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Peri partum

Michael Muleme, John Stenos, Gemma Vincent, Colin R Wilks, Joanne M Devlin, Angus Campbell, Alexander Cameron, Mark A Stevenson, Stephen Graves, Simon M Firestone
Coxiella burnetii may cause reproduction disorders in pregnant animals but subclinical infection in other animals. Unrecognised disease may delay implementation of control interventions, resulting in transmission of infection to other livestock and to humans. Seroreactivity to C. burnetii phase-specific antigens, is routinely used to interpret the course of human Q fever. This approach could be similarly useful in identifying new and existing infections in livestock herds to help describe risk factors or production losses associated with the infections and the implementation of disease-control interventions...
April 1, 2017: Preventive Veterinary Medicine
Justin Chua, Kathy Paizis, Simon Z He, Peter Mount
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) is a rare condition with the triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Other conditions that present in a similar manner peri-partum include thrombotic thrombocytopaenic purpura, and pregnancy associated conditions including HELLP syndrome (haemolysis, elevated liver enzymes and low platelets), severe pre-eclampsia and less commonly acute fatty liver of pregnancy. CASE REPORTS: We describe two cases of suspected aHUS, who presented post-partum with foetal death-in-utero at 33 and 37 weeks respectively...
February 2017: Nephrology
Mary McCauley, Catriona Stewart, Birhanu Kebede
BACKGROUND: To explore healthcare providers' knowledge and attitudes to the need for pain relief for women in labor. METHODS: A structured questionnaire (n = 200) distributed to healthcare providers working in the obstetric departments, including theatres, of three public hospitals in different settings (rural, peri-urban and urban) in Ethiopia. Descriptive analysis was performed using Excel 2013 and SPSS version 22 for associations. RESULTS: The response rate was 81...
February 7, 2017: BMC Pregnancy and Childbirth
M Hurwich, D Zimmer, E Guerra, E Evans, T Shire, M Abernathy, J T Shreve, G R Kolettis, M T McCurdy, F J Castellino, M Walsh
Amniotic fluid embolism (AFE) is an unusual cause of life threatening peri partum hemorrhage (PPH). AFE resuscitation is often associated with renal and respiratory insufficiency, and a coagulopathy similar to disseminated intravascular coagulation (DIC). Resuscitation requires immediate recognition and limited use of crystalloid. We present a case of PPH caused by AFE with resultant cardiac arrest, renal and respiratory failure, and DIC-like coagulopathy, whose successful resuscitation was guided by perfusionist-directed serial thromboelastography (TEG)...
December 2016: Journal of Extra-corporeal Technology
Neelima Sivadas, Arathi Radhakrishnan, B S Aswathy, Velayudhan Mohan Kumar, Kamalesh K Gulia
To develop an animal model for studies on peri-partum sleep disorders, sleep patterns in female Wistar rats during pregnancy, post-partum and after weaning, were assessed and associated adaptive changes in their anxiety were examined. Adult nulliparous female rats, maintained in standard laboratory conditions with ad libitum food and water, were surgically implanted with electroencephalogram and electromyogram electrodes under anaesthesia for objective assessment of sleep-wakefulness (S-W). After post-surgical recovery, three control recordings of S-W were taken for 24h before the animals were kept for mating...
November 27, 2016: Behavioural Brain Research
Martin J Blaser, Maria G Dominguez-Bello
The conservation of the microbiota within humans and other hominids suggests an ancient assembly that has been selected to optimize host fitness. Pregnancy induces changes in the maternal microbiome just before the intergenerational hand-off of the microbiota. Interventions, including peri-partum antibiotics and Cesarean sections, may have unintended effects on babies.
November 9, 2016: Cell Host & Microbe
Suvarna Satish Khadilkar, Akanksha Sood, Prajakta Ahire
OBJECTIVES: To design an objective and accurate method to assess the peri-partum blood loss and to document the benefits of using this method on estimation of blood loss by healthcare professionals. MATERIALS AND METHODS: This prospective study was conducted over 6 months at Cama Albless Hospital, Mumbai. To quantify the loss of liquid blood and clots, we made use of plastic drapes, measuring jars, gravimetric method and a training module along with novel clot conversion factor which was designed to validate the visual assessment of blood loss by healthcare professionals...
