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preeclampsia post partum

Laxman G Jessani, Aumir Moin, Shivaprasad Karnati, Keshavamurthy
Here we report two patients with late post-partum eclampsia without pre-existing preeclampsia presenting with atypical features of posterior reversible encephalopathy syndrome (PRES) which was diagnosed by serial MRI with good outcome emphasizing the fact that early diagnosis and treatment can prevent complications.
February 2016: Journal of the Association of Physicians of India
J Ambrozic, K Prokselj, M Lucovnik
INTRODUCTION: The ability to judge intravascular volume is fundamental in the management of patients with severe preeclampsia. Insufficient intravascular volume can result in decreased oxygen delivery to tissues and exacerbates organ dysfunction. On the other hand, fluid excesses can lead to fluid extravasation and pulmonary edema. Outside of pregnancy, transthoracic echocardiography and lung ultrasonography have become important diagnostic and monitoring tools in critically ill patients...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Peeter Juhanson, Kristiina Rull, Triin Kikas, Hannele Laivuori, Pille Vaas, Eero Kajantie, Seppo Heinonen, Maris Laan
: Context, Objectives: The study represents the first comprehensive analysis of Stanniocalcin 1 (STC1) hormone in human pregnancy, assessing clinical, life-style and genetic determinants of circulating STC1 at term. DESIGN, SETTING, PARTICIPANTS: Participants included women with (n=50) and without (n=316) preeclampsia (PE) at delivery, recruited in the REPROgrammed fetal and/or maternal METAbolism study (REPROMETA; 2006-2011, Estonia). Genetic association analysis combined PE cases (n=597) and controls (n=623) from the REPROMETA and FINNPEC (the Finnish Genetics of Preeclampsia Consortium; 2008-2011) studies...
September 7, 2016: Journal of Clinical Endocrinology and Metabolism
U Pecks, W Rath, N Kleine-Eggebrecht, N Maass, F Voigt, T W Goecke, M G Mohaupt, G Escher
OBJECTIVE: Lipids and steroid hormones are closely linked. While cholesterol is the substrate for (placental) steroid hormone synthesis, steroid hormones regulate hepatic lipid production. The aim of this study was to quantify circulating steroid hormones and lipid metabolites, and to characterize their interactions in normal and pathological pregnancies with a focus on hepatic and placental pathologies. METHODS: A total of 216 serum samples were analyzed. Group A consisted of 32 patients with uncomplicated pregnancies who were analyzed at three different time-points in pregnancy (from the first through the third trimester) and once post partum...
July 2016: Geburtshilfe und Frauenheilkunde
Renuka Shanmugalingam, Nina Reza Pour, Siang Chye Chuah, Thi Mong Vo, Roy Beran, Annemarie Hennessy, Angela Makris
BACKGROUND: Arterial dissection is a rare complication of pregnancy and puerperium. There have been reports of aortic, coronary and cervical artery dissection in association with preeclampsia, however, vertebral artery dissection is rarely reported particularly in the antenatal setting in the presence of a Hypertensive Disorder of Pregnancy (HDP).The general annual incidence of symptomatic spontaneous cervicocephalic arterial dissection is 0.0026 % and a data registry reported that 2...
2016: BMC Pregnancy and Childbirth
Martin Andreas, Lorenz Kuessel, Stefan P Kastl, Stefan Wirth, Kathrin Gruber, Franziska Rhomberg, Fatemeh A Gomari-Grisar, Maximilian Franz, Harald Zeisler, Michael Gottsauner-Wolf
BACKGROUND: Pregnancy associated cardiovascular pathologies have a significant impact on outcome for mother and child. Bioimpedance cardiography may provide additional outcome-relevant information early in pregnancy and may also be used as a predictive instrument for pregnancy-associated diseases. METHODS: We performed a prospective longitudinal cohort trial in an outpatient setting and included 242 pregnant women. Cardiac output and concomitant hemodynamic data were recorded from 11(th)-13(th) week of gestation every 5(th) week as well as at two occasions post partum employing bioimpedance cardiography...
2016: BMC Pregnancy and Childbirth
Justine Hugon-Rodin, Geneviève Plu-Bureau
Post-partum period is associated with specific characteristics in women with gestational disorders or preeclampsia. For breastfeeding women, the choice of antihypertensive treatment should take into account the impact on child health. The impact of breastfeeding on health mother must be also discussed. Moreover, for lactation inhibition, bromocriptine should not be used, especially in the context of gestational disorders. In post-partum period, the best contraceptive strategy is only-progestin contraception or non-hormonal contraceptives use...
