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https://www.readbyqxmd.com/read/29346120/a-view-from-the-uk-the-uk-and-ireland-confidential-enquiry-into-maternal-deaths-and-morbidity
#1
Marian Knight, Derek Tuffnell
The UK Confidential Enquiry into Maternal Deaths has been in operation for more than 60 years, during which time maternal mortality rates have fallen 10-fold. The program includes two aspects, surveillance and confidential case review, providing different information to aid quality improvement in maternity care. The enquiry now also reviews the care of women with specific severe morbidities. Recommendations have very clearly led to improved outcomes for women, most notably shown in the very low mortality rate due to hypertensive and related disorders of pregnancy...
January 16, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29345153/selective-serotonin-reuptake-inhibitor-use-in-pregnant-women-pharmacogenetics-drug-drug-interactions-and-adverse-effects
#2
Asher Ornoy, Gideon Koren
Possible negative effects of selective serotonin reuptake inhibitors (SSRIs) in pregnancy relate to congenital anomalies, negative perinatal events and neurodevelopmental outcome. Many studies are confounded by the underlying maternal disease and by pharmacogenetic and pharmacokinetic differences of these drugs. Areas covered: The possible interactions of SSRIs and serotonin and norepinephrine reuptake inhibitors with other drugs and the known effects of SSRIs on congenital anomalies, perinatal and neurodevelopmental outcome...
January 18, 2018: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29326803/treatment-of-early-stages-hodgkin-lymphoma-during-pregnancy
#3
Agustin Avilés, Maria-Jesus Nambo, Natividad Neri
Background: To assess maternal and fetal outcome of women and newborns who received chemotherapy during pregnancy to treat Hodgkin lymphoma (HL)in early stages (IA, IIA), we performed a retrospective analysis of a cohort of 44 pregnant women with HL and early stages, diagnosed and treated between 1988 to 2013, at a tertiary reference cancer center. Methods: We analyzed data on HL characteristics and treatment, with a particular attention to maternal and fetal complications; in children, we performed a longer follow-up to detect any anomaly in physical development, scholar performance, psychological, cardiac, neurological function, and intelligence tests...
2018: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29317337/heart-and-bile-acids-clinical-consequences-of-altered-bile-acid-metabolism
#4
REVIEW
Tharni Vasavan, Elisa Ferraro, Effendi Ibrahim, Peter Dixon, Julia Gorelik, Catherine Williamson
Cardiac dysfunction has an increased prevalence in diseases complicated by liver cirrhosis such as primary biliary cholangitis and primary sclerosing cholangitis. This observation has led to research into the association between abnormalities in bile acid metabolism and cardiac pathology. Approximately 50% of liver cirrhosis cases develop cirrhotic cardiomyopathy. Bile acids are directly implicated in this, causing QT interval prolongation, cardiac hypertrophy, cardiomyocyte apoptosis and abnormal haemodynamics of the heart...
January 6, 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29317240/toxicity-and-cardiac-effects-of-acute-exposure-to-tryptophan-metabolites-on-the-kynurenine-pathway-in-early-developing-zebrafish-danio-rerio-embryos
#5
Michal Majewski, Natalia Kasica, Anna Jakimiuk, Piotr Podlasz
Defects in tryptophan metabolism on the l-kynurenine pathway (KP) are implicated in a number of human diseases, including chronic kidney disease, brain edema or injury, tuberculosis and malaria - as well as cancer, neurodegenerative and autoimmune disorders. However, it is unclear to what extent detrimental effects of exposure to tryptophan metabolites might impact the early development of organism. Thus, this study examined the effects of KP exposure in zebrafish embryos starting at the blastula period (4hpf) and the segmentation stage (24hpf)...
