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https://www.readbyqxmd.com/read/29897824/the-risk-of-cardiovascular-disease-end-stage-renal-disease-and-stroke-in-post-partum-women-and-their-fetuses-after-a-hypertensive-pregnancy
#1
Mark W Cunningham, Babbette D LaMarca
Women with hypertensive pregnancy complications are at greater risk of developing cardiovascular disease (CVD), metabolic diseases, stroke, and end-stage renal disease later in life. Pregnancy complications not only effect the mother's long-term health, but also the health of the fetus immediately after delivery and into adulthood. The health of the fetus until adulthood can be influenced by developmental programming, in which the fetus is exposed to insults that will ultimately affect the growth of the offspring and increase the offspring's risk of developing hypertension, coronary heart disease, metabolic disease, and chronic kidney disease in adulthood...
June 13, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29897393/concomitant-abdominoplasty-and-laparoscopic-umbilical-hernia-repair
#2
Constant P van Schalkwyk, Joseph R Dusseldorp, Derek G Liang, Anil Keshava, Andrew J Gilmore, Steve Merten
Background: Umbilical hernia is a common finding in patients undergoing abdominoplasty, especially those who are post-partum with rectus divarication. Concurrent surgical treatment of the umbilical hernia at abdominoplasty presents a "vascular challenge" due to the disruption of dermal blood supply to the umbilicus, leaving the stalk as the sole axis of perfusion. To date, there have been no surgical techniques described to adequately address large umbilical herniae during abdominoplasty...
April 20, 2018: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29890966/maternal-near-miss-collection-at-an-australian-tertiary-maternity-hospital
#3
Skandarupan Jayaratnam, Sonia Kua, Caroline deCosta, Richard Franklin
BACKGROUND: Australia has a maternal mortality ratio of 6.8/100000 live births, a rate akin to other developed countries and consistent with the high level care provided within the Australian health care system. With maternal mortality at very low levels assessment of severe maternal morbidity is increasingly being used as an indicator of quality of care and to identify areas for improvement in maternity services. The WHO maternal 'near miss' criteria is a standardised tool has been increasingly used worldwide to assess maternal morbidity and standards of maternity care...
June 11, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29878650/is-there-benefit-to-continue-magnesium-sulfate-post-partum-in-women-receiving-magnesium-sulfate-prior-to-delivery-a-randomized-controlled-study
#4
Paulino Vigil-De Gracia, Jack Ludmir, Jorge Ng, Osvaldo Reyes-Tejada, Casilda Nova, Arnaldo Beltré, Vicente Y Chong M, Jorge Collantes, Eduardo Turcios, Roberto Lewis, Santiago Cabrera
OBJECTIVE: To determine if the use of Magnesium Sulfate post-delivery reduces the risk of eclampsia in severe preeclampsia exposed to at least 8 hours of Magnesium prior to delivery. DESIGN: Randomized multicentre controlled trial. SETTING: Latin America. POPULATION: Women with severe preeclampsia that had received 4 grams loading dose followed by 1 gram per hour for 8 hours maintenance dose prior to delivery. METHODS: 1113 women were randomized...
June 7, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29863100/-reversible-cerebral-vasoconstriction-syndrome-a-clinical-study-of-11-cases
#5
Makoto Takemaru, Shinichi Takeshima, Naoyuki Hara, Takahiro Himeno, Yuji Shiga, Jun Takeshita, Kazuhiro Takamatsu, Eiichi Nomura, Yutaka Shimoe, Masaru Kuriyama
This study reports eleven cases of reversible cerebral vasospasm syndrome (RCVS). Of the 11 patients, two were males and nine were females, with the average age of 47.9 ± 14.1 years. Many of these patients were young. The rates of severe, intractable and pulsative headache, generalized convulsions, and motor hemiparesis were 64%, 27%, and 36%, respectively. As complications of intracerebral lesions in the early stage of disease onset, convexal subarachnoid hemorrhage, lobar intracerebral hemorrhage, and posterior reversible encephalopathy syndrome were observed in 63%, 9%, and 45% of cases, respectively...