July 2016: La Presse Médicale
Arsenio Spinillo, Fausta Beneventi, Elena Locatelli, Vèronique Ramoni, Roberto Caporali, Claudia Alpini, Giulia Albonico, Chiara Cavagnoli, Carlomaurizio Montecucco
OBJECTIVE: To evaluate the impact of preclinical systemic autoimmune rheumatic disorders on pregnancy outcome. METHODS: In this longitudinal cohort study, patients were enrolled during the first trimester of pregnancy if they reported having had connective tissue disorder symptoms, were found to be positive for circulating autoantibodies, and on clinical evaluation were judged to have a preclinical or incomplete rheumatic disorder. The incidence of fetal growth restriction (FGR), preeclampsia, and adverse pregnancy outcomes in patients with preclinical rheumatic disorders was compared with that in selected controls, after adjustment for confounders by penalized logistic regression...
October 2016: Arthritis & Rheumatology
Ivan Varga, Ladislav Urban, Marianna Kajanová, Štefan Polák
PURPOSE: Key discoveries of recent years comprise detection of telocytes. These cells of connective tissue have extremely long cytoplasmic processes through which they form functionally connected spatial networks. Through their processes they mutually contact and functionally connect also cells of the immune system, nerve fibres and smooth muscle cells. They are located in various parts of the female reproductive system where they can perform specifically significant functions, which are summarized in our literature review...
August 2016: Archives of Gynecology and Obstetrics
Josip Anđelo Borovac, Joško Božić, Nikola Žaja, Krešimir Kolić, Vedran Hrboka
A case is reported of a 26-year-old primiparous woman in the 32nd week of gestation who presented to the emergency department with the symptoms of a severe headache, nausea and vomiting. The patient was diagnosed with preeclampsia that later progressed to eclampsia. This state was characterized by a sudden onset of a headache and diplopia that advanced to cortical blindness and precipitated significant alterations in mental status, most notable being global amnesia that resolved within 48 h. A post-partum magnetic resonance imaging of the brain in FLAIR mode revealed multiple cortico-subcortical areas of hyperintense signals suggestive of edematous lesions that chiefly involved occipital and parietal lobes with additional atypical manifestations...
April 2016: Oxford Medical Case Reports
Cecile M Yelnik, T Flint Porter, D Ware Branch, Carl A Laskin, Joan T Merrill, Marta M Guerra, Michael D Lockshin, Jill P Buyon, Michelle Petri, Lisa R Sammaritano, Mary D Stephenson, Mimi Y Kim, Jane E Salmon
OBJECTIVE: To measure variance in antiphospholipid antibody (aPL) levels during pregnancy and to determine if variation affects pregnancy outcomes. METHODS: We used data from the PROMISSE (Predictors of Pregnancy Outcome: Biomarkers in Antiphospholipid Antibody Syndrome and Systemic Lupus Erythematosus) study, a multicenter prospective study of pregnant women with aPL and/or systemic lupus erythematosus (SLE). Antiphospholipid antibodies were considered present if any of the following were positive: anticardiolipin (aCL), anti-β2 -glycoprotein I (anti-β2 GPI) titers ≥40 IgG phospholipid (GPL) or IgM phospholipid (MPL) units, and/or lupus anticoagulant (LAC)...
August 2016: Arthritis & Rheumatology
P Berlit
Neurological disorders caused by pregnancy and puerperium include the posterior reversible encephalopathy syndrome, the amniotic fluid embolism syndrome (AFES), the postpartum angiopathy due to reversible vasoconstriction syndrome, and the Sheehan syndrome. Hypertension and proteinuria are the hallmarks of preeclampsia, seizures define eclampsia. Hemolysis, elevated liver enzymes and low platelets constitute the HELLP syndrome. Vision disturbances including cortical blindness occur in the posterior reversible encephalopathy syndrome (PRES)...
February 2016: Fortschritte der Neurologie-Psychiatrie
Florent Ymele Fouelifack, Jeanne Hortence Fouedjio, Jovanny Tsuala Fouogue, Zacharie Sando, Loic Dongmo Fouelifa, Robinson Enow Mbu
BACKGROUND: Obesity is a rising public health issue worldwide. Guidelines regarding maternal body mass index (BMI) and gestational weight gain (GWG) are missing in Cameroon where maternal mortality rate remains very high. We hypothesized that obesity and inappropriate GWG are associated with poor pregnancy outcomes. We aimed at assessing associations of BMI and GWG with pregnancy outcomes. METHODS: This was a retrospective cohort study at the Yaoundé Central Hospital...
