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cardiac disease in pregnancy

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https://www.readbyqxmd.com/read/28100569/multiple-pregnancy-in-a-primigravida-with-uncorrected-pentalogy-of-fallot
#1
Pamela Partana, Jarrod Kah Hwee Tan, Ju Le Tan, Lay Kok Tan
Pentalogy of Fallot is a cyanotic congenital heart disease that has guarded prognosis without surgical intervention in infancy. Women with uncorrected defects rarely survive into childbearing age and pregnancy in this group is associated with a high rate of perinatal loss. Physiological cardiovascular changes in pregnancy can lead to maternal haemodynamic instability with subsequent adverse cardiac sequelae with or without fetal decompensation. Optimum management and pregnancy outcomes in mother with uncorrected Pentalogy of Fallot and twin pregnancy have not been described in the literature...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28094006/salt-aldosterone-and-extrarenal-na-sensitive-responses-in-pregnancy
#2
Paula Juliet Scaife, Markus Georg Mohaupt
Outside of pregnancy excessive salt consumption is known to be harmful being linked to increased blood pressure and cardiovascular disease. However, pregnancy represents a major change to a woman's physiology resulting in an intimate adaptation to environmental conditions. It is now becoming apparent that salt is essential for a number of these changes during pregnancy including haematological, cardiac adaptations as well as directly influencing placental development and the uteroplacental immune environment...
January 10, 2017: Placenta
https://www.readbyqxmd.com/read/28079767/primary-gastric-choriocarcinoma-presenting-as-a-pregnancy-of-unknown-location
#3
Alyssa Larish, Amanika Kumar, Sarah Kerr, Carrie Langstraat
BACKGROUND: Pregnancy of unknown location presents a diagnostic challenge, in rare occasions leading to the diagnosis of malignancy. We describe a case of β-hCG-secreting nongestational primary gastric choriocarcinoma presenting as a pregnancy of unknown location. CASE: A 37-year-old woman, gravida 4 para 3013, presented with several days of vaginal bleeding and rising β-hCG level without ultrasound localization of pregnancy. The diagnosis of pregnancy of unknown location was made and methotrexate administered at a β-hCG level of 7,779 milli-international units/mL...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28049534/case-report-maternal-mosaicism-resulting-in-inheritance-of-a-novel-gata6-mutation-causing-pancreatic-agenesis-and-neonatal-diabetes-mellitus
#4
Daphne Yau, Elisa De Franco, Sarah E Flanagan, Sian Ellard, Miriam Blumenkrantz, John J Mitchell
BACKGROUND: Haploinsufficiency of the GATA6 transcription factor gene was recently found to be the most common cause of pancreatic agenesis, a rare cause of neonatal diabetes mellitus. Although most cases are de novo, we describe three siblings with inherited GATA6 haploinsufficiency and the rare finding of parental mosaicism. CASE PRESENTATION: The proband was born at term with severe intrauterine growth restriction, the first child of non-consanguineous parents...
January 3, 2017: Diagnostic Pathology
https://www.readbyqxmd.com/read/28045917/impact-of-pregestational-weight-and-weight-gain-during-pregnancy-on-long-term-risk-for-diseases
#5
Ulrika Moll, Håkan Olsson, Mona Landin-Olsson
OBJECTIVE: The aim of this study was to analyse the impact of maternal BMI at start of pregnancy and maternal weight gain during pregnancy on the risk of various diseases later in life. METHODS: In a population-based cohort from southern Sweden, women with at least one delivery registered in the Swedish Medical Birth Register ten or more years before answering a health questionnaire were identified (n = 13,608). Complete data were found in 3,539 women. RESULTS: Women with BMI >25 at start of pregnancy had increased risk of developing obesity (OR 21...
