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thromboembolism in pregnancy

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https://www.readbyqxmd.com/read/29331855/retrievable-inferior-vena-cava-filters-in-pregnancy-risk-versus-benefit
#1
REVIEW
David A Crosby, Kevin Ryan, Niall McEniff, Patrick Dicker, Carmen Regan, Caoimhe Lynch, Bridgette Byrne
OBJECTIVE: Venous thromboembolism remains one of the leading causes of maternal mortality in the developed world. Retrievable inferior vena cava (IVC) filters have a role in the prevention of lethal pulmonary emboli when anticoagulation is contraindicated or has failed [1]. It is unclear whether or not the physiological changes in pregnancy influence efficacy and complications of these devices. The decision to place an IVC filter in pregnancy is complex and there is limited information in terms of benefit and risk to the mother...
December 21, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29324599/risk-factors-incidence-and-morbidity-associated-with-obstetric-clostridium-difficile-infection
#2
Jacob Ruiter-Ligeti, Sophie Vincent, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim
OBJECTIVE: To evaluate the risk factors, incidence, and morbidity associated with the diagnosis of obstetric Clostridium difficile infection. METHODS: We performed a retrospective cohort study on women admitted for delivery using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from the United States. The delivery admission records of pregnant women were reviewed between 1999 and 2013. After adjusting for demographic and clinical characteristics, we assessed risk factors for the diagnosis of C difficile infection using unconditional logistic regression...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29298686/a-single-center-experience-with-12-consecutive-cases-of-pregnancy-among-patients-with-membranous-ventricular-septal-aneurysm
#3
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/29296852/pregnancy-related-venous-thromboembolism-and-risk-of-occult-cancer
#4
Anette Tarp Hansen, Katalin Veres, Erzsébet Horváth-Puhó, Vera Ehrenstein, Paolo Prandoni, Henrik Toft Sørensen
The cancer risk during the first year after a pregnancy-related venous thromboembolism episode is higher than expected.An aggressive search for cancer in women with pregnancy-related venous thromboembolism is probably not warranted, due to low absolute risk.
October 24, 2017: Blood Advances
https://www.readbyqxmd.com/read/29280473/the-safety-of-low-molecular-weight-heparin-during-and-after-pregnancy
#5
Eric Lu, Joseph J Shatzel, Jennifer Salati, Thomas G DeLoughery
Importance: In industrialized countries, venous thromboembolism remains a leading cause of mortality in pregnant women. Low-molecular-weight heparin (LMWH) is the most commonly recommended anticoagulant in pregnancy, having been proven effective and safe in multiple prospective clinical trials. Objective: The aim of this article is to outline existing recommendations for proper use of LMWH in pregnancy and data on risks of LMWH. Evidence Acquisition: Wereviewed guidelines froma number of professional societies...
December 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29225678/pregnancy-in-women-with-klippel-trenaunay-syndrome-report-of-three-pregnancies-in-a-single-patient-and-review-of-literature
#6
Anish Keepanasseril, K Keerthana, Arun Keepanasseril, Dilip K Maurya, D Kadambari, Sharath Sistla
Klippel-Trenaunay syndrome is characterised by vascular abnormality which increases the risk of thromboembolism and haemorrhage. Physiological changes in pregnancy pose an increased risk to these complications. Being an uncommon disorder, there is limited literature about the management of women with pregnancy and Klippel-Trenaunay syndrome. We report in detail two of three pregnancies in a woman with Klippel-Trenaunay syndrome who had repeated episodes of haematochezia leading to anaemia, managed with Argon laser Photo-Coagulation in pregnancy and also reviewed the complications and the management of pregnant women with Klippel-Trenaunay syndrome...
