weeks) attending the obstetrical outpatient clinic, and 99 with normal pregnancies. RESULTS: In a group of patients presenting with mild to moderate symptoms of preeclampsia, a combination of C-terminal Pro Endothelin 1 (CT-Pro-ET1), sFlt-1 and systolic blood pressure reached an Area under Curve (AUC) of 0...
June 23, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28602034/blood-pressure-in-adolescent-patients-with-pre-eclampsia-and-eclampsia
#2
Sandra X Olaya-Garay, Paula A Velásquez-Trujillo, Paulino Vigil-De Gracia
OBJECTIVE: To compare variables among adolescent and adult patients diagnosed with severe pre-eclampsia or eclampsia. METHODS: The present cross-sectional study enrolled patients with severe pre-eclampsia or eclampsia treated at an intensive care unit in Neiva, Colombia, between January 1 and November 30, 2014. Patients were stratified using age (younger than 20 years [adolescents] and aged at least 20 years [adults]) and patient variables were compared between groups...
June 11, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28593773/-hellp-syndrome-requiring-therapeutic-plasma-exchange-due-to-progression-to-multiple-organ-dysfunction-syndrome-with-predominant-encephalopathy-respiratory-and-renal-insufficiency
#3
M Trávniková, J Gumulec, Z Kořístek, M Navrátil, M Janáč, J Pelková, P Šuráň, E Doležálková, O Šimetka
OBJECTIVE: Case report of woman with twin pregnancy complicated by HELLP syndrome which progressed to multiple organ dysfunction syndrome with predominant encephalopathy, renal and respiratory insufficiency with the need to perform repeated therapeutic plasma exchange. DESIGN: Case report. SETTING: Department of gynecology and obstetrics, University Hospital in Ostrava; Departmet of hematooncology, University Hospital in Ostrava; Department of gynecology and obstetrics, Vsetín hospital; Department of hematology and transfusion, Vsetín Hospital...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28567318/hemolysis-elevated-liver-enzymes-and-low-platelets-severe-fetal-growth-restriction-postpartum-subarachnoid-hemorrhage-and-craniotomy-a-rare-case-report-and-systematic-review
#4
Shadi Rezai, Justin Faye, Alexander Hughes, Mon-Lai Cheung, Joel R Cohen, Judy A Kaia, Paul N Fuller, Cassandra E Henderson
Introduction. Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a relatively uncommon but traumatic condition occurring in the later stage of pregnancy as a complication of severe preeclampsia or eclampsia. Prompt brain computed tomography (CT) or magnetic resonance imaging (MRI) and a multidisciplinary management approach are required to improve perinatal outcome. Case. A 37-year-old, Gravida 6, Para 1-0-4-1, Hispanic female with a history of chronic hypertension presented at 26 weeks and 6 days of gestational age...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28561152/-hypercapnic-raised-intracerebral-pressure-ecmo-therapy-despite-major-intracerebral-haemorrhage
#5
Matthias Unterberg, Hartmuth Nowak, André Gottschalk
We report a case of a 29-year-old primigravida asian woman with severe peripartal HELLP-syndrome. During delivery she developed coma. HELLP syndrome, complicated by severe intracerebral hemorrhage was detected. During course of therapy with drainage of intraventricular intracerebral hemorrhage, the patient developed pneumonia followed by severe acute respiratory distress syndrome (ARDS) with critically raised ICP. After 31 days of stabilization by extracorporeal membrane oxygenation (ECMO) and lung protective ventilation the patient was weaned of ECMO therapy...