2017: PloS One
https://www.readbyqxmd.com/read/28029179/prenatal-diagnosis-of-congenital-heart-diseases-by-fetal-echocardiography-in-second-trimester-a-chinese-multicenter-study
#6
Chen Chu, Yingliu Yan, Yunyun Ren, Xiaotian Li, Yonghao Gui
INTRODUCTION: The objective of our study was to evaluate the performance of detailed fetal echocardiography by skilled obstetric physician sonologists in the diagnosis of congenital heart disease (CHD) in a Chinese population. MATERIAL AND METHODS: This investigation included a multicenter prospective cohort of 10,259 pregnant women attending ten regional tertiary hospitals in China. The inclusion criteria were singleton pregnancy and gestational age 18 ~ ≤28 weeks...
December 28, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28006009/mode-of-delivery-and-pregnancy-outcome-in-women-with-congenital-heart-disease
#7
Joris Hrycyk, Harald Kaemmerer, Nicole Nagdyman, Moritz Hamann, Ktm Schneider, Bettina Kuschel
BACKGROUND: Advances in cardiac surgery and congenital cardiology have led to an increasing number of women with congenital heart disease (CHD) reaching childbearing age. In general, cardiologists recommend vaginal delivery for women with CHD to avoid complications from Caesarean section as many women with CHD tolerate vaginal delivery well. METHODS AND RESULTS: This is a single-center study comparing mode of delivery, pregnancy outcome, indications for Caesarean section and induction of labor between women with and without CHD...
2016: PloS One
https://www.readbyqxmd.com/read/28005501/imaging-of-heart-disease-in-women
#8
Tina D Tailor, Gregory A Kicska, Jill E Jacobs, Miguel H Pampaloni, Diana E Litmanovich, Gautham P Reddy
Ischemic heart disease is the number one cause of death of women in the United States, accounting for over a quarter of a million annual female deaths. Evidence within the last several decades supports sex-specific differences in the prevalence, symptoms, and prognosis of ischemic heart disease between men and women. Despite women having a lower burden of obstructive coronary artery disease compared with men, the prevalence of angina and mortality from ischemic heart disease is higher for women than men. In addition to ischemic heart disease, certain nonischemic conditions may also have sex-specific differences in clinical presentation and occurrence...
January 2017: Radiology
https://www.readbyqxmd.com/read/28005272/prophylactic-versus-selective-blood-transfusion-for-sickle-cell-disease-in-pregnancy
#9
REVIEW
Babasola O Okusanya, Olufemi T Oladapo
BACKGROUND: Pregnant women with sickle cell disease (HbSS, HbSC and HbSβThal) may require blood transfusion to prevent severe anaemia or to manage potential medical complications. Preventive blood transfusion in the absence of complications starting from the early weeks of pregnancy or blood transfusion only for medical or obstetric indications have been used as management policies. There is currently no consensus on the blood transfusion policy that guarantees optimal clinical benefits with minimal risks for such women and their babies...
22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28005240/complicated-pregnancies-in-inherited-distal-renal-tubular-acidosis-importance-of-acid-base-balance
#10
Harald Seeger, Peter Salfeld, Rüdiger Eisel, Carsten A Wagner, Nilufar Mohebbi
Inherited distal renal tubular acidosis (dRTA) is caused by impaired urinary acid excretion resulting in hyperchloremic metabolic acidosis. Although the glomerular filtration rate (GFR) is usually preserved, and hypertension and overt proteinuria are absent, it has to be considered that patients with dRTA also suffer from chronic kidney disease (CKD) with an increased risk for adverse pregnancy-related outcomes. Typical complications of dRTA include severe hypokalemia leading to cardiac arrhythmias and paralysis, nephrolithiasis and nephrocalcinosis...
December 22, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/28002851/prenatal-ultrasonographic-diagnosis-of-cataract-in-utero-manifestations-of-cryptic-disease
#11
Eran Ashwal, Asaf Achiron, Yinon Gilboa, Michal Berkenstadt, Mordecai Rosner, Reuven Achiron
Purpose To report and review our experience with antenatal evaluation for fetuses diagnosed with congenital cataract. Materials and Methods We retrospectively identified pregnancies diagnosed with fetal cataract during antenatal ultrasound. Evaluation of fetal eyes included intraocular anatomy and biometry. Data on fetal malformations, serology and fetal karyotype were collected. Results 8 cases, identified over the course of 10 years, were reviewed. Week 15 was the mean time for diagnosis (range 11 - 34)...