2015: BMC Research Notes
Amanda Finley, Brenton Rogers, Theodore Richards, Heather Vogel
We report a case of a right vertebral artery dissection in a 35-year-old woman, 3 weeks post partum, with manifestations of vertebrobasilar disease. She was 3 weeks out from the uneventful delivery of her fourth child, with presentation of acute neurological symptoms, predominantly intractable vertigo. Vertigo can have many non-specific generalised symptoms and clinical findings. Postpartum women have a lengthy list of possible aetiologies of vertigo not limited to our initially suspected preeclampsia, dural venous thrombosis and vertebral dissection...
2015: BMJ Case Reports
Mette-Elise Estensen, Guro Grindheim, Espen W Remme, Kristin Godang, Tore Henriksen, Pål Aukrust, Svend Aakhus, Lars Gullestad, Thor Ueland
OBJECTIVES: To investigate if circulating markers of systemic and vascular inflammation are associated with systemic arterial properties at term and 6months post-partum in women with preeclampsia (PE) and normal pregnancy (NP). STUDY DESIGN: Longitudinal, sampling at term and 6months post-partum in 34 women (32±6years) with PE and 61 women (32±5years) with NP. MAIN OUTCOME MEASURES: Circulating markers related to systemic and vascular inflammation were measured by enzyme immune-assay...
October 2015: Pregnancy Hypertension
A Ditisheim, M Boulvain, O Irion, A Pechère-Bertschi
Preeclampsia is a pregnancy-related syndrome, which still represents one of the major causes of maternal-fetal mortality and morbidity. Diagnosis can be made difficult due to the complexity of the disorder and its wide spectrum of clinical manifestations. In order to provide an efficient diagnostic tool to the clinician, medical societies regularly rethink the definition criteria. However, there are still clinical presentations of preeclampsia that escape the frame of the definition. The present review will address atypical forms of preeclampsia, such as preeclampsia without proteinuria, normotensive preeclampsia, preeclampsia before 20 weeks of gestation and post-partum preeclampsia...
September 9, 2015: Revue Médicale Suisse
E-G Simon, M Laffon
OBJECTIVE: To provide recommendations on maternal care after vaginal delivery, and management of complications in immediate post-partum period. METHODS: Bibliographic research from the Pubmed database and recommendations issued by the main scientific societies, and assignment of a level of evidence and a recommendation grade. RESULTS: After a vaginal delivery, monitoring of blood pressure, heart rate, bleeding, uterine involution, genital pain, urination, temperature, transit and signs of phlebitis is recommended (professional consensus)...
December 2015: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Phyllis August, Line Malha
No abstract text is available yet for this article.
November 3, 2015: Circulation
Everett F Magann, Songthip T Ounpraseuth, Christina D Miller, Sarah A Novotny, Nicole M Lee, William W Greenfield, John C Morrison
PURPOSE: The purpose of this study was to evaluate the labor characteristics and maternal/perinatal consequences following indicated induction of labor. METHODS: This retrospective study examined all of the indicated inductions over 24 months and at two institutions evaluated mode of delivery (vaginal versus cesarean) as well as a comprehensive list of labor characteristics and maternal/perinatal outcomes. RESULTS: There were 1577 indicated inductions with 1097/1577 (69...
2016: Journal of Maternal-fetal & Neonatal Medicine
Victoria Ossada, Alexander Jank, Holger Stepan
Our purpose was to investigate the influence of a uterine curettage on the immediate maternal sFlt-1 concentration post partum. Forty-six patients booked for delivery via primary caesarean section were included in a prospective open, case control study. Eighteen of them achieved an intraoperative curettage and formed the treatment group, 28 patients without curettage were enrolled in the control group. Maternal sFlt-1 serum values were measured immediately before and 24 h after delivery. Patients who underwent a uterine curettage showed a relative decrease of 70% (median 3670±1110 pg/mL-1143±270 pg/mL) in comparison to the control group with 65% (median 3132±636 pg/mL-1098±611 pg/mL; P=0...
April 2016: Journal of Perinatal Medicine
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