May 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28555168/a-case-of-sevoflurane-use-during-pregnancy-in-the-management-of-persistent-status-asthmaticus
#6
Jessica Parrott, Mitch Tener, Katie Dennis, Matthew Sharpe, Cecily Clark-Ganheart
BACKGROUND: Sevoflurane is rarely used for the treatment of status asthmaticus. We report a case of sevoflurane hepatotoxicity in pregnancy with presentation similar to HELLP syndrome. CASE: A G2P1001 at 23 weeks in status asthmaticus presented with pCO2 > 130 and pH < 7. She was nonresponsive to traditional therapy. Sevoflurane was added for a 24 hr period. Respiratory status improved. Extubation occurred on day 12. Workup for preeclampsia spectrum disorders occurred due to maternal hypertension...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28553148/severe-preeclampsia-and-eclampsia-incidence-complications-and-perinatal-outcomes-at-a-low-resource-setting-mpilo-central-hospital-bulawayo-zimbabwe
#7
Solwayo Ngwenya
BACKGROUND: Severe preeclampsia is a disorder of pregnancy characterized by high blood pressure and significant proteinuria after 20 weeks gestation. Severe preeclampsia and eclampsia have considerable adverse impacts on maternal, fetal, and neonatal health especially in low-resource countries. Hypertensive disorders of pregnancy are the third leading cause of maternal deaths in Sub-Saharan Africa. Significant avoidable maternal and neonatal morbidity and mortality may result. OBJECTIVES: This study aimed 1) to determine the incidence of severe preeclampsia/eclampsia in a low-resource setting; 2) to determine the maternal complications of severe preeclampsia/eclampsia in a low-resource setting; 3) to determine the perinatal outcomes of severe preeclampsia/eclampsia in a low-resource setting...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28545408/importance-of-correctly-interpreting-magnetic-resonance-imaging-to-diagnose-posterior-reversible-encephalopathy-syndrome-associated-with-hellp-syndrome-a-case-report
#8
Syuichi Tetsuka, Hiroaki Nonaka
BACKGROUND: Severe haemolysis, elevated liver enzyme levels, and low platelet count (HELLP) syndrome in pregnancy are possible underlying trigger factors for posterior reversible encephalopathy syndrome (PRES). Magnetic resonance imaging (MRI) shows diffuse signal abnormalities involving the subcortical white matter in the parieto-occipital lobes. Although the diagnosis of RPES was clearly established by the distinctive reversibility of clinical and radiological abnormalities, it is difficult to distinguish from differential diagnosis...
May 25, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28541089/decreased-frequency-of-peripheral-blood-cd8-cd25-foxp3-regulatory-t-cells-correlates-with-il-33-levels-in-pre-eclampsia
#9
Jianxiu Yu, Lei Qian, Fenghui Wu, Ming Li, Wei Chen, Hongyou Wang
OBJECTIVE: We aimed to investigate the role of CD8(+)CD25(+)Foxp3(+)regulatory T (Treg) cells in pre-eclampsia (PE). METHODS: This was a cross-sectional study of 46 patients with PE and 24 normotensive women within the third trimester of gestation. We analyzed the percentages of CD8(+)CD25(+)Foxp3(+)Treg cells in peripheral blood using flow cytometry and the serum levels of interleukin (IL)-6, IL-17A, IL-10, TGF-β1, IL-1β, and IL-33 by Luminex 200. RESULTS: We found that patients with PE had lower percentages of CD8(+)CD25(+)Foxp3(+)Treg cells than normotensive pregnant women...
May 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/28532255/outpatient-vs-inpatient-management-for-superimposed-preeclampsia-without-severe-features-a-retrospective-multicenter-study
#10
Corina N Schoen, Sindy C Moreno, Gabriele Saccone, Nora M Graham, Lauren C Hand, Giuseppe M Maruotti, Pasquale Martinelli, Vincenzo Berghella, Amanda Roman
PURPOSE: To determine if women with preterm superimposed preeclampsia without severe features can be successfully and safely triaged to outpatient management. MATERIALS AND METHODS: This was a multicenter, retrospective, cohort study of singleton pregnancies with superimposed preeclampsia without severe features diagnosed before 37 weeks managed outpatient versus inpatient at Thomas Jefferson University (Philadelphia, USA) and at University of Naples (Naples, Italy) from January 2008 to July 2015...
