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preeclampsia in postpartum

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https://www.readbyqxmd.com/read/28798930/adverse-pregnancy-outcomes-of-patients-with-history-of-first-trimester-recurrent-spontaneous-abortion
#1
Jing Yang, Yan Wang, Xiao-Ye Wang, Yan-Yu Zhao, Jing Wang, Yang-Yu Zhao
Although a history of first-trimester recurrent spontaneous abortion (FRSA) is regarded as a risk factor in antenatal care, the characteristic of subsequent pregnancy outcome is not clearly elucidated. Here, a retrospective analysis was performed on the clinical data of 492 singleton pregnant women. 164 of them with the history of FRSA were enrolled in study group, compared to 328 deliveries without the history of FRSA. For maternal outcomes, patients in the study group delivered earlier with mean gestational age and the incidences of cesarean section and postpartum hemorrhage were higher compared to the control group...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28796431/acute-kidney-injury-in-a-postpartum-woman-with-paroxysmal-nocturnal-hemoglobinuria-a-case-report-and-literature-review
#2
Masatoshi Nishimoto, Masaru Matsui, Hideo Tsushima, Kaori Tanabe, Miho Tagawa, Ken-Ich Samejima, Yasuhiro Akai, Yoshihiko Saito
Paroxysmal nocturnal hemoglobinuria is a rare clonal hematopoietic stem cell disorder characterized by intravascular hemolysis, hemoglobinuria, and inflammatory thrombotic state. Intravascular hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) can lead to acute and chronic renal injury through hemoglobin-mediated toxicity. A 32-year-old pregnant woman with myelodysplastic syndrome was admitted to our hospital with severe preeclampsia. Shortly after an urgent caesarean section, she became obtunded and showed signs of acute kidney injury (AKI) with anuria, severe intravascular hemolysis, and hypermagnesemia...
August 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28782324/congenital-perisylvian-syndrome-presenting-as-post-partum-seizures-with-preeclampsia
#3
Arun Agarwal, Manju Goyal, Jainendra Jain, Aakanksha Agarwal
Whether preceded by preeclampsia, or occuring without antecedent warning symptoms, eclamptic seizures usually occur in the antepartum period between 20 and 40 weeks of gestation or within a few hours to 2 days postpartum. We report the case of a patient with pre-eclampsia who developed seizures after more than 2 days of delivery. In view of late onset postpartum seizures and non-responsiveness to magnesium sulphate, she was further evaluated and diagnosed to have congenital perisylvian syndrome(CPS). In CPS, polymicrogyric cortex is distributed in variable extensions around the sylvian fissure i...
June 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28768228/preeclampsia-is-associated-with-increased-ambulatory-arterial-stiffness-index-in-type-1-diabetes-mellitus
#4
Hanine F M Al-Far, Ingvild H Tjessem, Jens Fuglsang, Finn F Lauszus
INTRODUCTION: Treatment of mild to moderate hypertension might not benefit maternal or fetal outcome. This pessimistic point of view may have come about by using non-validated methods for measuring blood pressure in pregnancy combined with inadequate methodology for diagnosis, treatment, and monitoring effects. AIM: To determine the association between AASI in women with type 1 diabetes mellitus (T1DM) and preeclampsia, and to assess the ability of AASI to diagnose preeclampsia...