January 6, 2018: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/29306901/cardiometabolic-health-among-adult-offspring-of-hypertensive-pregnancies-the-cardiovascular-risk-in-young-finns-study
#6
Robyn J Tapp, Alun D Hughes, Mika Kähönen, Tien Yin Wong, Nicholas Witt, Terho Lehtimäki, Nina Hutri-Kähönen, Pinki Sahota, Markus Juonala, Olli T Raitakari
BACKGROUND: Cardiometabolic health among adult offspring of hypertensive disorders of pregnancy (HDP) is relatively unknown. We hypothesized that offspring of HDP would have abnormalities in the retinal microvasculature and cardiac structure by midadulthood. METHODS AND RESULTS: The Cardiovascular Risk in Young Finns Study included randomly selected children from 5 Finnish university cities. The mean age of participants was 40 years (range 34-49 years) at the time of retinal photography and cardiac assessment...
January 6, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29305367/embolic-stroke-in-a-postpartum-patient-with-fontan-physiology
#7
Katherine VanHise, Linda Li, Emily Smith, Niamh Condon
In cardiac physiology, single ventricle typically refers to the presence of a dominant systemic ventricle along with a hypoplastic ventricle. The Fontan operation is used to repair the single ventricle by directing deoxygenated systemic venous flow to the pulmonary arterial circulation. Normal pregnancy physiology, particularly increased intravascular volume, increased heart rate, increased cardiac output, hypercoagulability and decreased systemic vascular resistance, can exacerbate cardiac disease in patients with Fontan circulation, leading to pregnancy complications...
January 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29298686/a-single-center-experience-with-12-consecutive-cases-of-pregnancy-among-patients-with-membranous-ventricular-septal-aneurysm
#8
Kana Wang, Xiaodong Wang, Haiyan Yu, Xinghui Liu, Aiyun Xing, Yong You
BACKGROUND: Membranous ventricular septal aneurysm (MVSA) is a rare cardiac anomaly that can occur as an isolated entity or being associated with other cardiac malformations. Complications of MVSA include thromboembolism, arrhythmia, rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and atrioventricular valve diseases.The success rate of pregnancy and delivery in patients with MVSA has not been reported in the literature. This study was to assess the clinical implications of this condition from our center's experience...
January 3, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29285173/rapamycin-therapy-for-neonatal-tuberous-sclerosis-complex-with-cardiac-rhabdomyomas-a-case-report-and-review
#9
Shanshan Mao, Qi Long, Huijia Lin, Jinling Liu
Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disease that varies greatly in its expression. The current study reports a novel case of TSC caused by a TSC2 mutation (TSC2c.1642_1643insA or TSC2p.K549fsX589), in which multiple cardiac rhabdomyomas were detected by fetal echocardiography in week 31 of pregnancy. The infant was delivered successfully; however, seizures began 16 days following birth. Subsequent genetic tests confirmed a diagnosis of TSC. Rapamycin treatment resulted in regression of cardiac rhabdomyomas and controlled seizures...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29273008/implementation-of-guidelines-for-multidisciplinary-team-management-of-pregnancy-in-women-with-pre-existing-diabetes-or-cardiac-conditions-results-from-a-uk-national-survey
#10
Cath Taylor, David R McCance, Lucy Chappell, Catherine Nelson-Piercy, Sara A Thorne, Khaled M K Ismail, James S A Green, Debra Bick
BACKGROUND: Despite numerous publications stating the importance of multidisciplinary care for women with pre-existing medical conditions, there is a lack of evidence regarding structure or processes of multidisciplinary working, nor impact on maternal or infant outcomes. This study aimed to evaluate the implementation of guidelines for multidisciplinary team (MDT) management in pregnant women with pre-existing diabetes or cardiac conditions. These conditions were selected as exemplars of increasingly common medical conditions in pregnancy for which MDT management is recommended to prevent or reduce adverse maternal and fetal outcomes...
December 22, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29261645/fetal-somatic-growth-trajectory-differs-by-type-of-congenital-heart-disease
#11
Kriti Puri, Carri R Warshak, Mounira A Habli, Amy Yuan, Rashmi D Sahay, Eileen C King, Allison Divanovic, James F Cnota
BackgroundThe growth trajectories of common measurements, including estimated fetal weight (EFW), head circumference (HC), and abdominal circumference (AC), in fetuses with congenital heart disease (CHD) have not been described for different cardiac lesions. We hypothesized that (i) fetuses with CHD have differential growth in utero, and (ii) different categories of CHD demonstrate different in utero growth curves.MethodsWe performed a retrospective observational cohort study of pregnancies with known fetal CHD seen from January 2000 to June 2013...
