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preeclampsia in postpartum

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https://www.readbyqxmd.com/read/29453467/loading-dose-only-versus-standard-dose-magnesium-sulfate-seizure-prophylaxis-in-severe-pre-eclamptic-women
#1
Surya Prasad Rimal, Pappu Rijal, Rabindra Bhatt, Kriti Thapa
INTRODUCTION: Magnesium sulfate is the drug of choice for prevention of seizures in the pre-eclamptic woman. There is no agreement in the published randomized trials regarding the optimal time to initiate magnesium sulfate, the dose to use (both loading and maintenance) as well as the duration of therapy. The objective of this study is to determine whether magnesium sulfate prophylaxis is needed for up to 24 hours postpartum in all patients with severe pre-eclampsia for the prevention of seizure...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29446070/a-hospital-based-retrospective-study-of-acute-postpartum-headache
#2
Angeliki Vgontzas, Matthew S Robbins
OBJECTIVE: To describe acute headache diagnoses in women presenting emergently in the postpartum period and to determine which factors may be associated with secondary vs primary headache. BACKGROUND: Hormonal, vascular, and procedural factors elevate the risk for both secondary and primary headache disorders in the postpartum period. Differentiating between these can be a diagnostic challenge, particularly among the most severe patients referred for urgent neurological consultation...
February 15, 2018: Headache
https://www.readbyqxmd.com/read/29394890/incidence-aetiology-and-outcomes-of-obstetric-related-acute-kidney-injury-in-malawi-a-prospective-observational-study
#3
William R Cooke, Ulla K Hemmilä, Alison L Craik, Chimwemwe J Mandula, Priscilla Mvula, Ausbert Msusa, Gavin Dreyer, Rhys Evans
BACKGROUND: Obstetric-related acute kidney injury (AKI) is thought to be a key contributor to the overall burden of AKI in low resource settings, causing significant and preventable morbidity and mortality. However, epidemiological data to corroborate these hypotheses is sparse. This prospective observational study aims to determine the incidence, aetiology and maternal-fetal outcomes of obstetric-related AKI in Malawi. METHODS: Women greater than 20 weeks gestation or less than 6 weeks postpartum admitted to obstetric wards at a tertiary hospital in Blantyre, Malawi, and at high-risk of AKI were recruited between 21st September and 11th December 2015...
February 2, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29386453/-nutritional-status-of-japanese-women-of-childbearing-age-and-the-ideal-weight-range-for-pregnancy
#4
Kyoko Nomura, Hiroko Kodama, Michiko Kido
According to the recent 2015 Nutrition Survey, the prevalence of being underweight (Body Mass Index, BMI <18.5 kg/m2) among women in their 20s is 22.3%. Women of childbearing age tend to have a lower intake of protein and their total energy intake is lower than the requirements established by the 2015 Dietary Reference Intakes for Japanese. There is a growing body of evidence showing that underweight women tend to bear small babies and that these babies have an increased risk of diabetes or cancer in their adulthood...
2018: Nihon Eiseigaku Zasshi. Japanese Journal of Hygiene
https://www.readbyqxmd.com/read/29383411/-neuromyelitis-optica-spectrum-disorder-and-pregnancy
#5
REVIEW
N Borisow, K Hellwig, F Paul
BACKGROUND: Neuromyelitis optica spectrum disorders (NMOSD) are autoimmune inflammatory diseases of the central nervous system that mainly affect women. In some of these patients NMOSD occurs during fertile age. For this reason, treating physicians may be confronted with questions concerning family planning, pregnancy and birth. OBJECTIVE: This study provides an overview on the influence of NMOSD on fertility, pregnancy complications and pregnancy outcome. The effect of pregnancy on NMOSD course and therapy options during pregnancy are discussed...
