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Aki and pregnancy

Muhammad Abdul Mabood Khalil, Muhammad Salman Ghazni, Jackson Tan, Nazish Naseer, Muhammad Ashhad Ullah Khalil
Ovarian hyperstimulation syndrome (OHSS) was first described in 1960. It may occur as a complication of gonadotropin hormone therapy during assisted pregnancy or for primary infertility. A 26-year-old female patient with polycystic ovarian syndrome and primary infertility was treated to conceive. She received intravenous gonadotropin-releasing hormone (GnRH) along with follicle-stimulating hormone in an outside private clinic. She presented to the emergency department with abdominal and chest pain, loose stool, vomiting, shortness of breath and decreasing urine output...
May 2016: Case Reports in Gastroenterology
V Mishra Vineet, A Goyal Preeti, S Aggarwal Rohina, S Choudhary, Tanvir Tanvir, D Dharaiya Nisarg, A Gaddagi Rashmi
BACKGROUND: Acute kidney injury (AKI) is a clinical syndrome characterized by a sudden decline in glomerular filtration rate leading to decreased excretion of nitrogenous waste products. It continues to be a common problem in developing countries. AIMS: The aim of this study was to understand AKI characteristics in pregnancy and identify the factors related to its unfavorable outcome. STUDY DESIGN: A prospective cross-sectional study. METHODS: This prospective study was conducted between January 2013 and May 2014...
October 2016: Journal of Obstetrics and Gynaecology of India
Emma M Heikkinen, Kokki Hannu, Heikkinen Aki, Ranta Veli-Pekka, Räsänen Juha, Voipio Hanna-Marja, Kokki Merja
Opioids given to pregnant and parturient women are relatively freely transferred across the placenta. Spinal, epidural and intravenous fentanyl have been studied in pregnant women and neonates, but foetal safety of fentanyl dosing with transdermal patch during pregnancy and labour is not sufficiently studied. Foetal pH is physiologically lower than maternal pH, and thus, opioids, that are weak bases, are ionized and may cumulate to foetus. Foetal asphyxia may further worsen acidosis and ion trapping induced by low pH is assumed to increase the foetal exposure to opioids...
September 8, 2016: Basic & Clinical Pharmacology & Toxicology
Hiroshi Kawamura, Keisuke Ishii, Aki Mabuchi, Ryo Yamamoto, Shusaku Hayashi, Nobuaki Mitsuda
AIM: To evaluate the incidence of twin-twin transfusion syndrome (TTTS) and the perinatal outcome at 28 days of age in monochorionic diamniotic (MCDA) pregnancies complicated with isolated polyhydramnios (I-Poly) and isolated oligohydramnios (I-Oligo) diagnosed < 26 weeks of gestation. METHODS: This was a retrospective study of women with MCDA pregnancies diagnosed with I-Poly or I-Oligo before 26 weeks of gestation over a period of six years. The incidence of subsequent TTTS and neonatal outcome in terms of intact survival (IS) at 28 days of age were evaluated...
August 24, 2016: Journal of Obstetrics and Gynaecology Research
J Prakash, P Pant, S Prakash, M Sivasankar, R Vohra, P K Doley, L K Pandey, U Singh
The incidence of acute kidney injury (AKI) in pregnancy is declining in developing countries but still remains a major cause of maternal and fetal morbidity and mortality. The aim of the study was to analyze the changing trends in pregnancy related AKI (PR-AKI) over a period of thirty-three years. Clinical characteristics of PR-AKI with respect to incidence, etiology and fetal and maternal outcomes were compared in three study periods, namely 1982-1991,1992-2002 and 2003-2014. The incidence of PR-AKI decreased to 10...
July 2016: Indian Journal of Nephrology
Dwomoa Adu, Perditer Okyere, Vincent Boima, Michael Matekole, Charlotte Osafo
AIMS: We review recent published data on demographics, causes, diagnoses, treatment, and outcome of acute kidney injury (AKI) in Africa. METHODS: A review of the incidence, etiology, diagnoses, and treatment of AKI in adults in Africa from studies published between the years 2000 and 2015. RESULTS: The incidence of AKI in hospitalized patients in Africa ranges from 0.3 to 1.9% in adults. Between 70 and 90% of cases of AKI are community acquired...
July 29, 2016: Clinical Nephrology
Ahmed Ibrahim, Momina M Ahmed, Seman Kedir, Delayehu Bekele
BACKGROUND: The first government funded and sustainable dialysis unit was established in Ethiopia at Saint Paul's Hospital Millennium Medical College (SPHMMC). This has led to the development of a unique cohort of patients about which very little is known. This study was conducted to describe the clinical profile and outcome of adult Acute Kidney Injury (AKI) patients treated with intermittent haemodialysis at the dialysis center of SPHMMC. METHODS: A retrospective review of clinical records of cases of AKI who required haemodialysis support during the time period from August 1, 2013 to February 1, 2015 was conducted...