December 21, 2016: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/27995289/the-fetus-with-ectopia-cordis-experience-and-expectations-from-two-centers
#12
Maria C Escobar-Diaz, Sherzana Sunderji, Wayne Tworetzky, Anita J Moon-Grady
Ectopia cordis (EC) is a rare congenital anomaly often associated with congenital heart disease (CHD). There is a lack of contemporary information on EC diagnosed prenatally. We sought to combine the experiences of two regional referral centers in order to evaluate current outcomes for EC. Clinical, echocardiographic features and perinatal outcomes of fetuses with EC managed at two large cardiac centers from 1995 to 2014 were retrospectively reviewed. Seventeen fetuses with EC were diagnosed at a median gestational age of 23 weeks (range 17-36)...
December 19, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27988927/cardiac-remodelling-in-a-baboon-model-of-intrauterine-growth-restriction-mimics-accelerated-ageing
#13
Anderson H Kuo, Cun Li, Jinqi Li, Hillary F Huber, Peter W Nathanielsz, Geoffrey D Clarke
KEY POINTS: Rodent models of intrauterine growth restriction (IUGR) successfully identify mechanisms that can lead to short-term and long-term detrimental cardiomyopathies but differences between rodent and human cardiac physiology and placental-fetal development indicate a need for models in precocial species for translation to human development. We developed a baboon model for IUGR studies using a moderate 30% global calorie restriction of pregnant mothers and used cardiac magnetic resonance imaging to evaluate offspring heart function in early adulthood...
November 6, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27988446/a-novel-variant-in-ryr2-causes-familiar-catecholaminergic-polymorphic-ventricular-tachycardia
#14
Cristina Bosch, Oscar Campuzano, Georgia Sarquella-Brugada, Sergi Cesar, Alexandra Perez-Serra, Monica Coll, Irene Mademont, Jesus Mates, Bernat Del Olmo, Anna Iglesias, Josep Brugada, Volker Petersen, Ramon Brugada
Catecholaminergic polymorphic ventricular tachycardia is a rare familial arrhythmogenic disease. It usually occurs in juvenile patients with a structurally normal heart and causes exercise-emotion triggered syncope and sudden cardiac death. The main gene associated with catecholaminergic polymorphic ventricular tachycardia is RyR2, encoding the cardiac ryanodine receptor protein which is involved in calcium homeostasis. After the identification of a 16 year-old man presenting with exercise-induced sudden cardiac death, clinically diagnosed as catecholaminergic polymorphic ventricular tachycardia, we collected the family information and performed a comprehensive genetic analysis using Next Generation Sequencing technology...
December 9, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27955851/-maternal-metabolic-diseases-related-to-pre-pregnancy-overweight-and-obesity-in-mexican-women-with-high-risk-pregnancy
#15
Salvador Hernández-Higareda, Omar-Alejandro Pérez-Pérez, Luz-Ma-Adriana Balderas-Peña, Brenda-Eugenia Martínez-Herrera, Ana-Leticia Salcedo-Rocha, Rosa-Emilia Ramírez-Conchas
INTRODUCTION: Pre-pregnancy obesity has been proposed as a risk factor related to gestational diabetes and hypertensive disorders during pregnancy. OBJECTIVES: Identify pregnancy related diseases associated with pre-pregnancy obesity as a risk factor ina high risk preganancy patient population. METHODS: 600 patients whose pre-pregnancy obesity had been assessed as a high risk factor were included in the study. The means, standard deviation, median, interquartile intervals, Pearson and Spearman correlation and logistic regression to estimate risk with the odds ratio and 95% confidence intervals were calculated...
