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https://www.readbyqxmd.com/read/28696852/imaging-of-pregnancy-related-vascular-complications
#1
R Scooter Plowman, Cylen Javidan-Nejad, Constantine A Raptis, Douglas S Katz, Vincent M Mellnick, Sanjeev Bhalla, Patricia Cornejo, Christine O Menias
Pregnancy results in substantial hemodynamic and prothrombotic changes that form the foundation for downstream vascular complications, both during pregnancy and in the postpartum period. In addition, several important risk factors, including older patient age, diabetes, and smoking, can increase the risk for vascular-related pregnancy complications. Because radiologists often play an important role in evaluation of the pregnant patient, understanding the pathophysiology of vascular-related complications in pregnancy and their imaging appearances is essential for diagnostic accuracy...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28678042/consensus-derived-clinical-decision-rules-to-guide-advanced-imaging-decisions-for-pulmonary-embolism-in-pregnancy-and-the-postpartum-period
#2
Gordon W Fuller, Catherine Nelson-Piercy, Beverley J Hunt, Fiona E Lecky, Steve Thomas, Kimberley Horspool, Steve Goodacre
No abstract text is available yet for this article.
July 3, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28615049/a-case-of-acute-sheehan-s-syndrome-and-literature-review-a-rare-but-life-threatening-complication-of-postpartum-hemorrhage
#3
Shinya Matsuzaki, Masayuki Endo, Yutaka Ueda, Kazuya Mimura, Aiko Kakigano, Tomomi Egawa-Takata, Keiichi Kumasawa, Kiyoshi Yoshino, Tadashi Kimura
BACKGROUND: Sheehan's syndrome occurs because of severe postpartum hemorrhage causing ischemic pituitary necrosis. Sheehan's syndrome is a well-known condition that is generally diagnosed several years postpartum. However, acute Sheehan's syndrome is rare, and clinicians have little exposure to it. It can be life-threatening. There have been no reviews of acute Sheehan's syndrome and no reports of successful pregnancies after acute Sheehan's syndrome. We present such a case, and to understand this rare condition, we have reviewed and discussed the literature pertaining to it...
June 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28570643/maternal-outcome-after-abdominal-packing-for-uncontrolled-postpartum-hemorrhage-despite-peripartum-hysterectomy
#4
Xavier Deffieux, Marie Vinchant, Ingrid Wigniolle, François Goffinet, Loïc Sentilhes
BACKGROUND: Intra-abdominal packing is a possible option for persistent bleeding following hysterectomy for postpartum hemorrhage. However, to date, only very limited data about maternal outcome after intra-abdominal packing for surgically uncontrolled hemorrhage following hysterectomy are available. The objective of the current study was to estimate maternal outcome after intra-abdominal packing following unsuccessful peripartum hysterectomy for postpartum hemorrhage. METHODS: A questionnaire was mailed to all maternity units performing more than 850 deliveries per year...
2017: PloS One
https://www.readbyqxmd.com/read/28561253/obstetric-disorders-in-the-icu
#5
Daniela N Vasquez, Lauren Plante, María N Basualdo, Gustavo G Plotnikow
Pregnant and postpartum patients represent a challenge to critical care physicians, as two patients in one have to be cared for and because specific obstetric disorders, not universally covered in formal critical care training, need to be managed. Pregnancy also alters physiologic norms, so that the critical care physician may either fail to recognize a value as abnormal in pregnancy or mistakenly identify as abnormal a value within the normal range for a pregnant woman. In this article, we will review the most frequent obstetric causes of admission of pregnant/postpartum patients to the intensive care unit (hypertensive disease of pregnancy, obstetric hemorrhage, and obstetric sepsis) along with their diagnostic criteria, clinical presentation, and recommended treatment...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28561251/management-of-acute-respiratory-failure-in-pregnancy
#6
Stephen E Lapinsky
Respiratory failure affects up to 1 in 500 pregnancies, more commonly in the postpartum period. The causes of respiratory failure include several pregnancy-specific conditions such as preeclampsia, amniotic fluid embolism, and peripartum cardiomyopathy. Pregnancy may also increase the risk or severity of other conditions, such as asthma, thromboembolism, viral pneumonitis, and gastric acid aspiration. Changes to maternal respiratory physiology and the presence of a fetus may affect the assessment and management of these patients...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28548570/embolic-mycotic-encephalitis-in-a-cow-following-mortierella-wolfii-infection-of-a-surgery-site
#7
Benjamin Curtis, Charlotte Hollinger, Ailam Lim, Matti Kiupel
A 5-y-old Holstein dairy cow had surgery for a suspected displaced abomasum 10 d postpartum, developed acute neurologic signs at day 19, and was found dead 21 d postpartum. At autopsy, there was a peri-incisional intramuscular abscess that communicated with the peritoneal cavity, as well as hemorrhage and malacia involving the brain, and multiple nodules in the liver, kidneys, and lungs. Fungal hyphae were seen histologically at the surgery site, on the surface of the liver, and in lesions of severe necrotizing vasculitis in the lungs, kidneys, brain, and liver...
