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https://www.readbyqxmd.com/read/28929001/recurrent-hellp-syndrome-at-22-weeks-of-gestation
#1
Peter Kascak, Milos Paskala, Peter Antal, Radovan Gajdosik
We describe a case of a woman who presented with HELLP syndrome in two subsequent pregnancies (age 36 and 40), at gestational age of 22 weeks in both pregnancies with a rapid onset and progression. She presented with characteristic clinical symptoms and laboratory findings. Both pregnancies were delivered by caesarean sections due to deterioration in the mother's condition, although neither pregnancy progressed into the 1st stage of the syndrome according to Mississippi classification. This case highlights the admittedly rare but serious condition of recurring HELLP syndrome at a gestational age before the limit of viability of the fetus...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28912922/obstetric-outcomes-of-twin-pregnancies-in-japanese-women-aged-40-and-older
#2
Shunji Suzuki
BACKGROUND: The aim of this study was to compare the obstetric outcomes of twin pregnancies between Japanese women aged ≥ 40 years and their younger counterparts aged 25 - 29. METHODS: This was a retrospective study of twin pregnancies managed at Japanese Red Cross Katsushika Maternity Hospital between 2002 and 2016. Women aged 40 and older at delivery (n = 117) were compared with women aged 25 - 29 at delivery (n = 536). RESULTS: Although the women ≥ 40 years old were more likely to have increased risks of HELLP (hemolytic, elevated liver enzymes and low platelet) syndrome and very low birth weight neonates, there were no measurable differences in obstetric outcomes such as hypertensive disorders, premature delivery and neonatal asphyxia between the two groups...
October 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28893157/basal-plate-myometrial-fibers-and-hypertensive-disorders-of-pregnancy-a-case-control-study
#3
Ann A Wang, Linda M Ernst, Emily S Miller
Introduction Basal plate myometrium (BPMYO), the pathological presence of myometrial fibers in the basal plate, is a common finding on pathological examination of the placenta, yet its clinical correlates are not well studied. As myometrial fibers are frequently located in proximity to poorly converted maternal spiral arteries, our objective was to determine whether BPMYO is associated with hypertensive disorders of pregnancy (HDP), a well-known clinical sequela of abnormal maternal artery remodeling. Methods This case-control study included women who delivered a live-born singleton gestation whose placentas were sent for pathological examination...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28867885/serious-visual-ocular-complications-in-pre-eclampsia-and-eclampsia
#4
Thangappah Radha Bai Prabhu
INTRODUCTION: Complete loss of vision is an uncommon ocular complication of pre-eclampsia/eclampsia. The conditions which lead to visual loss in pre-eclampsia include cortical blindness, retinal detachment, retinal vascular thrombosis and optic nerve atrophy. OBJECTIVES: The objective was to describe the cause, clinical course and prognosis in blindness complicating pre-eclampsia. METHODOLOGY: This is a prospective observational study conducted at the Govt...
October 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28863378/right-hepatectomy-after-spontaneous-hepatic-rupture-in-a-patient-with-preeclampsia-a-case-report
#5
Carlos A Millan, Juan C Forero
INTRODUCTION: Spontaneous hepatic rupture associated with preecalmpsia or HELLP syndrome is a rare and life threatining event, only 200 cases have been reported in the literature. PRESENTATION OF CASE: We present a case of a 31 year old female with 28 weeks of gestation that presented with acute abdominal pain, elevated blood pressure and altered liver enzymes an abdominal ultrasound that showed a subcapsular hematoma occupying the whole right lobe and free abdominal fluid, she required emergent laparotomy, C-section, hepatic packing, followed by angioembolization and finally right hepatectomy...
August 18, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28761227/acute-kidney-injury-in-pregnancy-specific-disorders
#6
REVIEW
J Prakash, V C Ganiger
The incidence of acute kidney injury in pregnancy (P-AKI) has declined significantly over the last three decades in developing countries. However, it is still associated with significant fetomaternal mortality and morbidity. The diagnosis of P-AKI is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate (GFR) are not validated in this population. The incidence of P-AKI with respect to total AKI cases has decreased in the last three decades from 25% in 1980s to 9% in 2000s at our centre...
July 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28760134/life-threatening-bleeding-from-gastric-dieulafoy-s-lesion-in-a-pregnant-woman-with-hellp-syndrome-a-case-report-and-literature-review
#7
Chen Si, Zhu Xiuli, Xie Li, Jia Yong, Zhou Ying, Zhang Kaiguang
BACKGROUND: Dieulafoy's lesion (DL) is one of the rare causes of upper gastrointestional bleeding. This disease is characterized by small sub-mucosal arteriole that eroded the stomach mucosa and cause severe upper GI bleeding without obvious ulceration. The most common location is fundus area of stomach and usually affects patients over 50 years of age with multiple comorbidities. CASE PRESENTATION: We report a case of life-threatening bleeding from DL during late pregnancy 31 weeks...
