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https://www.readbyqxmd.com/read/28931341/the-neurotoxic-effects-of-prenatal-gabapentin-and-oxcarbazepine-exposure-on-newborn-rats
#1
Zuleyha Erisgin, Bulent Ayas, Jens R Nyengaard, N Ercument Beyhun, Yuksel Terzi
Teratogenicity is a problematic issue for pregnant women because of x-ray radiation, drugs, genetic and unknown variables. First generation antiepileptic drugs (AED) like valproic acid are well-known teratogens for developing foetuses. However, their usage is necessary in order to prevent maternal seizures. The underlying mechanism of birth defects associated with AED exposure remains unclear and information about the neurotoxic effects of prenatal exposure to AED is still limited. Oxcarbazepine (OXC) and gabapentin (GBP) are second generation antiepileptic drugs...
September 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28878299/a-study-on-clinicoradiological-characteristics-and-pregnancy-outcomes-of-reversible-posterior-leukoencephalopathy-syndrome-in-preeclampsia-or-eclampsia
#2
Xiaobo Fang, Yanling Liang, Dunjin Chen, Fang He, Jia Chen, Fami Huang
Reversible posterior leukoencephalopathy syndrome (RPLS) is a critical maternal complication in preeclampsia or eclampsia during pregnancy. However, studies regarding the clinicoradiological and outcome differences between RPLS and non-RPLS pregnancies are scarce. We aimed to explore the incidence of RPLS, and summarize the clinicoradiological characteristics and pregnancy outcomes. We consecutively collected a total of 100 patients who were diagnosed with preeclampsia or eclampsia, and examined via magnetic resonance imaging (MRI) among 21 872 women between 2013 and 2016...
September 7, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28868271/prenatal-diagnosis-of-mosaic-tetrasomy-18p-in-a-case-without-sonographic-abnormalities
#3
Javad Karimzad Hagh, Thomas Liehr, Hamid Ghaedi, Mir Majid Mossalaeie, Shohreh Alimohammadi, Faegheh Inanloo Hajiloo, Zahra Moeini, Sadaf Sarabi, Davood Zare-Abdollahi
Small supernumerary marker chromosomes (sSMC) are still a major problem in clinical cytogenetics as they cannot be identified or characterized unambiguously by conventional cytogenetics alone. On the other hand, and perhaps more importantly in prenatal settings, there is a challenging situation for counseling how to predict the risk for an abnormal phenotype, especially in cases with a de novo sSMC. Here we report on the prenatal diagnosis of a mosaic tetrasomy 18p due to presence of an sSMC in a fetus without abnormal sonographic signs...
2017: International Journal of Molecular and Cellular Medicine
https://www.readbyqxmd.com/read/28854840/should-delivery-timing-for-repeat-cesarean-be-reconsidered-based-on-dating-criteria
#4
Kathleen F Brookfield, Sarah S Osmundson, Aaron B Caughey
PURPOSE: We sought to examine if the method of pregnancy dating at five increasing term gestational ages is associated with increasing neonatal morbidity. MATERIALS AND METHODS: A cohort of women who underwent elective repeat cesarean delivery at > 37 weeks' gestation were identified from the NICHD MFMU Network registry. We excluded women who were in labor, those carrying a fetus with a congenital anomaly, those with a nonreassuring fetal heart tracing, and those with preeclampsia, preexisting chronic hypertension or diabetes...
August 30, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28852582/term-neonate-with-atypical-hypoxic-ischemic-encephalopathy-presentation-a-case-report
#5
Nick Townley, Emily McNellis, Venkatesh Sampath
We describe a case of atypical hypoxic-ischemic encephalopathy (HIE) in a neonate following a normal pregnancy and delivery who was found to have an umbilical vein thrombosis. The infant arrived to our center with continuous bicycling movement of her lower extremities. She had a continuous electroencephalogram that showed burst suppression and magnetic resonance imaging of the brain showed diffusely abnormal cerebral cortical/subcortical diffusion restriction which may be secondary hypoxic-ischemic injury. Interestingly, a pathology report noted a focal umbilical vein thrombosis appearing to have compressed an umbilical artery with associated arterial dissection and hematoma...