May 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28503510/a-case-report-of-the-nutrition-support-for-a-patient-with-hellp-syndrome
#11
Seo Eun Yeon, Sun Jung Kim, Ju Hee Kim, Hae-Yun Chung, Se Hee Na, Song Mi Lee
A 30-year-old female patient, 18 weeks gestational age, with no prior medical history was admitted to hospital complaining severe right upper quadrant pain. The patient was admitted to intensive care unit (ICU) after emergency surgery to treat intraperitoneal hemorrhage caused by rupture of liver hematoma. Despite the absence of high blood pressure, the patient was diagnosed with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome on the basis of abnormal levels of blood aspartate aminotransferase/alanine aminotransferase, lactate dehydrogenase, total bilirubin, direct bilirubin, C-reactive protein (CRP) and platelet along with liver damage and proteinuria...
April 2017: Clinical Nutrition Research
https://www.readbyqxmd.com/read/28501825/maternal-bradycardia-occurring-prior-to-onset-of-hellp-syndrome-in-a-woman-with-pre-eclampsia
#12
Ami Hosokawa, Takeshi Umazume, Takahiro Yamada, Hisanori Minakami
A 36-year-old nulliparous woman developed pre-eclampsia at gestational week (GW) 28(-6/7) Cardiac status was checked regularly. Heart rate of 93 beats per minute (bpm) with left atrial diameter (LAD) of 35 mm, left ventricular hypertrophy and inferior vena cava diameter (IVCD) of 8 mm at GW 32(-0/7) decreased to 48 bpm with an expanded IVCD to 25 mm, dilated left atrium (LAD to 39 mm), increased pulmonary arterial pressure, increased systemic vascular resistance (approximate 3000  dyn s/cm(5)) and biphasic intrarenal venous flow pattern 3...
May 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28501275/dysregulation-of-the-fas-fasl-system-in-an-experimental-animal-model-of-hellp-syndrome
#13
Jacob Gibbens, Rachael Morris, Teylor Bowles, Shauna-Kay Spencer, Kedra Wallace
INTRODUCTION: Placental FasL is up-regulated in women with HELLP (hemolysis elevated liver enzyme and low platelet) syndrome and has been proposed to contribute to the liver damage seen in these patients. OBJECTIVE: This study aimed to determine if an experimental rodent model of HELLP also had dysregulation of Fas/FasL compared to normal pregnant (NP) rats. We also set out to determine if blockade of the endothelin system regulated Fas/FasL expression in HELLP rats...
April 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/28460634/acute-kidney-injury-during-pregnancy-and-puerperium-a-retrospective-study-in-a-single-center
#14
Chunhong Huang, Shanying Chen
BACKGROUND: Acute kidney injury (AKI) is rare in women during pregnancy and puerperium, however, it is related to increased morbidity and mortality rates. OBJECTIVE: The aim of this study was to investigate the incidence, characteristics, and outcomes of AKI during pregnancy and puerperium in a Chinese population. METHODS: In this study, pregnant women discharged from hospital between January 2008 and June 2015 were screened. AKI was defined if the level of serum creatitine >70...
May 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28454692/maternal-vascular-malperfusion-of-the-placental-bed-associated-with-hypertensive-disorders-in-the-boston-birth-cohort
#15
Blandine Bustamante Helfrich, Nymisha Chilukuri, Huan He, Sandra R Cerda, Xiumei Hong, Guoying Wang, Colleen Pearson, Irina Burd, Xiaobin Wang
INTRODUCTION: The associations of maternal conditions, before or during pregnancy, with placental lesions have not been adequately studied in populations. METHODS: In the Boston Birth Cohort, we evaluated associations between three maternal medical conditions (hypertensive disorders [HDs], gestational/pre-gestational diabetes and obesity), and placental histological findings, using a standardized classification system proposed by the Amsterdam Placental Workshop Group...