December 9, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27939485/postpartum-physiology-psychology-and-paediatric-follow-up-study-p4-study-study-protocol
#16
Gregory K Davis, Lynne Roberts, George Mangos, Amanda Henry, Franziska Pettit, Anthony O'Sullivan, Caroline S E Homer, Maria Craig, Samuel B Harvey, Mark A Brown
BACKGROUND: Women who have had hypertension in pregnancy are at greater risk of long term cardiovascular disease (CVD). Little is known about their cardiovascular risk postpartum or the effects on the woman's mental health and the outcomes of their infants. In this project we will study the physiological and psychological health of women and the physical health and development of their infants six months, two years and five years after birth. We will establish normal blood pressure (BP) and metabolic function for women who were normotensive in pregnancy and use these to assess women who had gestational hypertension (GH) or preeclampsia (PE)...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27939476/differences-in-cardiovascular-function-comparing-prior-preeclamptics-with-nulliparous-controls
#17
Ira M Bernstein, Sarah A Hale, Gary J Badger, Carole A McBride
OBJECTIVE: The objective of the current study was to evaluate cardiovascular function; including blood pressure, cardiac output, pulse wave velocity and vascular compliance in nonpregnant nulliparous women compared to women with a history of preterm preeclampsia. STUDY DESIGN: This was a case control study. Blood pressure was measured using the Finapres Pro. Baseline cardiac output was determined by echocardiography. Pulse wave velocity was estimated using simultaneous electrocardiographic tracings and ultrasound determined arterial flow waveforms and calculated as estimated distance divided by the time interval between EKG r-wave peak and ultrasound derived peak popliteal artery flow...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27933173/a-rare-case-of-gestational-thyrotoxicosis-as-a-cause-of-acute-myocardial-infarction
#18
Varalaxmi Bhavani Nannaka, Dmitry Lvovsky
: Angina pectoris in pregnancy is unusual and Prinzmetal's angina is much rarer. It accounts for 2% of all cases of angina. It is caused by vasospasm, but the mechanism of spasm is unknown but has been linked with hyperthyroidism in some studies. Patients with thyrotoxicosis-induced acute myocardial infarction are unusual and almost all reported cases have been associated with Graves' disease. Human chorionic gonadotropin hormone-induced hyperthyroidism occurs in about 1.4% of pregnant women, mostly when hCG levels are above 70-80 000 IU/L...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27931546/maternal-and-fetal-outcomes-in-pregnant-women-undergoing-balloon-mitral-valvotomy-for-rheumatic-mitral-stenosis
#19
Desabandhu Vinayakumar, G V Vinod, Suresh Madhavan, Mangalath Narayanan Krishnan
BACKGROUND: Rheumatic mitral stenosis constitutes a major cause of acquired heart disease complicating pregnancy in India. In the present study, we have studied the fetal and maternal outcomes of women undergoing balloon mitral valvotomy during pregnancy. METHODS AND RESULTS: 49 pregnant ladies were included in this study in whom balloon mitral valvotomy was performed. The mean age of these patients was 25.7±3.1 years. The mean gestational age was 23.5±5.2 weeks (12-36 weeks)...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27928260/emergency-redo-mitral-valve-replacement-immediately-after-caesarean-section
#20
İbrahim Duvan, Ümit Pınar Sungur, Burak Emre Onuk, Mehmet Şanser Ateş, İbrahim Sami Karacan, Murat Kurtoğlu
Surgery for heart diseases during pregnancy, especially necessitating cardiopulmonary bypass, is believed to trigger maternal and fetal risks and should be performed only when medical therapy has been unsuccessful to alleviate the cardiac decompensation. A 33-year-old pregnant woman in her 33rd week of gestation was admitted to our hospital. She had rheumatic mitral valvular stenosis and had undergone mitral valve replacement (MVR) with a mechanical prosthesis 11 years earlier in another center. Echocardiography revealed a thrombotic mass obstructing the leaflets of the mechanical mitral valve...
April 13, 2016: Journal of Tehran Heart Center
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