June 1, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29850023/transient-diabetes-insipidus-in-a-post-partum-woman-with-pre-eclampsia-associated-with-residual-placental-vasopressinase-activity
#6
Natassia Rodrigo, Samantha Hocking
This case illustrates the exceedingly rare phenomenon of transient diabetes insipidus, in association with pre-eclampsia, occurring in the post-partum period following an in vitro fertilisation pregnancy, in an otherwise well 48-year-old lady. Diabetes insipidus can manifest during pregnancy, induced by increased vasopressinase activity secreted by placental trophoblasts and usually manifests in the third trimester. This presentation elucidates not only the intricate balance between the physiology of pregnancy and hormonal homeostasis, but also the importance of post-partum care as the physiological changes of pregnancy still hold pathological potential in the weeks immediately following delivery...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29848449/biological-versus-mechanical-heart-valve-prosthesis-during-pregnancy-in-women-with-congenital-heart-disease
#7
Heleen Lameijer, Ymkje J van Slooten, Monique R M Jongbloed, Martijn A Oudijk, Marlies A M Kampman, Arie P van Dijk, Marco C Post, Barbara J Mulder, Krystyna M Sollie, Dirk J van Veldhuisen, Tjark Ebels, Joost P van Melle, Petronella G Pieper
BACKGROUND: We evaluate pregnancy outcome and anticoagulation regimes in women with mechanical and biological prosthetic heart valves (PHV) for congenital heart disease. METHODS: Retrospective multicenter cohort studying pregnancy outcomes in an existing cohort of patients with PHV. RESULTS: 52 women had 102 pregnancies of which 78 pregnancies (46 women) ≥20 weeks duration (59 biological, 19 mechanical PHV). Miscarriages (n = 19, ≤20 weeks) occurred more frequently in women using anticoagulation (P < ...
May 23, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29809179/-obstetric-emergencies-and-non-emergencies-at-central-military-hospital-i-our-vision-and-the-epidemiologic-horizon
#8
Luis M García-Núñez, Juan A Ramos-Martínez, Irving I Morales-Pogoda, Martín Fuentes-Durán, Edgar F Hernández-García, Raúl García-Ramírez
Background: Maternal morbidity and mortality pose a significant impact on national public health, being medical attention of obstetric emergencies (OE) and non-emergencies (ONE) of capital importance. Methods: Descriptive and epidemiologic analysis of OE/ONE at a 3rd level military echelon. Results: During a 34-months span, 48 patients were approached at the emergency department (1.4 admissions/month). Mean age: 29 ± 3 years (17-41). Eight patients (17%) were considered OE and 40 (83%) ONE...
2018: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/29804027/obstetrical-anal-sphincter-injuries-and-symptoms-after-subsequent-deliveries-a-60-patient-study
#9
Carine Fradet-Menard, Julia Deparis, Bertrand Gachon, Joanna Sichitiu, Fabrice Pierre, Xavier Fritel, David Desseauve
INTRODUCTION: More than half of women with a history of prior obstetric anal sphincter injuries (OASIS) will have another pregnancy. Currently, little is known concerning post-partum perineal symptoms in cases of a subsequent vaginal delivery. The aim of this study was to assess the frequency of perineal functional symptoms following a vaginal delivery after OASIS while comparing them to patients who did not have a subsequent delivery. MATERIAL AND METHOD: Retrospective cohort study between January 2000 and December 2011...
July 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29803894/impact-of-selective-serotonin-reuptake-inhibitors-ssris-during-pregnancy-and-lactation-a-focus-on-short-and-long-term-vascular-effects
#10
REVIEW
S Zullino, T Simoncini
SSRIs are the first choice for the treatment of mood disorders during pregnancy and lactation. Despite the known side effects, the benefits/risks balance suggests their use. Hypertensive disorders of pregnancy (HDP) and Intrauterine growth restriction (IUGR) are the main vascular effects of these drugs, with mechanisms that involves endothelial dysfunction in feto-placental system. These data are supported by animal models, even if preliminary findings are not yet adequately supported by molecular and clinical data...