October 2016: Journal of Obstetrics and Gynaecology of India
Karolina M Stepien, Anthony S Wierzbicki, Bwee T Poll-The, Hans R Waterham, Christian J Hendriksz
We describe the management and outcomes of pregnancy in a 27-year-old woman with infantile-onset Adult Refsum's disease (ARD). She presented in infancy but was diagnosed with ARD at the age of 10 on basis of phytanic acidaemia and later confirmed to have the phytanoyl-CoA hydroxylase ((PHYH) c.164delT, p.L55fsX12) mutation. Despite repeated plasmapheresis sessions and strict dietary surveillance for 20 years, her phytanic acid levels persistently stayed above the ideal target level of 100 μmol/L but remained below 400 μmol/L...
August 13, 2016: JIMD Reports
Nicola Mitchell-Jones, Michael McEwan, Mark Johnson
The management of venous thromboembolism and subsequent pulmonary embolism in pregnancy remains hugely challenging. In this case, we report the first use of a superior vena caval filter in pregnancy as an adjunct to pharmacological anticoagulation. This is the first reported use of a superior vena caval filter in pregnancy. We discuss the complexities of managing thromboembolism in pregnancy and the peri-partum period.
June 2016: Obstetric Medicine
Nicole L Davis, William C Miller, Michael G Hudgens, Charles S Chasela, Dorothy Sichali, Dumbani Kayira, Julie A E Nelson, Susan A Fiscus, Gerald Tegha, Deborah D Kamwendo, Joseph Rigdon, Jeffrey S A Stringer, Jonathan J Juliano, Sascha R Ellington, Athena P Kourtis, Denise J Jamieson, Charles Van Der Horst
BACKGROUND: Antiretroviral interventions are used to reduce HIV viral replication and prevent mother-to-child transmission. Viral suppression relies on adherence to antiretrovirals. METHODS: A two-phase study was conducted using data from the Breastfeeding, Antiretrovirals and Nutrition study. We included mothers randomized to 28 weeks of postpartum antiretrovirals with ≥1 plasma or breastmilk specimen. All mothers who transmitted HIV to their infants from 2-28 weeks (n=31) and 15% of mothers who did not (n=232) were included...
August 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Mark P Hehir, Adam Mackie, Michael S Robson
OBJECTIVE: To examine the outcomes of vaginal birth after cesarean (VBAC) in women, in spontaneous labor, delivering after 37 weeks' gestation at an institution where trial of labor after a previous cesarean delivery (TOLAC) is encouraged and management of labor is standardized. METHODS: This retrospective cohort study included 3071 women with one previous cesarean only and no vaginal delivery who underwent a trial of labor from 2001 to 2011. Women were managed using the standardized "active management of labor" intrapartum protocol...
June 2017: Journal of Maternal-fetal & Neonatal Medicine
Khakhu Tshilidzi Mathivha, Sithembiso Velaphi
BACKGROUND: Although the clinical features of infants with congenital tuberculosis (TB) are well established, the features of infants exposed to TB in utero including those who are non-infected, are not well reported. TB-exposed infants are at risk of developing TB post-delivery, and chemoprophylaxis, usually isoniazid, is therefore recommended. Isoniazid/rifampicin combined is an alternative, but little is known about its effectiveness. OBJECTIVE: To determine the clinical features of infants exposed to TB in utero and the proportion who develop TB infection and disease despite chemoprophylaxis with a 3-month course of isoniazid/rifampicin...
May 2017: Paediatrics and International Child Health
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
Kara Jensen, Rafiq Nabi, Koen K A Van Rompay, Spencer Robichaux, Jeffrey D Lifson, Michael Piatak, William R Jacobs, Glenn Fennelly, Don Canfield, Katie R Mollan, Michael G Hudgens, Michelle H Larsen, Angela M Amedee, Pamela A Kozlowski, Kristina De Paris
UNLABELLED: Despite significant progress in reducing peripartum mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) with antiretroviral therapy (ART), continued access to ART throughout the breastfeeding period is still a limiting factor, and breast milk exposure to HIV accounts for up to 44% of MTCT. As abstinence from breastfeeding is not recommended, alternative means are needed to prevent MTCT of HIV. We have previously shown that oral vaccination at birth with live attenuated Mycobacterium tuberculosis strains expressing simian immunodeficiency virus (SIV) genes safely induces persistent SIV-specific cellular and humoral immune responses both systemically and at the oral and intestinal mucosa...