January 30, 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/29370712/effect-of-preeclampsia-on-human-milk-cytokine-levels
#6
Natália Alves de Freitas, Luiza Tavares Carneiro Santiago, Cilmery Suemi Kurokawa, José Donizeti de Meira Junior, José Eduardo Corrente, Ligia Maria Suppo de Souza Rugolo
INTRODUCTION: Preeclampsia (PE) is a systemic inflammatory disease, and its effect on human milk immune components is poorly understood. OBJECTIVE: To investigate whether PE affects human milk cytokine levels. METHODS: This was a prospective observational study involving mothers diagnosed with PE and with singleton pregnancy with no fetal malformation. The following cases were excluded: diabetes, chorioamnionitis, use of illicit drugs and alcohol, mastitis and congenital infection...
January 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29365329/the-relationship-between-body-mass-index-in-pregnancy-and-adverse-maternal-perinatal-and-neonatal-outcomes-in-rural-india-and-pakistan
#7
Vanessa L Short, Stacie E Geller, Janet L Moore, Elizabeth M McClure, Shivaprasad S Goudar, Sangappa M Dhaded, Bhalachandra S Kodkany, Sarah Saleem, Farnaz Naqvi, Omrana Pasha, Robert L Goldenberg, Archana B Patel, Patricia L Hibberd, Ana L Garces, Marion Koso-Thomas, Menachem Miodovnik, Dennis D Wallace, Richard J Derman
OBJECTIVE:  The objective of this study was to describe the relationship between early pregnancy body mass index (BMI) and maternal, perinatal, and neonatal outcomes in rural India and Pakistan. STUDY DESIGN:  In a prospective, population-based pregnancy registry implemented in communities in Thatta, Pakistan and Nagpur and Belagavi, India, we obtained women's BMI prior to 12 weeks' gestation (categorized as underweight, normal, overweight, and obese following World Health Organization criteria)...
January 24, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29349936/preeclampsia-increases-the-incidence-of-postpartum-cerebrovascular-disease-in-korean-population
#8
Yejin Park, Geum Joon Cho, Log Young Kim, Tae Seon Lee, Min Jeong Oh, Young Han Kim
BACKGROUND: Multiple studies have been reported regarding preeclampsia as a possible risk factor of cerebrovascular disease (CVD). However, the correlation of preeclampsia and CVD, whether it is a cause-effect relationship or they are sharing common predisposing condition, is not well understood. Therefore, the aim of this study was to investigate the association between the preeclampsia during pregnancy and development of postpartum CVD. METHODS: A total of 1,384,550 Korean women who had a delivery between January 1, 2010 and December 31, 2012, were enrolled...
February 5, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29331477/atypical-presentation-of-pregnancy-related-hemolytic-uremic-syndrome
#9
Salim Baghli, Catherine Abendroth, Umar Farooq, Jennifer A Schaub
The cause of acute kidney injury during pregnancy and in the postpartum period can be particularly challenging to diagnose, especially when it is necessary to differentiate among preeclampsia; eclampsia; hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome; and thrombotic microangiopathies (TMAs). All these disease entities can present with kidney failure, microangiopathic hemolytic anemia, and thrombocytopenia. We present a teaching case of atypical hemolytic uremic syndrome in the postpartum period in a young woman who was found to have mutations of uncertain clinical significance in the complement cascade, including in C3, CFH, and CFI...
January 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29325324/-obstetric-outcome-in-pregnancy-complained-with-pulmonary-hypertension
#10
C X Zhu, W Xiong, J Yang, H Q Chen, G Niu, Z L Wang
Objective: To identify whether pregnancy outcomes vary by the severity of pulmonary hypertension. Methods: A retrospective study was conducted on 78 cases of pregnancies complained with pulmonary hypertension who delivered in the First Affiliated Hospital, Sun Yat-sen University from 2006 to 2016.The selected cases were divided into three groups according to severity of pulmonary hypertension: mild pulmonary hypertension group (mild PAH group) was defined as a mean pulmonary artery pressure 30-49 mmHg, moderate pulmonary hypertension (moderate PAH group) as mean pulmonary artery pressure 50-69 mmHg and severe pulmonary hypertension (severe PAH group) as mean pulmonary artery pressure 70 mmHg or greater...