2016: BMC Nephrology
Haruka Muto, Ryo Yamamoto, Keisuke Ishii, Reisa Kakubari, Sachi Takaoka, Aki Mabuchi, Nobuaki Mitsuda
OBJECTIVE: Hypertensive disorders in pregnancy are major causes of maternal mortality and morbidity. Although the combined risk assessments of maternal history, blood pressure, uterine artery Doppler, and maternal serum marker seem to be highly predictive of the development of hypertensive disorders, this method is a little complicated to be performed on many low-risk pregnant women. The aim of this study is to evaluate the use of maternal characteristics, and physical findings early in the second trimester, as predictive factors of hypertensive disorders...
June 2016: Taiwanese Journal of Obstetrics & Gynecology
John Feehally
The International Society of Nephrology's (ISN) 0by25 initiative aims to prevent avoidable deaths from acute kidney injury (AKI) by 2025, most of which occur in low and lower middle-income countries (LLMICs). To increase evidence about the epidemiology of AKI, especially in LLMICs, ISN conducted a 'Global Snapshot', a multinational, cross-sectional study in which 322 physicians from 72 countries in 6 continents identified 3,664 adults and 354 children with AKI who were under their care of which 45% were from LLMICs, nevertheless low-income countries were under-represented...
2016: Annals of Nutrition & Metabolism
Aki Mabuchi, Ryo Yamamoto, Keisuke Ishii, Reisa Kakubari, Sachi Takaoka, Haruka Muto, Nobuaki Mitsuda
OBJECTIVE: The aim of this study was to determine the predictive value of high-normal blood pressure (HNBP) during the early second trimester for hypertensive disorders in pregnancy, including gestational hypertension (GH) and preeclampsia (PE). METHODS: This was a retrospective single-center cohort study of 2143 singleton pregnant women. The association of HNBP, ranging from 130/85 to 139/89 mmHg between 14 and 19 weeks of gestation, with the development of hypertensive disorders was assessed by multivariable logistic regression analyses...
May 2016: Hypertension in Pregnancy
Taito Miyamoto, Tatsuji Hoshino, Nobutaka Hayashi, Ruriko Oyama, Asuka Okunomiya, Sachiko Kitamura, Noriko Ohtake, Mami Suga, Kazunao Miyamoto, Aki Takaoka, Takuya Aoki, Yuko Imamura, Seiji Nagano, Masato Kita
Introduction New-onset systemic lupus erythematosus (SLE) during pregnancy is rare and difficult to diagnose, especially in cases that manifest as preeclampsia. We report a patient with new-onset SLE that manifested as preeclampsia during pregnancy and provide a review of the literature to identify factors for a rapid diagnosis. Case A 32-year-old primigravid Japanese woman was diagnosed with severe preeclampsia and underwent emergent cesarean section at 29 weeks of gestation. Her hypertension and renal disorder gradually improved after the operation, but her thrombocytopenia and anemia worsened...
March 2016: American Journal of Perinatology Reports
Sachi Takaoka, Keisuke Ishii, Takako Taguchi, Reisa Kakubari, Haruka Muto, Aki Mabuchi, Ryo Yamamoto, Shusaku Hayashi, Nobuaki Mitsuda
OBJECTIVE: To identify the clinical features and risk factors for diagnosis of a postpartum-onset hypertensive disorder. METHODS: A retrospective cohort study of singleton pregnancies. Clinical features of postpartum-onset hypertensive disorders were evaluated, and prenatal risk factors were also identified with a multivariate logistic regression model. RESULTS: Of 1,964 women, 57 (2.9%) developed hypertensive disorder after delivery. The independent risk factors were assisted reproductive technology, pre-pregnancy body mass index, chronic nephritis, hypothyroidism, high-normal blood pressure before or at delivery, and cesarean section...
2016: Hypertension in Pregnancy
Taro Imaeda, Taka-Aki Nakada, Ryuzo Abe, Yoshihisa Tateishi, Shigeto Oda
Streptococcal toxic shock syndrome (STSS), an invasive Streptococcus pyogenes (Group A streptococcus) infection with hypotension and multiple organ failure, is quite rare in pregnancy but is characterized by rapid disease progression and high fatality rates. We present a case of STSS with infection-induced cardiac dysfunction in a pregnant woman who was treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). A 24-year-old multiparous woman in the third trimester had early symptoms of high fever and diarrhea 1 day prior to admission to the hospital emergency department...
