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https://www.readbyqxmd.com/read/28696852/imaging-of-pregnancy-related-vascular-complications
#1
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/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#2
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#3
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28561253/obstetric-disorders-in-the-icu
#4
Daniela N Vasquez, Lauren Plante, María N Basualdo, Gustavo G Plotnikow
Pregnant and postpartum patients represent a challenge to critical care physicians, as two patients in one have to be cared for and because specific obstetric disorders, not universally covered in formal critical care training, need to be managed. Pregnancy also alters physiologic norms, so that the critical care physician may either fail to recognize a value as abnormal in pregnancy or mistakenly identify as abnormal a value within the normal range for a pregnant woman. In this article, we will review the most frequent obstetric causes of admission of pregnant/postpartum patients to the intensive care unit (hypertensive disease of pregnancy, obstetric hemorrhage, and obstetric sepsis) along with their diagnostic criteria, clinical presentation, and recommended treatment...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28561251/management-of-acute-respiratory-failure-in-pregnancy
#5
Stephen E Lapinsky
Respiratory failure affects up to 1 in 500 pregnancies, more commonly in the postpartum period. The causes of respiratory failure include several pregnancy-specific conditions such as preeclampsia, amniotic fluid embolism, and peripartum cardiomyopathy. Pregnancy may also increase the risk or severity of other conditions, such as asthma, thromboembolism, viral pneumonitis, and gastric acid aspiration. Changes to maternal respiratory physiology and the presence of a fetus may affect the assessment and management of these patients...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28188959/amniotic-fluid-embolism-pathophysiology-from-the-perspective-of-pathology
#6
Naoaki Tamura, Mustari Farhana, Tomoaki Oda, Hiroaki Itoh, Naohiro Kanayama
Amniotic fluid embolism (AFE) is recognized as a type of syndrome characterized by the abrupt onset of hypoxia, hypotension, seizures, or disseminated intravascular coagulopathy (DIC), occurring during labor, delivery, or immediately postpartum, caused by the inflow of amniotic components into the maternal circulation. AFE is a rare condition but one of the most serious obstetrical complications, resulting in a high mortality rate among pregnant women. Despite earlier recognition and intensive critical management, we often encounter patients who unfortunately do not recover from the exacerbation of AFE-related conditions...
April 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28151819/epidemiology-of-cardiac-arrest-during-hospitalization-for-delivery-in-canada-a-nationwide-study
#7
Mrinalini Balki, Shiliang Liu, Juan Andrés León, Leyla Baghirzada
BACKGROUND: Cardiac arrest in pregnancy is a rare and devastating condition with high mortality and morbidity. The objective of this study was to generate information about maternal cardiac arrest in Canada by examining the frequency, temporal incidence, associated conditions, potential etiologies, and survival rates. METHODS: This retrospective population-based study used hospitalization data from the discharge abstract database of the Canadian Institute for Health Information relating to obstetric deliveries in Canada from April 1, 2002, to March 31, 2015...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27687451/successful-recovery-after-amniotic-fluid-embolism-in-a-patient-undergoing-vacuum-assisted-vaginal-delivery
#8
Eric M Wise, Ricky Harika, Fatima Zahir
Amniotic fluid embolism (AFE) is a rare, catastrophic emergency that requires prompt recognition and treatment. Despite early recognition and supportive therapy, the morbidity and mortality remain high. We report a case of AFE after vacuum-assisted vaginal delivery resulting in hemodynamic collapse and subsequent multiorgan failure. Management included mechanical ventilation, extracorporeal membrane oxygenation, and continuous veno-venous hemodialysis. The patient was able to make a full recovery with minimal sequelae...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27541321/amniotic-fluid-embolism-using-the-medical-staff-process-to-facilitate-streamlined-care
#9
Peter M Hession, Cynthia J Millward, Joyce E Gottesfeld, Thomas F Rehring, Kevin B Miller, Paul M Chetham, S Kel Muckleroy, Christopher A Bates, Harris W Hollis
Amniotic fluid embolism (AFE) is a catastrophic consequence of labor and delivery that often results in maternal and neonatal death. These poor outcomes are related largely to the rarity of the event in a population overwhelmingly biased by overall good health. Despite the presence of national AFE registries, there are no published algorithmic approaches to its management, to our knowledge. The purpose of this article is to share a care pathway developed by a multidisciplinary group at a community teaching hospital...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27513791/adult-respiratory-distress-syndrome
#10
REVIEW
S Cutts, R Talboys, C Paspula, E M Prempeh, R Fanous, D Ail
Adult respiratory distress syndrome (ARDS) has now been described as a sequela to such diverse conditions as burns, amniotic fluid embolism, acute pancreatitis, trauma, sepsis and damage as a result of elective surgery in general. Patients with ARDS require immediate intubation, with the average patient now being ventilated for between 8 and 11 days. While the acute management of ARDS is conducted by the critical care team, almost any surgical patient can be affected by the condition and we believe that it is important that a broader spectrum of hospital doctors gain an understanding of the nature of the pathology and its current treatment...
January 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27512467/acute-respiratory-failure-in-pregnancy
#11
REVIEW
Stephen E Lapinsky
Respiratory failure affects up to 0.2% of pregnancies, more commonly in the postpartum period. Altered maternal respiratory physiology affects the assessment and management of these patients. Respiratory failure may result from pregnancy-specific conditions such as preeclampsia, amniotic fluid embolism or peripartum cardiomyopathy. Pregnancy may increase the risk or severity of other conditions, including thromboembolism, asthma, viral pneumonitis, and gastric acid aspiration. Management during pregnancy is similar to the nonpregnant patient...