May 24, 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29797074/complicated-primary-cesarean-delivery-increases-the-risk-for-uterine-rupture-at-subsequent-trial-of-labor-after-cesarean
#11
Lina Salman, Liran Hiersch, Anat Shmueli, Eyal Krispin, Arnon Wiznitzer, Rinat Gabbay-Benziv
PURPOSE: To evaluate whether cesarean delivery (CD) indication, labor status, and other primary CD characteristics affect the risk for uterine rupture in subsequent deliveries. METHODS: A case-control study of women attempting trial of labor after cesarean (TOLAC) in a single, tertiary, university-affiliated medical center (2007-2016). Deliveries complicated by uterine rupture were matched to successful vaginal birth after cesarean (VBAC) deliveries in a 1:3 ratio...
May 24, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29784553/postural-orthostatic-tachycardia-syndrome-during-pregnancy-a-systematic-review-of-the-literature
#12
REVIEW
Kate Morgan, Catherine Chojenta, Meredith Tavener, Angela Smith, Deb Loxton
PURPOSE: Postural Orthostatic Tachycardia Syndrome is most commonly seen in women of child bearing age, however little is known about its effects in pregnancy. METHOD: A systematic review was conducted in March 2015 and updated in February 2018. Medline, Embase, PsychInfo, CINHAL, and the Cochrane Library were searched from database inception. The ClinicalTrials.gov site and bibliographies were searched. MeSH and Emtree headings and keywords included; Postural Orthostatic Tachycardia Syndrome, Postural Tachycardia Syndrome, and were combined with pregnancy and pregnancy related subject headings and keywords...
May 9, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29744974/ring-compression-suture-for-controlling-post-partum-hemorrhage-during-cesarean-section
#13
Guang-Tai Li, Xiao-Fan Li, Yun-He Zhang, Yue Si, Guang-Rui Li, Hong-Mei Xu
AIM: To avoid complications associated with uterine compression sutures, we devised a ring compression suture (RCS). METHODS: The RCS was performed on 12 patients with post-partum hemorrhage (PPH) during cesarean section. The suture was inserted 0.5 cm below the attachment point of the uterosacral ligament into the uterine cavity and pushed downward through the cervical canal into the vagina. The other end of the stitch was threaded through the lower abdominal wall, from the inside of the abdomen cavity to the outside of the abdominal wall, emerging at the external surface of the lower abdomen 2 cm lateral to the ventral median line and 1 cm above the symphysis pubis...
May 10, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29737274/antiepileptic-drug-monitoring-in-pregnancy-empire-a-double-blind-randomised-trial-on-effectiveness-and-acceptability-of-monitoring-strategies
#14
Shakila Thangaratinam, Nadine Marlin, Sian Newton, Annalise Weckesser, Manny Bagary, Lynette Greenhill, Rachel Rikunenko, Maria D'Amico, Ewelina Rogozińska, Andrew Kelso, Kelly Hard, Jamie Coleman, Ngawai Moss, Tracy Roberts, Lee Middleton, Julie Dodds, Angela Pullen, Sandra Eldridge, Alexander Pirie, Elaine Denny, Doug McCorry, Khalid S Khan
BACKGROUND: Pregnant women with epilepsy on antiepileptic drugs (AEDs) may experience a reduction in serum AED levels. This has the potential to worsen seizure control. OBJECTIVE: To determine if, in pregnant women with epilepsy on AEDs, additional therapeutic drug monitoring reduces seizure deterioration compared with clinical features monitoring after a reduction in serum AED levels. DESIGN: A double-blind, randomised trial nested within a cohort study was conducted and a qualitative study of acceptability of the two strategies was undertaken...
May 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29717296/profile-of-caesarean-section-in-mid-western-regional-hospital-in-nepal
#15
Keshar Bahadur Dhakal, Sulochana Dhakal, Saroj Bhandari
BACKGROUND: Rising rate of caesarean section since few decades has been a global public health issue.This study is aimed to determine the rate of caesarean section plus examine the indications and complications of caesarean section. METHODS: A retrospective cross-sectional study was conducted using secondary data sources at Mid-Western Regional Hospital in Surkhet, Nepal. Data were collected from patients'records ofthe hospital dating from 16 July 2016 to 15 July 2017...