August 15, 2016: Journal of Virology
Vahid Mohammadi, Ehsan Anassori, Shoja Jafari
Makouei sheep is one of the famous breeds in Iran which is reared in Azerbaijan province for their meat, milk and wool. Fifty clinically healthy Makouei ewes were selected to study the variations in energy-related blood metabolites during peri-partum period. Blood was collected from Jugular vein from each sheep on day 7 before the expected lambing time, day of parturition and also day 7 postpartum to determine total protein, albumin, urea, cholesterol, glucose, triglyceride, β-hydroxybutyrate (BHB) and non- esterified fatty acid (NEFA) levels...
2016: Veterinary Research Forum
Tristan Banks, Joy Kang, Isabella Watts, Mary Ellen G Tyrosvoutis, Aung Myat Min, Nay Win Tun, Lily Keereecharoen, Wiriya Simmawong, Sunaree Wanyatip, Borimas Hanboonkunupakarn, François Nosten, Rose McGready
INTRODUCTION: Infection from Hepatitis B primarily results from peri-partum vertical transmission and the risk increases in the presence of hepatitis B e antigen. We aimed to evaluate a new screening program for hepatitis B in pregnant women as a component of antenatal services in a marginalized population. METHODOLOGY: Counseling and screening for hepatitis B screening was offered to all women at the first visit, at Shoklo Malaria Research Unit (SMRU) antenatal clinics on the Thai-Myanmar border...
April 28, 2016: Journal of Infection in Developing Countries
Ben Clevenger, Kurinchi Gurusamy, Andrew A Klein, Gavin J Murphy, Stefan D Anker, Toby Richards
AIMS: Anaemia is increasingly recognized as having an independent impact upon patient outcomes in cardiac disease. The role of novel iron therapies to treat anaemia is increasing. This systematic review and meta-analysis assesses the efficacy and safety of iron therapies for the treatment of adults with anaemia. METHODS AND RESULTS: Electronic databases and search engines were searched as per Cochrane methodology. Randomized controlled trials (RCTs) of iron vs. inactive control or placebo, as well as alternative formulations, doses, and routes in anaemic adults without chronic kidney disease or in the peri-partum period were eligible...
July 2016: European Journal of Heart Failure
A Nowroozi-Asl, N Aarabi, A Rowshan-Ghasrodashti
The transition from late gestation to early lactation is a critical period in a dairy cow's life so that dairy cows undergo tremendous changes during this period. The aim of this study was to determine blood levels of ghrelin, leptin, glucose, β-ydroxybutyrate (BHB), non-esterified fatty acids (NEFA), triglycerides (TG), triiodothyronine (T3) and thyroxine (T4) in dairy Holstein cows (n=20) and their correlations during the transition period. Blood samples were collected weekly from 3 wk antepartum to 6 wk postpartum from 20 high-yielding Holstein-Friesian cows...
2016: Polish Journal of Veterinary Sciences
Gaspare Di Lorenzo, Gennaro Martucci, Sergio Sciacca, Rosalia Longo, Michele Pilato, Antonio Arcadipane
Pregnant women with mechanical prosthetic heart valves have an increased risk of thrombosis and valve malfunctioning. Surgery carries a high risk of mortality for the mother and the fetus. A strategy for effective anticoagulation is crucial for these patients because both oral anticoagulants and heparin are associated with high risks for the mother and the fetus. The treatment of a pregnant woman with thrombosis and valve malfunction is a challenge, even for multidisciplinary teams, as cardiac surgery carries considerable risks...
October 2016: Perfusion
Esther Cathyln Atukunda, Godfrey Rwambuka Mugyenyi, Celestino Obua, Elly Bronney Atuhumuza, Nicholas Musinguzi, Yarine Fajardo Tornes, Amon Ganaafa Agaba, Mark Jacob Siedner
BACKGROUND: Accurate estimation of blood loss is central to prompt diagnosis and management of post-partum hemorrhage (PPH), which remains a leading cause of maternal mortality in low-resource countries. In such settings, blood loss is often estimated visually and subjectively by attending health workers, due to inconsistent availability of laboratory infrastructure. We evaluated the diagnostic accuracy of weighed blood loss (WBL) versus changes in peri-partum hemoglobin to detect PPH...
2016: PloS One
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