June 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Shiyo Ota, Jun Sahara, Aki Mabuchi, Ryo Yamamoto, Keisuke Ishii, Nobuaki Mitsuda
AIM: The prognosis for non-immune hydrops fetalis (NIHF) is still poor despite progress in perinatal care. We have examined perinatal and 1-year outcomes for NIHF in relation to gestational age at diagnosis and underlying etiology in order to identify predictors of mortality. METHODS: A retrospective review was conducted of 92 pregnancies with NIHF managed in hospital between 2000 and 2012. The gestational age at diagnosis, etiology, perinatal outcome, and 1-year outcome were recorded, and their associations assessed...
April 2016: Journal of Obstetrics and Gynaecology Research
Ayumi Taguchi, Aki Yamashita, Kei Kawana, Takeshi Nagamatsu, Hitomi Furuya, Eri Inoue, Yutaka Osuga, Tomoyuki Fujii
Preterm birth is one of the most common obstetrical complications, with an incidence of about 5% to 18% of all pregnancies worldwide. Acute chorioamniotic infection is likely antecedent to preterm birth through the local production of inflammatory mediators, followed by uterine contraction and cervical ripening. Microbial chorioamnionitis and local inflammation synergistically form a vicious circle toward preterm birth. Principal therapeutic interventions focus on anti-infection and anti-inflammation strategies to block this vicious circle...
December 1, 2015: Reproductive Sciences
Jai Prakash, Vijay Pratap Singh
Renal cortical necrosis (RCN) is characterized by patchy or diffuse ischemic destruction of all the elements of renal cortex resulting from significantly diminished renal arterial perfusion due to vascular spasm and microvascular injury. In addition, direct endothelial injury particularly in setting of sepsis, eclampsia, haemolytic uremic syndrome (HUS) and snake bite may lead to endovascular thrombosis with subsequent renal ischemia. Progression to end stage renal disease is a rule in diffuse cortical necrosis...
November 6, 2015: World Journal of Nephrology
Natarajan Gopalakrishnan, Jeyachandran Dhanapriya, Periyasamy Muthukumar, Ramanathan Sakthirajan, Thanigachalam Dineshkumar, S Thirumurugan, T Balasubramaniyan
BACKGROUND: Acute kidney injury (AKI) is a serious complication in pregnancy, resulting in significant maternal morbidity/mortality and fetal loss. Although the incidence of pregnancy-related acute kidney injury (PRAKI) has decreased in developed countries, it is still common in developing nations. METHODS: A prospective observational study was done between January 2010 and December 2014 to report the incidence, clinical spectrum, maternal and fetal outcome of AKI in pregnancy...
2015: Renal Failure
Hayato Tada, Masa-Aki Kawashiri, Takuya Nakahashi, Kunimasa Yagi, Daisuke Chujo, Azusa Ohbatake, Yukiko Mori, Shunsuke Mori, Mitsuhiro Kometani, Hiroshi Fujii, Atsushi Nohara, Akihiro Inazu, Hiroshi Mabuchi, Masakazu Yamagishi, Kenshi Hayashi
BACKGROUND: Although of interest, few data exist on the clinical characteristics of Japanese patients with an extremely high triglyceride level (≥ 1000 mg/dL). OBJECTIVE: We assessed the clinical characteristics of Japanese patients with an extremely high triglyceride level. METHODS: We investigated the presence of coronary artery disease, history of pancreatitis, the presence of fatty liver, and the potential causes of elevated triglyceride in Japanese subjects with an extremely high level of fasting triglyceride (≥ 1000 mg/dL) among 70,368 subjects whose serum triglyceride was measured for any reason at Kanazawa University Hospital from April 2004 to March 2014...
July 2015: Journal of Clinical Lipidology
Yu-mei Liu, Hong-da Bao, Zhen-zhen Jiang, Ya-juan Huang, Nian-song Wang
OBJECTIVE: To determine the incidence, causes and prognosis of pregnancy-related acute kidney injury (PR-AKI) in Chinese women. METHODS: From July 2004 to February 2013, 18,589 women of Han ethnicity who attended the Obstetrics and Nephrology Department of our tertiary hospital were investigated, and individuals meeting the PR-AKI criteria were included in the analysis. The WanFang, Chinese Science Journal, Chinese Knowledge, MEDLINE, EMBASE and Cochrane library databases were searched, and literature describing PR-AKI diagnoses with Chinese women as study subjects and a sample size of ≥5 were included...
2015: Internal Medicine
Dario Gasbarra, Elja Arjas, Aki Vehtari, Rémy Slama, Niels Keiding
This paper was inspired by the studies of Niels Keiding and co-authors on estimating the waiting time-to-pregnancy (TTP) distribution, and in particular on using the current duration design in that context. In this design, a cross-sectional sample of women is collected from those who are currently attempting to become pregnant, and then by recording from each the time she has been attempting. Our aim here is to study the identifiability and the estimation of the waiting time distribution on the basis of current duration data...
October 2015: Lifetime Data Analysis
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