September 2015: Obstetric Medicine
https://www.readbyqxmd.com/read/27393078/seizures-in-the-peripartum-period-epidemiology-diagnosis-and-management
#12
REVIEW
A G M Aya, B Ondze, J Ripart, P Cuvillon
The occurrence of seizures in the peripartum period is a rare but particularly challenging situation. Seizures in the peripartum period could result from three categories of conditions: first and most frequent is the exacerbation of a known pre-existing seizure disorder, mainly epilepsy. A therapeutic evaluation is needed; second is the new onset of seizures due to a non-pregnancy-related problem. An accurate diagnosis and a specific treatment are required; third is range of pregnancy-related conditions. The present review focuses on this third category, with a special attention to disorders occurring in the peripartum period...
October 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27393077/cardiovascular-emergencies-and-cardiac-arrest-in-a-pregnant-woman
#13
REVIEW
Anne-Sophie Ducloy-Bouthors, Max Gonzalez-Estevez, Benjamin Constans, Alexandre Turbelin, Catherine Barre-Drouard
No abstract text is available yet for this article.
October 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27306294/koagulopatia-ze-zu%C3%A5-ycia-jako-wiod%C3%A4-cy-objaw-zatoru-p%C3%A5-ynem-owodniowym-opis-przypadku
#14
Agnieszka Helena Koziołek, Michał Gaca, Krzysztof Szymanowski Szymanowski, Elżbieta Ziętek-Bartlewicz
Amniotic fluid embolism is a rare and diagnostically challenging obstetric disease of high mortality rate. We present a case of a 33-year old parturient after vaginal birth, who presented with severe hemorrhagic shock with low platelet count and coagulopathy resistant to treatment with plasma, platelets and coagulation factors and despite of surgical management of bleeding. Laboratory findings revealed consumptive coagulopathy. Other symptoms included dyspnea and atelectatic changes on chest x-ray, together with augmentation of the heart with no proof of ventricular insufficiency in echocardiographic examination...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27303125/wandering-gastrostomy
#15
Naduthottam Palaniswami Kamalesh, Kurumboor Prakash, Ganesh Narayanan Ramesh
Percutaneous endoscopic gastrostomy (PEG) is a relatively safe and effective method of providing nutrition to patients with neurologic deficits or proximal gastrointestinal pathology. Complications that follow this common procedure include dislodgement, dysfunction, infection, gastric/colonic perforation, bleeding, peritonitis, or death. The emergency physician should be aware of the complications and symptoms/signs associated for appropriate management of these patients. We present a case of a young lady who developed a cerebral infarction following amniotic fluid embolism during her cesarean section and had undergone a PEG tube placement...
April 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27153475/amniotic-fluid-embolism-update-and-review
#16
Pervez Sultan, Katherine Seligman, Brendan Carvalho
PURPOSE OF REVIEW: This article reviews our current understanding of amniotic fluid embolism (AFE), specifically the pathogenesis, treatment strategies, potential diagnostic tests and future therapeutic interventions for AFE. RECENT FINDINGS: The incidence and case mortality of AFE varies widely because of heterogeneous diagnostic criteria and varying reporting mechanisms across the world. Amniotic fluid embolism is thought to be caused by abnormal activation of immunologic mechanisms following entry of fetal antigens into maternal circulation...
June 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26987420/amniotic-fluid-embolism-diagnosis-and-management
#17
Luis D Pacheco, George Saade, Gary D V Hankins, Steven L Clark
OBJECTIVE: We sought to provide evidence-based guidelines regarding the diagnosis and management of amniotic fluid embolism. STUDY DESIGN: A systematic literature review was performed using MEDLINE, PubMed, EMBASE, and the Cochrane Library. The search was restricted to English-language articles published from 1966 through March 2015. Priority was given to articles reporting original research, in particular randomized controlled trials, although review articles and commentaries were consulted...
August 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26715344/amniotic-fluid-embolism-a-historical-perspective-in-diagnosis-and-management
#18
Matthew West
No abstract text is available yet for this article.
January 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/26604229/an-example-of-prompt-and-appropriate-multidisciplinary-management-leading-to-an-exceptionally-good-outcome-a-case-complicated-by-amniotic-fluid-embolism
#19
Deesha Patel, Osaeloke Osakwe, Sayanti Ghosh
Amniotic fluid embolism (AFE) is a rare and serious phenomenon; we describe a rare case of AFE occurring after a second trimester surgical termination in a private clinic, which, with prompt transfer and appropriate multidisciplinary management, had an exceptionally good outcome. The patient developed hypotension, respiratory arrest and disseminated intravascular coagulopathy following the procedure but with aggressive management she made a full recovery without any neurological or long-term sequelae.
2015: BMJ Case Reports
https://www.readbyqxmd.com/read/26092134/from-appearance-to-essence-10%C3%A2-years-review-of-atypical-amniotic-fluid-embolism
#20
REVIEW
Fangrong Shen, Lu Wang, Weiwen Yang, Youguo Chen
PURPOSE: Amniotic fluid embolism (AFE) is an unpredictable and unpreventable complication of maternity. The presentation may range from relatively subtle clinical events to sudden maternal cardiac arrest. However, the neglected diagnosis of non-classical form of AFE (atypical AFE) is very common. The aim of this study was to examine population-based regional data from Suzhou, China. Based on the analysis of all available case reports, we put forward an outline of atypical AFE and investigate whether any variation identified could be ascribed to methodology...
February 2016: Archives of Gynecology and Obstetrics
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