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hellp syndrome guidelines

Sibel Sak, Mert Barut, Hakim Celik, Adnan Incebiyik, Elif Ağaçayak, Hacer Uyanikoglu, Adnan Kirmit, Muhammet Sak
OBJECTIVE: The aim of this study was investigate the maternal serum concentrations of copper (Cu) and ceruloplasmin (CP) in patients with mild preeclampsia, severe preeclampsia, and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, and to determine their associations with the severity of the disease. METHODS: This study was carried out at the largest tertiary care health center in the southeast region in Turkey and Department of Obstetrics and Gynecology...
June 10, 2018: Journal of Maternal-fetal & Neonatal Medicine
Satoshi Yokoyama, Takayuki Nukada, Yuka Ikeda, Shigeto Hara, Akira Yoshida
BACKGROUND: Peritoneal dialysis (PD) for acute kidney injury (AKI) of newborns has been performed safely. AKI occurs in 8 to 24% of extremely low birth weight (ELBW) infants. Although PD has only been used occasionally in ELBW infants, prognosis is poor for ELBW infants with AKI. Several reports have described successful PD in these infants, but no guideline-based evidence concerning indications for renal replacement therapy in ELBW infants are currently available. Here, we report on our experience with PD in an ELBW infant with AKI resulting from septic shock...
November 9, 2017: Surgical Case Reports
Dániel Bereczki, Norbert Szegedi, Zoltán Szakács, István Gubucz, Zsolt May
An estimated 25-40% of ischemic strokes are classified as cryptogenic, which means the cause of the cerebral infarction remains unidentified. One of the potential pathomechanisms - especially among young patients with no cardiovascular risk factors - is paradoxical embolism through a patent foramen ovale. Pregnancy, cesarean delivery and the postpartum period are associated with an increased risk of cerebrovascular events. Factors that may contribute to ischemic strokes during gestation and puerperium include classic cardiovascular risk factors, changes in hemostaseology/hemodynamics, and pregnancy-specific disorders such as pre-eclampsia, eclampsia, postpartum cerebral angiopathy or peripartum cardiomyopathy...
2016: Neurologia i Neurochirurgia Polska
Renato T Souza, Jose G Cecatti, Renato Passini, Ricardo P Tedesco, Giuliane J Lajos, Marcelo L Nomura, Patricia M Rehder, Tabata Z Dias, Samira M Haddad, Rodolfo C Pacagnella, Maria L Costa
BACKGROUND: About 15 million children are born under 37 weeks of gestation worldwide. Prematurity is the leading cause of neonatal deaths and short/long term morbidities, entailing consequences not only for the individual, but also their family, health agencies, facilities and all community. The provider-initiated preterm birth is currently one of the most important obstetric conditions related to preterm births, particularly in middle and high income countries, thus decreasing the need for therapeutic preterm birth is essential to reduce global prematurity...
2016: PloS One
Cihan Cetin, Selim Buyukkurt, Gulsah Seydaoglu, Bekir Kahveci, Cenk Soysal, Fatma Tuncay Ozgunen
OBJECTIVE: To compare the safety and efficacy of two misoprostol regimens for mid-trimester pregnancy terminations. METHODS: Retrospective analysis of 263 cases of pregnancy terminations with misoprostol between 12 and 24 weeks was performed. Group 1 (total 129 patients) consisted of patients who were given 200 mcg vaginal misoprostol every 4 h until the abortion, whereas Group 2 patients (total 134 patients) were given misoprostol as in International Federation of Gynecology and Obstetrics's (FIGO) 2012 recommendation...
2016: Journal of Maternal-fetal & Neonatal Medicine
(no author information available yet)
No abstract text is available yet for this article.
June 1, 2015: American Journal of Perinatology
Amanda R Vest, Leslie S Cho
Hypertensive disorders of pregnancy represent the second commonest cause of direct maternal death and complicate an estimated 5-10 % of pregnancies. Classification systems aim to separate hypertension similar to that seen outside pregnancy (chronic and gestational hypertension) from the potentially fatal pregnancy-specific conditions. Preeclampsia, HELLP syndrome, and eclampsia represent increasing severities of this disease spectrum. The American College of Obstetricians and Gynecologists' 2013 guidelines no longer require proteinuria as a diagnostic criterion, because of its variable appearance in the disease spectrum...