December 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/29222251/preventing-venous-thromboembolism-during-pregnancy-and-postpartum-crossing-the-threshold
#7
REVIEW
Leslie Skeith
When should a patient with a known thrombophilia or prior venous thromboembolism (VTE) receive low-molecular-weight heparin (LMWH) prophylaxis during pregnancy and/or the postpartum period? Accurately predicting thrombotic and bleeding risks and knowing what to do with this information is at the heart of decision-making in these challenging scenarios. This article will explore the concept of a risk threshold from clinician and patient perspectives and provide guidance for the use of antepartum and postpartum LMWH prophylaxis in women with a known thrombophilia or prior VTE...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29196364/lesson-of-the-month-2-use-of-thrombolysis-for-ischaemic-stroke-in-pregnancy-a-case-report-and-review-of-literature
#8
Asim Khan, Paris Hosseini, Branimir Nevajda, Sami Khan
A nine-week pregnant 33-year-old female presented with sudden-onset right-sided hemiparesis, hemisensory loss, dysarthria and homonymous hemianopia. She was known to have eleven previous miscarriages and used recreational drugs. A CT-head was unremarkable. The patient was subsequently diagnosed with an acute thromboembolic infarct and chose alteplase after counselling. During thrombolysis an ultrasound identified a foetus with no concerning features.  A post-thrombolysis CT revealed a left-sided posterior cerebral infarct...
December 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29184862/the-clinical-significance-of-d-dimer-concentrations-in-patients-with-gestational-hypertensive-disorders-according-to-the-severity
#9
Se Jeong Kim, Hyo Jeong Ahn, Jung Yeon Park, Byoung Jae Kim, Kyu Ri Hwang, Taek Sang Lee, Hye Won Jeon, Sun Min Kim
Objective: Pregnancy is a major risk factor of thromboembolism, and the patients with preeclampsia (PE) are known to have higher risk of thromboembolic complications than normal pregnant women. D-dimer is a well-established laboratory marker for the screening of venous thromboembolism (VTE), but the concentrations of d-dimer tend to increase physiologically in pregnant women throughout the gestational age. We performed this study to evaluate the clinical significance of d-dimer concentrations in patients with gestational hypertensive disorders (GHD) according to the severity...
November 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29170876/venous-thromboembolism-in-assisted-reproductive-technologies-comparison-between-unsuccessful-versus-successful-cycles-in-an-italian-cohort
#10
Michela Villani, Giovanni Favuzzi, Pasquale Totaro, Elena Chinni, Gennaro Vecchione, Patrizia Vergura, Lucia Fischetti, Maurizio Margaglione, Elvira Grandone
Pregnancies after assisted reproductive technologies (ART) have been associated with an increased risk of venous thromboembolism (VTE). On the contrary, the magnitude of this risk in unsuccessful ART cycles (not resulting in a clinical pregnancy) has not yet been clearly defined. In this study, we evaluated the incidence of VTE in unsuccessful cycles and compared it with that recorded in successful cycles in the same study population. From a cohort of 998 women consecutively referred by local Fertility Clinics to our Atherosclerosis and Thrombosis Unit (April 2002-July 2011), we identified and included women with at least one cycle of ovarian stimulation and a negative history for VTE...
November 23, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29170316/19%C3%A2-accuracy-of-biomarkers-for-venous-thromboembolism-in-pregnancy-the-diagnosis-of-pulmonary-embolism-in-pregnancy-dipep-biomarker-study
#11
Steve Goodacre, Beverley Hunt, Kiran Parmar, Neil Shephard, Kimberley Horspool
OBJECTIVE: To estimate the accuracy of biomarkers for venous thromboembolism (VTE) in pregnant and postpartum women with suspected pulmonary embolism (PE). DESIGN: Observational cohort study augmented with additional cases with VTE. SETTING: Emergency departments and maternity units at eleven prospectively recruiting sites. PARTICIPANTS: Pregnant or postpartum women presenting with suspected PE or diagnosed DVT. INTERVENTIONS: Research nurses/midwives collected a blood sample from women with suspected PE or diagnosed DVT and data relating to diagnostic imaging, treatment and adverse outcomes...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170307/10%C3%A2-decision-analysis-modelling-of-diagnostic-strategies-for-suspected-pulmonary-embolism-in-pregnancy-the-dipep-economic-evaluation
#12
Daniel Pollard, Steve Goodacre, Matthew Stevenson, Gordon Fuller
BACKGROUND: Using diagnostic imaging for suspected pulmonary embolism (PE) in pregnancy involves weighing the benefits, harms and costs of different approaches to selecting women for imaging. OBJECTIVES: To estimate the effectiveness of diagnostic strategies for PE in pregnancy and postpartum, in terms of adverse outcomes from venous thromboembolism, bleeding and radiation exposure, and cost effectiveness, measured as the incremental cost per quality-adjusted life year (QALY)...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29169973/-maternal-death-by-venous-thromboembolic-disease
#13
M Rossignol, E Morau, M Dreyfus
Pregnancy and postpartum are very high-risk periods for venous thromboembolism events (TEE), which seems to extend far beyond the classical 6-8 weeks after childbirth. Pulmonary embolism (PE) is one of the 3 main causes of direct maternal death in western countries. Between 2010 an 2012 in France, 24 deaths were related to PE giving a maternal mortality ratio of 1/100,000, which is not different from the former report (2007-2009). PE is responsible of 9% of maternal deaths, in equal position with postpartum hemorrhage and amniotic fluid embolism...