July 25, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28761227/acute-kidney-injury-in-pregnancy-specific-disorders
#5
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/28713290/advanced-maternal-age-worsens-postpartum-vascular-function
#6
Jude S Morton, Alison S Care, Raven Kirschenman, Christy-Lynn Cooke, Sandra T Davidge
The age at which women experience their first pregnancy has increased throughout the decades. Pregnancy has an important influence on maternal short- and long-term cardiovascular outcomes. Pregnancy at an advanced maternal age increases maternal risk of gestational diabetes, preeclampsia, placenta previa and caesarian delivery; complications which predict worsened cardiovascular health in later years. Aging also independently increases the risk of cardiovascular disease; therefore, combined risk in women of advanced maternal age may lead to detrimental cardiovascular outcomes later in life...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28708773/angiotensin-ii-responsiveness-after-preeclampsia-translational-data-from-an-experimental-rat-model-and-early-onset-human-preeclampsia
#7
Anne M van der Graaf, Tsjitske J Toering, Mienke W K van der Wiel, Anne-Roos S Frenay, Gerd Wallukat, Ralf Dechend, Gerjan Navis, Henk Groen, A Titia Lely, Marijke M Faas
OBJECTIVE: Formerly preeclamptic women have an increased risk for cardiovascular and renal disease later in life. It is unknown which mechanisms contribute to this increased risk and whether this is induced by preeclampsia or by prepregnancy factors. We hypothesized that the increased risk for cardiovascular disease is partly due to an increased angiotensin II (ang II) responsiveness postpartum and that preeclampsia itself is involved in inducing this increased ang II responsiveness. METHODS: In never-pregnant, formerly healthy pregnant rats and rats with former experimental preeclampsia [experimental preeclampsia model induced by low-dose endotoxin infusion on day 14 of pregnancy; endotoxin-infused pregnant rats (EP-rats)], ang II responsiveness was studied by measuring changes in blood pressure (BP) and proteinuria after chronic ang II infusion with osmotic minipumps (200 ng/kg per min)...
July 13, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28706365/obstetric-outcome-in-women-with-chronic-liver-disease
#8
Pinky Jena, C N Sheela, Rao Preethi Venkatachala, Harshad Devarbhavi
AIM: This study determines the prevalence, causes and outcome of pregnancy in women with chronic liver diseases in a tertiary level teaching institute in Southern India. METHODS: Retrospective analysis of case records was carried out between December 2010 and May 2015 in the departments of Obstetrics and Gynecology and Gastroenterology including pregnant women diagnosed to have chronic liver diseases prenatally or during pregnancy. RESULTS: The frequency of chronic liver disease in pregnancy was 50 among 10,823 deliveries (0...
August 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28697030/severe-postpartum-headache-and-hypertension-caused-by-reversible-cerebral-vasoconstriction-syndrome-a-case-report
#9
Ed McIlroy, Rajamani Sethuraman, Reshma Woograsingh, Catherine Nelson-Piercy, Edward Gilbert-Kawai
Reversible cerebrovascular vasoconstriction syndrome is an uncommon condition that presents as severe headache and hypertension. Recent literature suggests a 1% incidence in postpartum headache cases. It can cause subarachnoid hemorrhages, cerebral ischemia, and seizures. It is often misdiagnosed as postdural puncture headache or preeclampsia. In this case, a postpartum woman, who had received epidural anesthesia for labor, presented 5 days postpartum with severe headache that did not resolve with an epidural blood patch...
July 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28696852/imaging-of-pregnancy-related-vascular-complications
#10
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/28669620/prenatal-tdap-immunization-and-risk-of-maternal-and-newborn-adverse-events
#11
J Bradley Layton, Anne M Butler, Dongmei Li, Kim A Boggess, David J Weber, Leah J McGrath, Sylvia Becker-Dreps
Many countries recommend combined tetanus toxoid, reduced diphtheria toxoid and acellular pertussis immunization (Tdap) during pregnancy to stimulate transplacental transmission of pertussis antibodies to newborns. The immune system can be altered during pregnancy, potentially resulting in differing immunization risks in pregnant women. The safety of widespread Tdap immunization during pregnancy needs to be established. Our objective was to assess whether prenatal Tdap immunization was associated with adverse birth outcomes, and to evaluate the effect of timing of Tdap administration on these outcomes...
July 24, 2017: Vaccine
https://www.readbyqxmd.com/read/28652473/increased-angiotensin-ii-sensitivity-contributes-to-microvascular-dysfunction-in-women-who-have-had-preeclampsia
#12
Anna E Stanhewicz, Sandeep Jandu, Lakshmi Santhanam, Lacy M Alexander
Women who have had preeclampsia have increased cardiovascular disease risk; however, the mechanism(s) responsible for this association remain unclear. Microvascular damage sustained during a preeclamptic pregnancy may persist postpartum. The putative mechanisms mediating this dysfunction include a reduction in NO-dependent dilation and an increased sensitivity to angiotensin II. In this study, we evaluated endothelium-dependent dilation, angiotensin II sensitivity, and the therapeutic effect of angiotensin II receptor blockade (losartan) on endothelium-dependent dilation in vivo in the microvasculature of women with a history of preeclampsia (n=12) and control women who had a healthy pregnancy (n=12)...