July 31, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28737473/association-between-the-high-soluble-fms-like-tyrosine-kinase-1-to-placental-growth-factor-ratio-and-adverse-outcomes-in-asymptomatic-women-with-early-onset-fetal-growth-restriction
#8
Satoshi Shinohara, Yuzo Uchida, Mayuko Kasai, Rei Sunami
OBJECTIVE: To assess whether the high soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio is associated with adverse outcomes (e.g., HELLP syndrome [hemolysis, elevated liver enzymes, and low platelets], severe hypertension uncontrolled by medication, non-reassuring fetal status, placental abruption, pulmonary edema, growth arrest, maternal death, or fetal death) and a shorter duration to delivery in early-onset fetal growth restriction (FGR). METHODS: Thirty-four women with FGR diagnosed at <34...
July 24, 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/28720086/pregnancy-outcomes-in-patients-with-acute-kidney-injury-during-pregnancy-a-systematic-review-and-meta-analysis
#9
Youxia Liu, Xinxin Ma, Jie Zheng, Xiangchun Liu, Tiekun Yan
BACKGROUND: Presently, the matter of pregnancy outcomes of patients with pregnancy related AKI (PR-AKI) were disputed. Thus, we conducted a meta-analysis to evaluate the impact of PR-AKI on pregnancy outcomes. METHOD: We systematically searched MEDLINE, Embase, VIP, CNKI and Wanfang Databases for cohort or case-control studies in women with PR-AKI and those without AKI as a control group to assess the influence of PR-AKI on pregnancy outcomes and kidney outcome...
July 18, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28711077/acute-kidney-injury-in-pregnancy
#10
Belinda Jim, Vesna D Garovic
Pregnancy-related acute kidney injury (AKI) has declined in incidence in the last three decades, although it remains an important cause of maternal and fetal morbidity and mortality. Pregnancy-related causes of AKI such as preeclampsia, acute fatty liver of pregnancy, HELLP (Hemolysis, Elevated Liver function tests, Low Platelets) syndrome, and the thrombotic microangiopathies (thrombotic thrombocytopenic purpura, atypical hemolytic-uremic syndrome [HUS]) exhibit overlapping features and often present as diagnostic dilemmas...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711073/lupus-nephritis-and-pregnancy-concerns-and-management
#11
Liz Lightstone, Michelle A Hladunewich
Pregnancy associated with lupus, especially lupus nephritis, is often fraught with concern for both the mother and fetus. Thus, it is paramount that care begins preconception so that proper planning in terms of optimizing the medical regimen, discontinuation of fetotoxic agents, and treatment of active disease can occur. It is well known that active nephritis at the time of conception is associated with poor outcomes. Even with quiescent disease, recent data indicate that being lupus anticoagulant-positive, nonwhite or Hispanic, and using antihypertensive medications were all predictors of worse pregnancy outcomes...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28704180/placental-protein-13-pp13-in-combination-with-papp-a-and-free-leptin-index-fli-in-first-trimester-maternal-serum-screening-for-severe-and-early-preeclampsia
#12
Carin P De Villiers, Paula L Hedley, Sophie Placing, Karen R Wøjdemann, Anne-Cathrine Shalmi, Anting L Carlsen, Line Rode, Karin Sundberg, Ann Tabor, Michael Christiansen
BACKGROUND: Placental protein-13 (PP13) is involved in placental invasion and has been suggested as a maternal serum marker of preeclampsia (PE) development. However, the discriminatory ability of PP13 in first trimester has not been completely clarified. METHODS: PP13 was measured in first trimester (week 10+3-13+6) maternal serum from 120 PE pregnancies and 267 control pregnancies and was correlated with clinical parameters. The population screening performance of PP13 in combination with the PE markers pregnancy associated plasma protein A (PAPPA) and free leptin index (fLI) was assessed by Monte Carlo simulation...
July 12, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28696852/imaging-of-pregnancy-related-vascular-complications
#13
R Scooter Plowman, Cylen Javidan-Nejad, Constantine A Raptis, Douglas S Katz, Vincent M Mellnick, Sanjeev Bhalla, Patricia Cornejo, Christine O Menias
Pregnancy results in substantial hemodynamic and prothrombotic changes that form the foundation for downstream vascular complications, both during pregnancy and in the postpartum period. In addition, several important risk factors, including older patient age, diabetes, and smoking, can increase the risk for vascular-related pregnancy complications. Because radiologists often play an important role in evaluation of the pregnant patient, understanding the pathophysiology of vascular-related complications in pregnancy and their imaging appearances is essential for diagnostic accuracy...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28676729/-spontaneous-hepatic-haematoma-in-a-pregnant-woman-during-labour
#14
M Polo Gil, E Uriarte Rosquil, I Plaja Martí, J Del Río Manterola, T Lánderer Vázquez, M Remón Izquieta
Spontaneous hepatic rupture during labour is a rare condition. Because of the difficulty in diagnosing hepatic rupture in pregnant women, it is often associated with a high mortality rate. Although pregnant women with HELLP syndrome are more prone to hepatic rupture, it can also occur with other liver pathologies and even in healthy women. We should be vigilant in case of suspicious clinical signs even if we have no evidence of preeclampsia. An early diagnosis will be the key to reducing the mortality and morbidity rate...
June 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28670595/massive-hepatic-infarction-caused-by-hellp-syndrome
#15
Adam E Mikolajczyk, John Renz, Geraldine Diaz, Lindsay Alpert, John Hart, Helen S Te
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
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
#16
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%C3%A2-eclampsia
#17
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...
September 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
#18
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
#19
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
#20
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
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