July 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28817240/prenatal-presentation-of-mabry-syndrome-with-congenital-diaphragmatic-hernia-and-phenotypic-overlap-with-fryns-syndrome
#6
Kara K Reynolds, Jane Juusola, Gregory M Rice, Philip F Giampietro
We report on a family in which initial features were compatible with Fryns syndrome. The first sibling was a stillborn female with a left diaphragmatic hernia (DH). Her clinical features overlapped with Fryns syndrome. The second pregnancy, a male fetus, was followed for polyhydramnios, hypoplastic mandible, mild enlargement of the fetal bladder, hydronephrosis, and rocker bottom foot deformities. He had facial features similar to his sibling and a large cleft of the secondary palate, small jaw, and secundum atrial septal defect...
August 17, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28814092/flow-cytometric-examination-of-apoptotic-effect-on-brain-tissue-in-postnatal-period-created-by-intrauterine-oxcarbazepine-and-gabapentin-exposure
#7
Z Erisgin, Y Tekelioglu
OBJECTIVE: For epileptics, pregnancy contains the balance between no seizure period and antiepileptic use having the least teratogenicity risk. The purpose is to analyse with flow cytometry the apoptotic effects on postnatal brain tissue caused by prenatal use of second generation antiepileptics oxcarbazepine (OXC) and gabapentin (GBP) having different effect mechanisms. METHOD: 30 (n = 5 each group) Wistar albino male rats (45-days-old) are used. First 3 groups are exposed to OXC (100 mg/kg/day), GBP (50 mg/kg/day), and saline, respectively on the 1st-5th prenatal days (preimplantation-implantation period) while the second 3 groups are exposed to the same substances on the 6th-15th prenatal days (organogenesis), respectively...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28804536/combined-respiratory-chain-deficiency-and-uqcc2-mutations-in-neonatal-encephalomyopathy-defective-supercomplex-assembly-in-complex-iii-deficiencies
#8
René G Feichtinger, Michaela Brunner-Krainz, Bader Alhaddad, Saskia B Wortmann, Reka Kovacs-Nagy, Tatjana Stojakovic, Wolfgang Erwa, Bernhard Resch, Werner Windischhofer, Sarah Verheyen, Sabine Uhrig, Christian Windpassinger, Felix Locker, Christine Makowski, Tim M Strom, Thomas Meitinger, Holger Prokisch, Wolfgang Sperl, Tobias B Haack, Johannes A Mayr
Vertebrate respiratory chain complex III consists of eleven subunits. Mutations in five subunits either mitochondrial (MT-CYB) or nuclear (CYC1, UQCRC2, UQCRB, and UQCRQ) encoded have been reported. Defects in five further factors for assembly (TTC19, UQCC2, and UQCC3) or iron-sulphur cluster loading (BCS1L and LYRM7) cause complex III deficiency. Here, we report a second patient with UQCC2 deficiency. This girl was born prematurely; pregnancy was complicated by intrauterine growth retardation and oligohydramnios...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28796689/partnering-of-public-academic-and-private-entities-to-reestablish-maternal-mortality-review-in-georgia
#9
Michael K Lindsay, David Goodman, Seema Csukas, Pat Cota, Tammy L Loucks, Jane E Ellis
The pregnancy-related mortality ratio in the United States has increased over the past 25 years. Georgia's pregnancy-related mortality ratio is among the highest in the United States. Confronted with this harsh reality, Georgia reestablished maternal mortality review as one strategy to address its high maternal mortality. To achieve a comprehensive process for review of maternal deaths involved securing the knowledge, resources, and support of physician experts, public health agencies and professional organizations as well as representatives in the state legislature...
September 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28762701/epilepsy-treatment-options
#10
REVIEW
Gerald Liu, Nicole Slater, Allen Perkins
The occurrence of a single seizure does not always require initiation of antiepileptic drugs. Risk of recurrent seizures should guide their use. In adults, key risk factors for recurrence are two unprovoked seizures occurring more than 24 hours apart, epileptiform abnormalities on electroencephalography, abnormal brain imaging, nocturnal seizures, or an epileptic syndrome associated with seizures. In children, key risk factors are abnormal electroencephalography results, an epileptic syndrome associated with seizures, severe head trauma, and cerebral palsy...