August 2017: Hypertension
https://www.readbyqxmd.com/read/28648013/-retrospective-analysis-of-anesthetic-and-perioperative-management-in-patients-of-acute-fatty-liver-of-pregnancy
#13
Y Y Qu, H Zeng, X Y Guo, M Li
Objective: To retrospectively analyze the clinical characteristics of patients with acute fatty liver of pregnancy (AFLP), and to discuss perioperative and anesthetic management. Methods: A retrospective review was conducted on the records of pregnant patients with a diagnosis of acute fatty liver of pregnancy in Peking University Third Hospital from January 2007 to December 2015. 12 cases were identified. The clinical features, preoperative laboratory findings, types of delivery, anesthetic techniques for cesarean section, and the outcomes of parturients and fetus were collected and analyzed...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28629246/clinical-significance-of-primary-symptoms-in-women-with-placental-abruption
#14
Youwen Mei, Yonghong Lin
BACKGROUND: To evaluate the clinical significance of primary symptoms in women with placental abruption. METHODS: A retrospective study of 273 cases of placental abruption was performed. The subjects were classified into two groups according to primary symptoms: 210 cases of the vaginal bleeding group and 63 cases of the abdominal pain group. The clinical features, maternal and neonatal outcomes were compared between two groups. RESULTS: The incidence of preeclampsia and preterm birth in the vaginal bleeding group was significantly lower than abdominal pain group, while the incidence of premature rupture of membrane (PROM) in the former group was higher than that in the latter group...
July 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28625281/the-petra-perinatal-emergency-team-response-assessment-scale-a-high-fidelity-simulation-validation-study
#15
Mrinalini Balki, David Hoppe, David Monks, Lynn Sharples, Mary Ellen Cooke, Lawrence Tsen, Rory Windrim
OBJECTIVE: The objective of this study was to establish the validity and reliability of a new interdisciplinary teamwork assessment scale, the Perinatal Emergency Team Response Assessment (PETRA), to assess team dynamics during a simulated obstetric crisis. METHODS: This observational cohort study was conducted using high-fidelity simulation and multidisciplinary obstetric teams in order to evaluate the validity and reliability of the previously developed PETRA scale for the assessment of teamwork in the management of obstetric crises...
July 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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
#16
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/28561251/management-of-acute-respiratory-failure-in-pregnancy
#17
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/28546662/pregnancy-outcome-in-patients-with-solitary-kidney
#18
Vineet V Mishra, Kavita M Mistry, Sakshi S Nanda, Sumesh Choudhary, Rohina Aggarwal, Khushali Gandhi
BACKGROUND: Solitary kidney may be congenital or as a result of nephrectomy. There is a lot of literature available on quality of life in these patients, but there is limited data on pregnancy outcome. OBJECTIVES: To study pregnancy outcome in patients with solitary kidney either congenital or due to nephrectomy. MATERIALS AND METHODS: Study Design This is a retrospective observational study conducted at tertiary health center in Ahmedabad, from 2011 to 2014...
June 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28532393/maternal-care-quality-in-near-miss-and-maternal-mortality-in-an-academic-public-tertiary-hospital-in-yogyakarta-indonesia-a-retrospective-cohort-study
#19
Yuli Mawarti, Adi Utarini, Mohammad Hakimi
BACKGROUND: Reducing maternal mortality remains a major challenge for health care systems worldwide. The factors related to maternal mortality were extensively researched, and maternal death clusters around labour, delivery and the immediate postpartum period. Studies on the quality of maternal care in academic medical centre settings in low income countries are uncommon. METHODS: A retrospective cohort study of maternal deaths was conducted in an academic public tertiary hospital in Yogyakarta, and maternal near misses were used as controls...
May 22, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28532255/outpatient-versus-inpatient-management-for-superimposed-preeclampsia-without-severe-features-a-retrospective-multicenter-study
#20
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, PA) and at University of Naples (Naples, Italy) from January 2008 to July 2015...
June 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
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