December 19, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29303121/maternal-and-obstetric-complications-among-hiv-infected-women-treated-with-highly-active-antiretroviral-treatment-at-a-regional-hospital-in-durban-south-africa
#11
H M Sebitloane, J Moodley
INTRODUCTION: HIV is the leading cause of maternal deaths in resource-poor countries. The use of highly active antiretroviral treatment (HAART) has been shown to almost eliminate vertical transmission and improve maternal health outcomes. Its effect on direct obstetric conditions has not been well documented. METHODS: We conducted a retrospective study of women who delivered at a regional hospital from April 1, 2011, to April 30, 2014. We employed a stratified random selection, where the first 50 files recorded in the birth register during each calendar month were chosen, at a ratio of one HIV uninfected for every 4 infected women...
November 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29301455/body-mass-index-at-11-13%C3%A2-weeks-gestation-and-pregnancy-complications-in-a-southern-chinese-population-a-retrospective-cohort-study
#12
Piya Chaemsaithong, Tak Yeung Leung, Daljit Sahota, Yvonne Kwun Yue Cheng, Wing Cheong Leung, Tsz Kin Lo, Liona Chiu Yee Poon
OBJECTIVE: To assess the association between body mass index (BMI) and adverse pregnancy outcomes. MATERIALS AND METHODS: A multicentre retrospective cohort study was conducted in three hospitals in Hong Kong including 67 248 women with singleton pregnancy at 11-13 weeks between 2010-2016. The relationship between maternal BMI and [1] miscarriage or stillbirth, [2] development of preeclampsia (PE), [3] gestational hypertension (GH), [4] development of gestational diabetes mellitus (GDM), [5] spontaneous preterm delivery (sPTD) < 34 and < 37 weeks, [6] delivery of a small for gestational age (SGA) or large for gestational age (LGA) neonate, [7] caesarean section (CS) and [8] postpartum haemorrhage (PPH) were examined after adjusting for confounding factors...
January 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29237307/oligohydramnios-is-an-independent-risk-factor-for-perinatal-morbidity-among-women-with-pre-eclampsia-who-delivered-preterm
#13
Alex Rabinovich, Keren Holtzman, Ilana Shoham-Vardi, Moshe Mazor, Offer Erez
PURPOSE: The purpose of this study is to determine the relationship between oligohydramnios and adverse maternal and neonatal outcomes in a unique cohort of preterm pre-eclamptic patients. MATERIALS AND METHODS: A retrospective matched case-control study comparing 81 preterm parturients (28 0/7 and 36 6/7 weeks) with pre-eclampsia and oligohydramnios to 81 preterm pre-eclamptic patients with a normal amniotic fluid index (AFI). RESULTS: About 4...
December 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29225682/frontal-lobe-meningioma-mimicking-preeclampsia-a-case-study
#14
Jinny Y Foo, Gregory K Davis, Mark A Brown
We report a case of a left frontal lobe meningioma presenting in a woman with proteinuric preeclampsia in her first term pregnancy. The patient had a background of antepartum migraines that resolved in the second trimester of pregnancy. Postpartum, she required urgent surgery and sustained convulsions after surgery. She had no residual disease and has had another successful pregnancy. This case highlights the importance of cerebral imaging in the context of an atypical clinical course of preeclampsia. Although headaches are common in pregnancy and usually benign, other, more serious, diagnoses should be considered with atypical headaches, a change in the nature of the headache, and headaches that persist despite appropriate treatment...
December 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/29223622/airway-changes-following-labor-and-delivery-in-preeclamptic-parturients-a-prospective-case-control-study
#15
P Ahuja, D Jain, N Bhardwaj, K Jain, S Gainder, M Kang
BACKGROUND: Preeclampsia is associated with greater narrowing of the airway than normal pregnancy, but it is not known if these changes worsen during labor and delivery. The aim of the study was to evaluate the airway during and after labor in women with or without preeclampsia. METHODS: Twenty-five normal and 25 severely preeclamptic pregnant women in early labor were recruited in this single-center, prospective, case-control study. Airway assessment was performed (a) before active labor (b) within one hour of delivery and (c) 24-48 h postpartum...