May 1, 2017: Journal of Veterinary Diagnostic Investigation
https://www.readbyqxmd.com/read/28534017/delayed-postpartum-hemoperitoneum-due-to-uterine-artery-pseudoaneurysm-rupture
#8
Kyu-Sang Kyeong, Ji-Yeon Moon, Song-Hwa Chae, Seung Hwa Hong, Minho Kang, Eun-Hwan Jeong
A 30-year-old woman experienced severe abdominal pain 8 days after vaginal delivery. The patient was diagnosed with hemoperitoneum due to rupture of the left uterine artery pseudoaneurysm, which was confirmed via ultrasound with color Doppler and computed tomography scans. This patient was treated with bilateral uterine artery embolization to maintain fertility. A uterine artery pseudoaneurysm that causes delayed postpartum hemorrhage can occur after cesarean section or vaginal delivery. A uterine artery pseudoaneurysm can be fatal, so its detection and diagnosis are critical...
May 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28492181/coinfection-by-streptococcus-phocae-and-cetacean-morbillivirus-in-a-short-beaked-common-dolphin-delphinus-delphis
#9
J Díaz-Delgado, E Sierra, A I Vela, M Arbelo, D Zucca, K R Groch, A Fernández
We describe gross, histopathological, and immunohistochemical features of Streptococcus phocae and cetacean morbillivirus coinfection in a short-beaked common dolphin Delphinus delphis. Major gross findings were cutaneous purulent nodules in the tail fluke, vegetative mitral valve endocarditis, and presumed postpartum pyometra. Histologic examination revealed bacterial septicemia characterized by widespread intravascular coccoid bacterial emboli. These were associated with fibrinonecrotizing to pyogranulomatous dermatitis and panniculitis, embolic pneumonia, neutrophilic and lymphoplasmacytic meningochoroiditis, random neutrophilic hepatitis, lymphoplasmacytic myocarditis and epicarditis, necrotizing adrenalitis, suppurative endometritis, and multicentric reactive lymphadenopathy...
May 11, 2017: Diseases of Aquatic Organisms
https://www.readbyqxmd.com/read/28491165/carbon-dioxide-angiography-and-arterial-embolization-could-successfully-control-postpartum-uterine-hemorrhage-for-the-patient-with-hypersensitivity-to-iodine-compound
#10
Sayaka Kawashita, Masanori Kaneuchi, Daisuke Nakayama, Naoki Fuchi, Yuko Murakami, Kiyonori Miura, Hideaki Masuzaki
Transcatheter arterial embolization has become a common management option for intractable postpartum uterine hemorrhage. Iodinated contrast agents are commonly used for embolotherapy but cannot be used in patients with renal dysfunction or iodine allergy. A 37-year-old woman spontaneously delivered a healthy girl but developed severe postpartum uterine hemorrhage, probably due to placenta accrete. Contrast-enhanced computed tomography revealed extravasation of the iodinated contrast agent into the uterine cavity...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28471117/antepartum-hemorrhage-from-previous-cesarean-sectioned-uterus-as-a-potential-sign-of-uterine-artery-pseudoaneurysm
#11
Ning Zhang, Wei-Hua Lou, Xue-Bin Zhang, Jian-Hua Lin, Wen Di
Postpartum hemorrhage (PPH), a leading cause of maternal mortality, can occur within 24 h of delivery (primary PPH), or during the period from 24 h after delivery to Week 6 of puerperium (secondary PPH). It requires health professionals to be alert to the symptoms to ensure prompt diagnosis and treatment, especially in the case of rupture of a uterine artery pseudoaneurysm (UAP) due to its life-threatening consequence (Baba et al., 2014). Most of the published case reports or case serials describe UAP as a possible cause of delayed PPH after traumatic procedures during delivery or pregnancy termination, including cesarean section (CS), manual removal of the placenta, or dilation and curettage (D&C) (Wald, 2003)...
May 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28460634/acute-kidney-injury-during-pregnancy-and-puerperium-a-retrospective-study-in-a-single-center
#12
Chunhong Huang, Shanying Chen
BACKGROUND: Acute kidney injury (AKI) is rare in women during pregnancy and puerperium, however, it is related to increased morbidity and mortality rates. OBJECTIVE: The aim of this study was to investigate the incidence, characteristics, and outcomes of AKI during pregnancy and puerperium in a Chinese population. METHODS: In this study, pregnant women discharged from hospital between January 2008 and June 2015 were screened. AKI was defined if the level of serum creatitine >70...