July 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28739514/inhibition-of-blood-brain-barrier-efflux-transporters-promotes-seizure-in-pregnant-rats-role-of-circulating-factors
#11
Abbie C Johnson, Erica S Hammer, Sophie Sakkaki, Sarah M Tremble, Gregory L Holmes, Marilyn J Cipolla
Seizure-provoking factors circulate late in gestation during normal pregnancy, but do not readily gain access to the brain due to the protective nature of the blood-brain barrier. In particular, efflux transporters are powerful ATP-driven pumps that actively prevent unwanted compounds from entering the brain. We hypothesized that acute inhibition of efflux transporters at the blood-brain barrier would result in spontaneous seizures in pregnant rats. We further hypothesized that the blood-brain barrier protects the maternal brain from seizure by increasing expression and/or activity of p-glycoprotein (P-gp), a major efflux transporter...
July 21, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28732257/epileptiform-discharges-in-eeg-and-seizure-risk-in-adolescent-children-of-women-with-epilepsy
#12
Joseph Samuel, Manna Jose, V S Nandini, Sanjeev V Thomas
We aimed to study the epileptiform discharges (ED) and seizure risk in EEG of 12-18-year-old children of women with epilepsy (WWE). Children of WWE who were prospectively followed up in the Kerala registry of epilepsy and pregnancy (KREP), aged 12-16years (n=92; males 48, females 44) underwent clinical evaluation and a 30-min digital 18-channel EEG. The EEG showed epileptiform discharges in 13 children (5 males and 8 females). The EDs were generalized in 9 and focal in 4 (occipital 2, frontal 1, and centroparietal 1)...
July 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28729328/comparative-safety-of-antiepileptic-drugs-for-neurological-development-in-children-exposed-during-pregnancy-and-breast-feeding-a-systematic-review-and-network-meta-analysis
#13
Areti Angeliki Veroniki, Patricia Rios, Elise Cogo, Sharon E Straus, Yaron Finkelstein, Ryan Kealey, Emily Reynen, Charlene Soobiah, Kednapa Thavorn, Brian Hutton, Brenda R Hemmelgarn, Fatemeh Yazdi, Jennifer D'Souza, Heather MacDonald, Andrea C Tricco
OBJECTIVES: Compare the safety of antiepileptic drugs (AEDs) on neurodevelopment of infants/children exposed in utero or during breast feeding. DESIGN AND SETTING: Systematic review and Bayesian random-effects network meta-analysis (NMA). MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched until 27 April 2017. Screening, data abstraction and quality appraisal were completed in duplicate by independent reviewers. PARTICIPANTS: 29 cohort studies including 5100 infants/children...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28689331/pathophysiology-and-current-clinical-management-of-preeclampsia
#14
REVIEW
Lorena M Amaral, Kedra Wallace, Michelle Owens, Babbette LaMarca
Preeclampsia is characterized by blood pressure greater than 140/90 mmHg in the second half of pregnancy. This disease is a major contributor to preterm and low birth weight babies. The early delivery of the baby, which becomes necessary for maintaining maternal well-being, makes preeclampsia the leading cause for preterm labor and infant mortality and morbidity. Currently, there is no cure for this pregnancy disorder. The current clinical management of PE is hydralazine with labetalol and magnesium sulfate to slow disease progression and prevent maternal seizure, and hopefully prolong the pregnancy...
August 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28686357/homozygous-null-variant-in-cradd-encoding-an-adaptor-protein-that-mediates-apoptosis-is-associated-with-lissencephaly
#15
Tamar Harel, Nuphar Hacohen, Avraham Shaag, Moshe Gomori, Amihood Singer, Orly Elpeleg, Vardiella Meiner
Lissencephaly is a severe malformation of cortical development, most often attributed to abnormalities in neuronal migration. It is associated with a severe prognosis including developmental delay, intellectual disability, and seizures. Lissencephaly can be reliably diagnosed during late gestation by neurosonography or fetal magnetic resonance imaging (MRI). We report two sibling male fetuses who were diagnosed with delayed cortical sulcation highly suggestive of lissencephaly during late pregnancy. After receiving genetic counseling, the parents elected to terminate the pregnancies based on the neuroradiological findings and the associated severe prognosis...