November 6, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29222249/thrombocytopenia-in-pregnancy
#16
REVIEW
Douglas B Cines, Lisa D Levine
Thrombocytopenia develops in 5% to 10% of women during pregnancy or in the immediate postpartum period. A low platelet count is often an incidental feature, but it might also provide a biomarker of a coexisting systemic or gestational disorder and a potential reason for a maternal intervention or treatment that might pose harm to the fetus. This chapter reflects our approach to these issues with an emphasis on advances made over the past 5 to 10 years in understanding and managing the more common causes of thrombocytopenia in pregnancy...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29215510/timing-and-risk-factors-of-postpartum-stroke
#17
Gloria Too, Timothy Wen, Amelia K Boehme, Eliza C Miller, Lisa R Leffert, Frank J Attenello, William J Mack, Mary E DʼAlton, Alexander M Friedman
OBJECTIVE: To characterize risk and timing of postpartum stroke readmission after delivery hospitalization discharge. METHODS: The Healthcare Cost and Utilization Project's Nationwide Readmissions Database for calendar years 2013 and 2014 was used to perform a retrospective cohort study evaluating risk of readmission for stroke within 60 days of discharge from a delivery hospitalization. Risk was characterized as odds ratios (ORs) with 95% CIs based on whether patients had hypertensive diseases of pregnancy (gestational hypertension or preeclampsia), or chronic hypertension, or neither disorder during the index hospitalization...
January 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29198848/association-between-surgically-diagnosed-endometriosis-and-adverse-pregnancy-outcomes
#18
Innie Chen, Shifana Lalani, Ri-Hua Xie, Minxue Shen, Sukhbir S Singh, Shi-Wu Wen
OBJECTIVE: To examine the association between surgically diagnosed endometriosis and pregnancy outcomes in subsequent pregnancies. DESIGN: Retrospective cohort study of women who delivered a singleton live birth from 2003 to 2013 in Ottawa, Ontario, Canada. SETTING: Tertiary level academic center. PATIENT(S): Pregnant women with surgically diagnosed endometriosis were identified using International Classification of Diseases-10 codes from previous hospital admissions and were compared with pregnant women with no prior admission for endometriosis for the occurrences of adverse pregnancy outcomes...
November 29, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29187935/-haemorrhagic-stroke-of-the-brainstem-secondary-to-postpartum-eclampsia-about-a-case-and-literature-review
#19
REVIEW
Khadija Ennaqui, Assia Makayssi, Houssine Boufettal, Naima Samouh
Strokes are rare but severe accidents during pregnancy and post-partum period. They are responsible for high mortality and morbidity rates. Pre-eclampsia, eclampsia, and strokes are significantly related. Endothelial dysfunction, alteration of brain self-regulation and severe hypertension are, probably, the cause of many strokes in pregnant women and during postpartum period. We report a case of hemorrhagic stroke of the brainstem in a nonmonitored 21-year old patient at 38 weeks pregnant admitted with severe preeclampsia complicated by eclampsia and then by haemorrhagic stroke of the brainstem on the second post-operative day after cesarean section performed due to suspicion of retroplacental haematoma arisen since her admission...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29176311/effect-of-magnesium-on-glomerular-filtration-rate-and-recovery-of-hypertension-in-women-with-severe-preeclampsia
#20
Chatchai Kreepala, Wongsakorn Luangphiphat, Alfredo Villarroel, Maethaphan Kitporntheranunt, Krittanont Wattanavaekin, Teeraya Piyajarawong
INTRODUCTION: Magnesium sulfate is used for preventing seizures in patients with severe preeclampsia. Previous studies have demonstrated that magnesium plays a significant role in the endothelial function and might have clinically beneficial vasodilating properties. OBJECTIVES: This study is aimed at evaluating the effect of magnesium sulfate on the glomerular filtration rate (GFR) during the first 24 h after delivery and during the duration of recovery from hypertension in preeclampsia...
October 20, 2017: Nephron
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