March 13, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29712720/metabolic-disorders-during-pregnancy-and-postpartum-cardiometabolic-risk
#16
EDITORIAL
Angelo Maria Patti, Kalliopi Pafili, Nikolaos Papanas, Manfredi Rizzo
Hormonal changes during pregnancy can trigger gestational diabetes (GDM), which is constantly increasing. Its main characteristic is pronounced insulin resistance, but it appears to be a multifactorial process involving several metabolic factors; taken together, the latter leads to silent or clinically evident cardiovascular (CV) events. Insulin resistance and central adiposity are of crucial importance in the development of metabolic syndrome, and they appear to correlate with CV risk factors, including hypertension and atherogenic dyslipidaemia...
May 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29707205/timely-referral-saves-the-lives-of-mothers-and-newborns-midwifery-led-continuum-of-care-in-marginalized-teagarden-communities-a-qualitative-case-study-in-bangladesh
#17
Animesh Biswas, Rondi Anderson, Sathyanarayanan Doraiswamy, Abu Sayeed Md Abdullah, Nabila Purno, Fazlur Rahman, Abdul Halim
Background: Prompt and efficient identification, referral of pregnancy related complications and emergencies are key factors to the reduction of maternal and newborn morbidity and mortality. As a response to this critical need, a midwifery led continuum of reproductive health care was introduced in five teagardens in the Sylhet division, Bangladesh during 2016. Within this intervention, professional midwives provided reproductive healthcare to pregnant teagarden women in the community.  This study evaluates the effect of the referral of pregnancy related complications...
2018: F1000Research
https://www.readbyqxmd.com/read/29694631/humoral-hypercalcemia-of-pregnancy-treated-with-bisphosphonates
#18
Ronit Koren, Ortal Neeman, Shlomit Koren, Carlos A Benbassat
Hypercalcemia can be hazardous during pregnancy, most cases being due to primary hyperparathyroidism. We report a case of hypercalcemia with suppressed PTH levels necessitating treatment with bisphosphonates during pregnancy. A 38-year-old woman at the 26th week gestation was admitted because of symptomatic hypercalcemia. She did not take any medication that could influence her calcium levels. Physical examination was unremarkable. Laboratory tests on admission were: calcium 12.7 mg/dL (8.5-10.5 mg/dL), phosphorus 1...
February 2018: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29679628/long-and-short-term-outcomes-of-gestational-diabetes-mellitus-gdm-among-south-asian-women-a-community-based-study
#19
REVIEW
B H Sudasinghe, C N Wijeyaratne, P S Ginige
AIMS: To quantify short and long-term outcomes of Gestational Diabetes Mellitus (GDM) among South Asians. METHODS: Prospective cohort-study in Gampaha District, Sri Lanka following a community-prevalence study (WHO 1999 criteria). All women with GDM (exposed) and within sample non-GDM (non-exposed) were recruited. Data was gathered at selected intervals until one-year post-partum by interviewer-administered questionnaire, anthropometry, blood pressure, post-partum 75gOGTT and cholesterol...
April 19, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29627031/pregnancy-outcomes-in-women-with-spinal-muscular-atrophy-a-review
#20
REVIEW
Elena Abati, Stefania Corti
Spinal muscular atrophy (SMA) is an autosomal recessive disease characterized by muscle weakness and atrophy resulting from progressive degeneration and loss of the anterior horn cells in the spinal cord and brain stem nuclei. The onset of weakness ranges from prenatal age to young adulthood. Thus, many female patients reach fertile age and may consider getting pregnant. However, only little information is available about outcomes and complications of pregnancy in women with SMA. In this review, we compared different studies on the subject, then we analyzed outcomes in the different stages of the pregnancy (preconceptional period, embryonal period, fetal period, delivery and post partum), with a special focus on maternal and fetal complications, prematurity, mode of delivery, anesthesiological risk, respiratory function and influence of pregnancy on the disease course...
May 15, 2018: Journal of the Neurological Sciences
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