April 2017: Placenta
https://www.readbyqxmd.com/read/28434090/a-best-practice-position-statement-on-the-role-of-the-nephrologist-in-the-prevention-and-follow-up-of-preeclampsia-the-italian-study-group-on-kidney-and-pregnancy
#16
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Santina Castellino, Giuseppe Gernone, Domenico Santoro, Gabriella Moroni, Donatella Spotti, Franca Giacchino, Rossella Attini, Monica Limardo, Stefania Maxia, Antioco Fois, Linda Gammaro, Tullia Todros
Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndrome (haemolysis, increase in liver enzyme, low platelets) are included. Both nephrologists and obstetricians are involved in the management of the disease, according to different protocols, and the clinical management, as well as the role for each specialty, differs worldwide...
June 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28433984/haemophagocytic-lymphohistiocytosis-presenting-as-hellp-syndrome-a-diagnostic-and-therapeutic-challenge
#17
Robert Noel Kerley, Raymond Michael Kelly, Mary Rose Cahill, Louise Clare Kenny
Haemophagocytic lymphohistiocytosis (HLH) is a rare, potentially fatal, haematological disorder, which can be clinically challenging to diagnose and manage. We report a case of HLH in a previously healthy 33-year-old primigravida. The patient presented at 22 weeks gestation with dyspnoea, abdominal pain, anaemia, thrombocytopenia and elevated liver enzymes suggestive of HELLP syndrome.HELLP, a syndrome characterised by haemolysis, elevated liver enzymes and low platelets is considered a severe form of pre-eclampsia...
April 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28393002/hellp-syndrome-in-a-pregnant-patient-with-gitelman-syndrome
#18
Minhyeok Lee, Dong-Il Kim, Kyung-Ho Lee, Jun-Hyun Byun, Jiyong Hwang, Won-Min Hwang, Sung-Ro Yun, Se-Hee Yoon
Gitelman syndrome is characterized by hypokalemia, metabolic alkalosis, hypocalciuria, and hypomagnesemia. The clinical course of Gitelman syndrome in pregnant women remains unclear, but it is thought to be benign. We report here the first Korean case of atypical eclampsia in a 31-year-old who was diagnosed with Gitelman syndrome incidentally during an antenatal screening test. The patient did well during pregnancy despite significant hypokalemia. At 33 weeks' gestation, the patient exhibited eclampsia, hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, and renal insufficiency without significant hypertension or proteinuria...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28376740/maternal-27-hydroxycholesterol-concentrations-during-the-course-of-pregnancy-and-in-pregnancy-pathologies
#19
Brigitte Sophia Winkler, Ulrich Pecks, Laila Najjari, Nicola Kleine-Eggebrecht, Nicolai Maass, Markus Mohaupt, Geneviève Escher
BACKGROUND: The oxysterol 27-hydroxycholesterol (27-OHC) plays an important role in the regulation of cholesterol homeostasis. Pregnancy pathologies like preeclampsia (PE), HELLP-syndrome (HELLP), intrauterine growth restriction (IUGR) and intrahepatic cholestasis in pregnancy (ICP) are linked to disturbances in lipid metabolism. In the present study, we hypothesized a specific gestational regulation of 27-OHC and compromised 27-OHC levels due to placental and hepatic diseases in pregnancy resulting in a dysregulation of lipid metabolism...
April 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28367651/outcomes-in-an-obstetrical-population-with-hereditary-thrombophilia-and-high-tobacco-use
#20
Byron Calhoun, Elizabeth Hoover, Dara Seybold, Mike Broce, Ashley Hill, Burk Shaible, Luis A Bracero
OBJECTIVE: The purpose of this study was to examine birth outcomes in women treated or untreated for thrombophilia during pregnancies affected or not by tobacco exposure. METHODS: This was a retrospective cohort study of consecutive women from a single maternal fetal medicine clinic who delivered between January 2009 and December 2013. We compared birth outcomes by four groups of thrombophilia and smoking combinations and then by treated or untreated groups. RESULTS: Of the 8889 pregnant women in this study, 113 had thrombophilia and 97 received treatment...
April 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
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