December 20, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29248924/is-there-more-to-zika-complex-cardiac-disease-in-a-case-of-congenital-zika-syndrome
#12
Asimenia Angelidou, Zoe Michael, Arda Hotz, Kevin Friedman, Sitaram Emani, Kerri LaRovere, Helen Christou
The epidemic of Zika virus (ZIKV) has resulted in a surge of newborns with microcephaly and brain abnormalities. In this report, we describe the first case, to our knowledge, of congenital Zika syndrome with concomitant critical congenital heart disease. The mother had a confirmed ZIKV infection in the first trimester of pregnancy. Fetal ultrasonography at 31 weeks of gestation revealed cerebral cortical calcifications and hypoplastic left heart syndrome. The severity of brain involvement was assessed by postnatal magnetic resonance imaging and echocardiogram, and palliative surgery was performed...
December 16, 2017: Neonatology
https://www.readbyqxmd.com/read/29231167/glucose-inhibits-cardiac-muscle-maturation-through-nucleotide-biosynthesis
#13
Haruko Nakano, Itsunari Minami, Daniel Braas, Herman Pappoe, Xiuju Wu, Addelynn Sagadevan, Laurent Vergnes, Kai Fu, Marco Morselli, Christopher Dunham, Xueqin Ding, Adam Z Stieg, James K Gimzewski, Matteo Pellegrini, Peter M Clark, Karen Reue, Aldons J Lusis, Bernard Ribalet, Siavash K Kurdistani, Heather Christofk, Norio Nakatsuji, Atsushi Nakano
The heart switches its energy substrate from glucose to fatty acids at birth, and maternal hyperglycemia is associated with congenital heart disease. However, little is known about how blood glucose impacts heart formation. Using a chemically defined human pluripotent stem-cell-derived cardiomyocyte differentiation system, we found that high glucose inhibits the maturation of cardiomyocytes at genetic, structural, metabolic, electrophysiological, and biomechanical levels by promoting nucleotide biosynthesis through the pentose phosphate pathway...
December 12, 2017: ELife
https://www.readbyqxmd.com/read/29229509/diagnosis-of-congenital-abnormalities-with-post-mortem-ultrasound-in-perinatal-death
#14
L Tuchtan, E Lesieur, C Bartoli, C Delteil, L Sarda-Quarello, J Torrents, S Sigaudy, M-D Piercecchi, G Gorincour
PURPOSE: To determine the sensitivity and specificity of post-mortem ultrasound in the diagnosis of major congenital abnormalities of fetuses using conventional autopsy as the standard of reference. MATERIAL AND METHODS: All fetuses coming from terminations of pregnancy or intrauterine fetal deaths in a single institution were included. A total of 75 fetuses were included during the study period. The results of post-mortem ultrasound examinations were compared to those of conventional autopsy that served as standard of reference...
December 8, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29190635/neonatal-lupus-case-series-of-a-tertiary-hospital
#15
Ana Raquel Teixeira, Mariana Rodrigues, Hercília Guimarães, Cláudia Moura, Iva Brito
Neonatal lupus (NL) is a very rare condition with an estimated incidence of 1 in 20.000 pregnancies. It is caused by the transplacental passage of autoantibodies anti-Ro/SSA, antiSa/SSB antibodies and/or anti-U1 RNP antibodies into the fetal circulation. The mother may be completely asymptomatic or have a known inflammatory rheumatic disease, such as Sjögren syndrome (SS) or Systemic Lupus Erythematosus (SLE). Clinical manifestations are diverse, being the most common cutaneous and cardiac. The authors present a case series of eight cases diagnosed with NL between January 2008 and December 2016 in a tertiary hospital and a brief revision of the literature...