March 2014: Current Atherosclerosis Reports
Danielle M Townsley
Pregnancy induces a number of physiologic changes that affect the hematologic indices, either directly or indirectly. Recognizing and treating hematologic disorders that occur during pregnancy is difficult owing to the paucity of evidence available to guide consultants. This review discusses specifically the diagnosis and management of benign hematologic disorders occurring during pregnancy. Anemia secondary to iron deficiency is the most frequent hematologic complication and is easily treated with oral iron formulations; however, care must be taken not to miss other causes of anemia, such as sickle cell disease...
July 2013: Seminars in Hematology
Ludwina Szczepaniak-Chicheł, Andrzej Tykarski
Arterial hypertension concerns 7-10% of pregnancies and leads to an increased risk of complications for both, the mother and the child. This rate will probably rise in the years to come due to the notable tendency among women to delay the decision to become pregnant - values of blood pressure and occurrence of arterial hypertension increase with age, as well as due to the growing problem of obesity resulting from inappropriate dietary habits and lack of regular everyday physical activity. Difficulties with management of that clinical condition are partly related with lack of unified and widely accepted guidelines...
October 2012: Ginekologia Polska
S F M Häusler, T Bernar, S Rau, P Kranke, J Dietl, L Rieger
BACKGROUND: A severe hepatopathy constitutes a serious threat during pregnancy and poses considerable challenges to the treating physicians. A broad spectrum of pregnancy-dependent or independent diseases like HELLP-syndrome, liver infection or acute fatty liver of pregnancy (AFLP) is characterized by these affections of the liver. In this study, we present a series of 3 cases with life-threatening hepatopathies and discuss the current state of the literature. A special focus is placed on pathogenesis and differential diagnosis...
December 2012: Zeitschrift Für Geburtshilfe und Neonatologie
Josien A Terwisscha van Scheltinga, Ineke Krabbendam, Marc E A Spaanderman
OBJECTIVE: Guidelines define hypertension diagnosed before 20 weeks' gestation as chronic hypertension (CH) and thereafter as gestational hypertension (GH). We tested whether hypertension diagnosed before 20 weeks is preceded by CH and whether pregnancy outcome depends on the time of onset of hypertension. DESIGN: Retrospective cohort study. SETTING: Tertiary obstetric center. POPULATION: Women with a history of obstetric vascular complications...
March 2013: Acta Obstetricia et Gynecologica Scandinavica
Hussein Lesio Kidanto, Peter Wangwe, Charles D Kilewo, Lennarth Nystrom, Gunnila Lindmark
BACKGROUND: Criteria-based audits (CBA) have been used to improve clinical management in developed countries, but have only recently been introduced in the developing world. This study discusses the use of a CBA to improve quality of care among eclampsia patients admitted at a University teaching hospital in Dar es Salaam Tanzania. OBJECTIVE: The prevalence of eclampsia in MNH is high (≈6%) with the majority of cases arriving after start of convulsions. In 2004-2005 the case-fatality rate in eclampsia was 5...
2012: BMC Pregnancy and Childbirth
A Brassier, C Ottolenghi, N Boddaert, P Sonigo, T Attié-Bitach, A-E Millischer-Bellaiche, G Baujat, V Cormier-Daire, V Valayannopoulos, N Seta, M Piraud, B Chadefaux-Vekemans, C Vianey-Saban, R Froissart, P de Lonlay
Inherited metabolic diseases are mostly due to enzyme deficiency in one of numerous metabolic pathways, leading to absence of a compound downstream from and the accumulation of a compound upstream from the deficient metabolite(s). Diseases of intoxication by proteins (aminoacidopathies, organic acidurias, urea cycle defects) and by sugars (galactosemia, fructosemia) usually do not give prenatal symptoms since mothers protect their fetuses from pathological metabolite accumulation. A well-known exception is hypoplasia of corpus callosum, as is sometimes observed in nonketotic hyperglycinemia and sulfite oxidase deficiency...
September 2012: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
M Khellaf, V Loustau, P Bierling, M Michel, B Godeau
The occurrence of thrombocytopenia during pregnancy is frequent (about 10%). Etiologies of thrombocytopenia are dominated by the gestational thrombocytopenia (>75%), which requires no exploration and no specific treatment; it usually occurs during the last trimester of pregnancy and corrects itself spontaneously after delivery. Other etiologies are: (1) immune thrombocytopenia (ITP) either primary or associated with other pathologies; ITP may appear early in the first trimester of pregnancy, (2) thrombotic microangiopathy syndromes, and (3) obstetric thrombocytopenia: eclampsia and HELLP syndrome (hemolysis elevated liver enzymes, and low platelet count)...