July 7, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28666184/pregnancy-outcome-in-women-with-epilepsy-in-western-china-a-prospective-hospital-based-study
#16
Shixu He, Huili Zhu, Xiangmiao Qiu, Xi Zhu, Anjiao Peng, Jianan Duan, Lei Chen
OBJECTIVE: Gaps exist in the diagnosis and treatment of women with epilepsy (WWE) between China and Euro-American countries. We aim to find out and share our experience of the multidisciplinary integrated treatment for WWE. METHODS: We prospectively registered WWE who were diagnosed by both epileptologists and obstetrician in our green way system for the past 5years (2009-2015). Registration information include years of education, epilepsy history, seizure type and frequency, pregnancy and delivery complications, delivery mode, and Apgar score of newborn...
June 27, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28659187/tuberculous-meningoencephalitis-associated-with-brain-tuberculomas-during-pregnancy-a-case-report
#17
Sadie Namani, Shemsedin Dreshaj, Arieta Zogaj Berisha
BACKGROUND: Tuberculous meningitis is globally highly prevalent and is commoner in resource-limited countries and in patients with immunosuppression. Central nervous system tuberculosis is one of the severest forms of extrapulmonary tuberculosis during pregnancy and associated brain tuberculomas have been rarely reported. With the availability of neuroimaging at our hospital center, we present the first case of tuberculous meningoencephalitis associated with brain tuberculomas during pregnancy...
June 29, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28651124/a-review-of-people-who-did-not-attend-an-epilepsy-clinic-and-their-clinical-outcomes
#18
I Minshall, A Neligan
PURPOSE: To review the clinical outcomes of people who failed to attend or failed subsequent follow up in a Primary Care based specialist epilepsy service. METHOD: The case notes of 200 people who had failed to initially attend the service or subsequent follow up from 2005 to 2013 were reviewed. RESULTS: Clinical outcomes were determined for 152 people, with the remaining 48 having left the area. For those not attending at all, 64% had no further recorded events, a further 22% came under alternative specialist care and were managed appropriately, 6% were already in remission at the time of referral or at follow up and stayed seizure free...
June 17, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28651086/age-at-first-febrile-seizure-correlates-with-perinatal-maternal-emotional-symptoms
#19
Fanny Thébault-Dagher, Catherine M Herba, Jean R Séguin, Gina Muckle, Sonia J Lupien, Lionel Carmant, Marie-Noëlle Simard, Gabriel D Shapiro, William D Fraser, Sarah Lippé
OBJECTIVE: Prenatal exposure to stress and fever are factors lowering seizure threshold in animal models. The fever effect on seizure threshold is well documented in human infants, however the associations between maternal perinatal stress and infants' susceptibility to seizures is unknown. This is the first study in humans to investigate longitudinally, whether in humans, the effect of maternal perinatal emotional symptoms such as stress, anxiety and depression that may trigger a biological stress response on age at first seizure occurrence...
June 10, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28641176/epilepsy-and-pregnancy-for-healthy-pregnancies-and-happy-outcomes-suggestions-for-service-improvements-from-the-multispecialty-uk-epilepsy-mortality-group
#20
REVIEW
J P Leach, P E Smith, J Craig, M Bagary, D Cavanagh, S Duncan, A R C Kelso, A G Marson, D McCorry, L Nashef, C Nelson-Piercy, R Northridge, K Sieradzan, S Thangaratinam, M Walker, J Winterbottom, M Reuber
Between 2009 and 2012 there were 26 epilepsy-related deaths in the UK of women who were pregnant or in the first post-partum year. The number of pregnancy-related deaths in women with epilepsy (WWE) has been increasing. Expert assessment suggests that most epilepsy-related deaths in pregnancy were preventable and attributable to poor seizure control. While prevention of seizures during pregnancy is important, a balance must be struck between seizure control and the teratogenic potential of antiepileptic drugs (AEDs)...
August 2017: Seizure: the Journal of the British Epilepsy Association
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