May 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28432715/complications-of-pregnancy-and-labour-in-women-with-klippel-tr%C3%A3-naunay-syndrome-a-nationwide-cross-sectional-study
#13
Ser Horbach, M M Lokhorst, Ceu Oduber, S Middeldorp, Jam van der Post, Cmam van der Horst
OBJECTIVE: To evaluate complications of pregnancy, including thromboembolism, in women with extensive vascular malformations associated with Klippel-Trénaunay syndrome (KTS). DESIGN: Nationwide cross-sectional study. SETTING: Two tertiary expert centres and the Dutch Klippel-Trénaunay patient organisation. SAMPLE: Adult women with KTS. METHODS: Patients with KTS were invited to participate in a comprehensive online survey about their obstetric history...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28410584/case-crossover-study-to-examine-the-change-in-postpartum-risk-of-pulmonary-embolism-over-time
#14
Grégoire Ficheur, Alexandre Caron, Jean-Baptiste Beuscart, Laurie Ferret, Yu-Jin Jung, Charles Garabedian, Régis Beuscart, Emmanuel Chazard
BACKGROUND: Although the current guidelines recommend anticoagulation up until 6 weeks after delivery in women at high risk of venous thromboembolism (VTE), the risk of VTE may extend beyond 6 weeks. Our objective was to estimate the risk of a pulmonary embolism in successive 2-week intervals during the postpartum period. METHODS: In a population-based, case-crossover study, we analyzed the French national inpatient database from 2007 to 2013 (n = 5,517,680 singleton deliveries)...
April 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28355242/fluoroscopy-free-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-for-controlling-life-threatening-postpartum-hemorrhage
#15
Knut Haakon Stensaeth, Edmund Sovik, Ingrid Natasha Ylva Haig, Erna Skomedal, Arve Jorgensen
BACKGROUND: Severe postpartum hemorrhage occurs in 1/1000 women giving birth. This condition is often dramatic and may be life threatening. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has in recent years been introduced as a novel treatment for hemorrhagic shock. We present a series of fluoroscopy-free REBOA for controlling life threatening postpartum hemorrhage. METHODS: In 2008 an 'aortic occlusion kit' was assembled and used in three Norwegian university hospitals...
2017: PloS One
https://www.readbyqxmd.com/read/28329897/maternal-labor-delivery-and-perinatal-outcomes-associated-with-placental-abruption-a-systematic-review
#16
Katheryne L Downes, Katherine L Grantz, Edmond D Shenassa
Objective Risk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes. Methods We searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. We excluded case studies, conference abstracts, and studies that lacked a referent/comparison group or did not clearly characterize placental abruption...
March 22, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28292635/value-of-round-ligament-artery-embolization-in-the-management-of-postpartum-hemorrhage
#17
Grégoire Leleup, Audrey Fohlen, Anthony Dohan, Lara Bryan-Rest, Vincent Le Pennec, Olivier Limot, Olivier Le Dref, Philippe Soyer, Jean-Pierre Pelage
PURPOSE: To evaluate the feasibility and efficacy of embolization of the round ligament arteries in the management of postpartum hemorrhage. MATERIALS AND METHODS: Eleven women (mean age, 31 y) underwent round ligament artery because of persistent or recurrent hemorrhage after initial uterine or internal iliac artery embolization. RESULTS: A total of 16 round ligament arteries were embolized. The round ligament artery arose from the inferior epigastric artery in 11 cases (69%) and directly from the external iliac artery in 5 (31%)...
May 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28252305/-analysis-of-maternal-morbidity-and-mortality-in-slovak-republic-in-the-years-2007-2012
#18
M Korbeľ, A Krištúfková, M Dugátová, J Daniš, B Némethová, P Kaščák, Z Nižňanská
OBJECTIVE: Analysis of maternal morbidity and mortality in Slovak Republic (SR) in the years 2007-2012. DESIGN: Epidemiological perinatological nation-wide. SETTINGS: 1st Department of Gynaecology and Obstetrics School of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic. METHODS: The analysis of selected maternal morbidity and mortality data prospective collected in the years 2007-2012 from all obstetrics hospitals in the Slovak Republic...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28251148/emergent-uterine-arterial-embolization-using-n-butyl-cyanoacrylate-in-postpartum-hemorrhage-with-disseminated-intravascular-coagulation
#19
Soichiro Obata, Michi Kasai, Junko Kasai, Kazuo Seki, Zenjiro Sekikawa, Izumi Torimoto, Shigeo Takebayashi, Fumiki Hirahara, Shigeru Aoki
Although it is widely accepted that uterine artery embolization (UAE) is an effective therapeutic strategy for postpartum hemorrhage (PPH), no consensus has been reached regarding the efficacy of UAE in patients with PPH with disseminated intravascular coagulation (DIC). This single-center retrospective cohort study included patients treated with UAE using NBCA for PPH between 2010 and 2015. The patients were divided into DIC and non-DIC groups, according to the obstetrical DIC score and the overt DIC diagnostic criteria issued by the International Society of Thrombosis and Haemostasis (ISTH), and their clinical outcomes were compared...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28245191/serum-fibrinogen-levels-could-be-an-index-of-successful-use-of-balloon-tamponade-in-postpartum-hemorrhage
#20
Ayaka Nakashima, Kazuhide Ogita, Masaya Chita, Takeshi Yokoi
OBJECTIVE: The object of our study was to determine whether serum fibrinogen levels could be used to predict the success rates of balloon tamponade and decrease the use of invasive methods. METHODS: This retrospective study, conducted at Rinku General Medical Center, was aimed to identify factors associated with high success rates in balloon tamponade. Forty-six patients with postpartum hemorrhage (PPH), non-responsive to uterotonics and treated with balloon tamponade between April 2008 and March 2015, were included...
February 28, 2017: Journal of Perinatal Medicine
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