August 2012: La Revue de Médecine Interne
A T Dennis
Pre-eclampsia is a leading cause of maternal morbidity and mortality. Substandard care is often present and many deaths are preventable. The aim of this review is to summarise the key management issues for anaesthetists in the light of the current literature. A systematic literature search of electronic databases was undertaken including MEDLINE, EMBASE and the Cochrane Library using the key words obstetrics, pregnancy, pregnancy complications, maternal, pre-eclampsia, preeclampsia, cardiac function, haemodynamics, haemolysis, elevated liver enzymes, low platelets (HELLP), eclampsia, anaesthesia, anesthesia, neuraxial...
September 2012: Anaesthesia
Baha M Sibai
OBJECTIVE: We sought to review the risks and benefits of expectant management of severe preeclampsia remote from term, and to provide recommendations for expectant management, maternal and fetal evaluation, treatment, and indications for delivery. METHODS: Studies were identified through a search of the MEDLINE database for relevant peer-reviewed articles published in the English language from January 1980 through December 2010. Additionally, the Cochrane Library, guidelines by organizations, and studies identified through review of the above documents and review articles were utilized to identify relevant articles...
September 2011: American Journal of Obstetrics and Gynecology
Etienne Ciantar, James J Walker
Pre-eclampsia and eclampsia have been known to us for centuries. Significant improvements have been made in our knowledge of the disease, however, delivery remains the only effective form of treatment. There is widespread variation of practice in the management of hypertensive disease in pregnancy, which may lead to substandard care. The use of aspirin in preventing pre-eclampsia, the lack of correlation between urinary protein and adverse outcome, and the ineffectiveness of corticosteroids in the management of hemolysis and elevated liver enzymes and low platelets syndrome are a few of the developments that will alter the way this condition is managed...
September 2011: Women's Health
M Schott, A Henkelmann, Y Meinköhn, J-P Jantzen
Postpartum onset of eclampsia and HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome is a rare but life-threatening complication for both mother and fetus. A case of a 38-year-old parturient (gravida 2, para 1) who was asymptomatic prior to delivery is reported. Emergency caesarean section had to be performed due to sudden onset of fetal bradycardia as a result of partial placental separation. The perioperative course was characterized by new onset hypertension, nausea and restlessness; within 2 h the patient suffered a generalized seizure which was treated with magnesium sulfate and hydralazine...
April 2011: Der Anaesthesist
Denise H J Delahaije, Sander M J van Kuijk, Carmen D Dirksen, Simone J S Sep, Louis L Peeters, Marc E Spaanderman, Hein W Bruinse, Laura D de Wit-Zuurendonk, Joris A M van der Post, Johannes J Duvekot, Jim van Eyck, Mariëlle G van Pampus, Mark A B H M van der Hoeven, Luc J Smits
BACKGROUND: Preeclampsia and HELLP syndrome may have serious consequences for both mother and fetus. Women who have suffered from preeclampsia or the HELLP syndrome, have an increased risk of developing preeclampsia in a subsequent pregnancy. However, most women will develop no or only minor complications. In this study, we intend to determine cost-effectiveness of recurrence risk guided care versus care as usual in pregnant women with a history of early-onset preeclampsia. METHODS/DESIGN: We developed a prediction model to estimate the individual risk of recurrence of early-onset preeclampsia and the HELLP syndrome...
October 11, 2010: BMC Pregnancy and Childbirth
A-S Ducloy-Bouthors
Clotting disorders are associated with the severe, early and complicated forms of PE. Compensated hypercoagulability states associated with a thrombocytopenia (PLT<150k/mm(3)) affect 25 to 50% of severe PE patients. Laboratory markers of platelet and endothelial activation are the early increase of fibronectin levels, the worsening of the thrombocytopenia and the raised platelet turnover. The excessive thrombin formation is physiologically compensated by a rise in thrombin-antithrombin (TAT) complex levels, which is the most specific marker of a PE pregnancy, and a decrease in anti-thrombin (AT) activity...
May 2010: Annales Françaises D'anesthèsie et de Rèanimation
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