October 2017: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/29183331/four-successful-pregnancies-in-a-patient-with-fontan-palliation-and-congenital-heart-disease-a-case-report
#16
Khalid S Al Najashi, Syed Mehdi, Shazia Mohsin, Merna Atiyah, Hafez A Abdullah, Jassim Abdulhameed, Ahmed M Al Zahrani
BACKGROUND: Fontan is a palliative procedure in patients with single ventricle. Single ventricle supports systemic cardiac output and pulmonary blood flow is passively directed to the right pulmonary artery. Women with Fontan palliation are reported to have increased maternal risk during pregnancy. There are few reports of successful pregnancies in such cases. However data on these pregnancies is lacking, we consider this to be the first reported from kingdom of Saudi Arabia. CASE PRESENTATION: We present a 35-year-old woman from the Kingdom of Saudi Arabia who had Fontan surgery and who had four successful pregnancies and multiple miscarriages...
November 28, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29181330/evaluation-of-admission-indications-clinical-characteristics-and-outcomes-of-obstetric-patients-admitted-to-the-intensive-care-unit-of-a-teaching-hospital-center-a-five-year-retrospective-review
#17
Farnoush Farzi, Ali Mirmansouri, Zahra Atrkar Roshan, Bahram Naderi Nabi, Gelareh Biazar, Shima Yazdipaz
Background: Care of obstetric patients has always been a challenge for critical care physicians, because in addition to their complex pregnancy-related disease, fetal viability is considered. Objectives: The aim of this study was to review the admission indications, clinical characteristics and outcomes of obstetric patients, admitted to the intensive care unit of Alzzahra teaching hospital affiliated to Guilan University of Medical Sciences, Rasht, Iran. Methods: This retrospective cohort study was conducted on pregnant /post-partum (up to 6 weeks) patients admitted to the ICU over a 5-year period from April 2009 to April, 2014...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29173607/clinical-features-and-outcomes-of-acute-coronary-syndrome-in-women-with-previous-pregnancy-complications
#18
Sophie Grand'Maison, Louise Pilote, Kenny Schlosser, Duncan J Stewart, Marisa Okano, Natalie Dayan
BACKGROUND: Women with previous cardiometabolic complications of pregnancy experience double the risk of cardiovascular disease. However, few data exist on the clinical effect of these complications at the time of an acute coronary syndrome (ACS). The objective of this work was to compare risk factors, clinical features, and outcomes among women with premature ACS with or without previous pregnancy complications (gestational diabetes and/or hypertensive disorders of pregnancy). METHODS: Data were obtained from a multicentre cohort of individuals hospitalized with premature ACS...
December 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29166205/pregnant-women-with-heart-disease-placental-characteristics-and-their-association-with-fetal-adverse-events
#19
Fabio V Lima, Paraskevi Koutrolou-Sotiropoulou, Puja B Parikh, Cecilia Avila, Javed Butler, Kathleen Stergiopoulos
BACKGROUND: Pregnant women with heart disease (HD) have higher rates of adverse fetal outcomes. We describe placental pathologic characteristics and their association with fetal events. METHODS: In pregnant women, known HD were categorized into: (1) cardiomyopathy (CM) or (2) other HD (congenital, coronary, arrhythmia, or valvular). Outcomes were maternal major adverse cardiac events (MACE), fetal adverse clinical events (FACE), a composite of infant death, prematurity, underweight status, intracranial hemorrhage, and respiratory distress...
September 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/29164116/potential-of-metformin-to-improve-cardiac-risk-in-postpartum-women-with-gestational-diabetes
#20
Oscar A Viteri, Mary Alice Sallman, Pauline M Berens, Pamela D Berens, Farah H Amro, Maria S Hutchinson, Susan M Ramin, Sean C Blackwell, Jerrie S Refuerzo, Judith A Smith
Objective: Pregnancy is associated with an increase in total cholesterol, high density lipoproteins (HDL), and low-density lipoproteins (LDL). Postpartum, HDL and LDL decrease over the first 12 weeks postpartum. Oxidized LDL (ox-LDL) is a marker of oxidative stress-related inflammation, which is associated with obesity and also with development of cardiovascular disease. Cardiovascular protection and weight loss are benefits from metformin, especially in women with diabetes. The objective of this study was to compare changes in lipid profiles and biomarkers for obesity during the initial 6 weeks postpartum between women with gestational diabetes mellitus (GDM) treated with metformin versus placebo...
2017: Frontiers in Medicine
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