November 20, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29167317/rodent-vertical-sleeve-gastrectomy-alters-maternal-immune-health-and-feto-placental-development
#14
Redin A Spann, Wiiliam J Lawson, Gene L Bidwell, C Austin Zamarripa, Rodrigo O Maranon, Sibali Bandyopadhyay, Erin R Taylor, Jane F Reckelhoff, Michael R Garrett, Bernadette E Grayson
Bariatric surgery is increasingly employed to improve fertility and reduce obesity related co-morbidities in obese women. Surgical weight loss not only improves the chance of conception but reduces the risk of pregnancy complications including pre-eclampsia, gestational diabetes, and macrosomia. However, bariatric procedures increase the incidence of intrauterine growth restriction (IUGR), fetal demise, thromboembolism and other gestational disorders. Using our rodent model of vertical sleeve gastrectomy (VSG), we tested the hypothesis that VSG in diet-induced, obese dams would cause immune and placental structural abnormalities that may be responsible for fetal demise during pregnancy...
November 22, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29166819/pregnancy-outcomes-among-women-with-asthma
#15
Haitham Baghlaf, Andrea R Spence, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim
PURPOSE: The purpose of this study is to examine the association between maternal asthma and pregnancy, delivery and neonatal outcomes. MATERIALS AND METHODS: We carried out a retrospective cohort study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) database from 2003 to 2011. Among women who delivered during this time period, we compared pregnancy, delivery, and neonatal outcomes in asthmatics versus non-asthmatics. Multivariate logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals...
November 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29153467/ovarian-torsion-in-pediatric-and-adolescent-patients-a-systematic-review
#16
Roshni Dasgupta, Elizabeth Renaud, Adam B Goldin, Robert Baird, Danielle B Cameron, Meghan A Arnold, Karen A Diefenbach, Ankush Gosain, Julia Grabowski, Yigit S Guner, Tim Jancelewicz, Akemi Kawaguchi, Dave R Lal, Tolulope A Oyetunji, Robert L Ricca, Julia Shelton, Stig Somme, Regan F Williams, Cynthia D Downard
OBJECTIVE: Ovarian torsion in pediatric patients is a rare event and is primarily managed by pediatric general surgeons. Torsion can be treated with detorsion of the ovary or oopherectomy. Oopherectomy is the most common procedure performed by pediatric general surgeons for ovarian torsion. The purpose of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee was to examine evidence from the medical literature and provide recommendations regarding the optimal treatment of ovarian torsion...
November 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29150108/economy-class-syndrome-what-is-it-and-who-are-the-individuals-at-risk
#17
Luci Maria SantAna Dusse, Marcos Vinícius Ferreira Silva, Letícia Gonçalves Freitas, Milena Soriano Marcolino, Maria das Graças Carvalho
The term 'economy class syndrome' refers to the occurrence of thrombotic events during long-haul flights that mainly occur in passengers in the economy class of the aircraft. This syndrome results from several factors related to the aircraft cabin (immobilization, hypobaric hypoxia and low humidity) and the passenger (body mass index, thrombophilia, oral contraceptives or hormone replacement therapy, cancer), acting together to predispose to excessive blood coagulation, which can result in venous thromboembolism...
October 2017: Revista Brasileira de Hematologia e Hemoterapia
https://www.readbyqxmd.com/read/29112658/adding-azithromycin-to-cephalosporin-for-cesarean-delivery-infection-prophylaxis-a-cost-effectiveness-analysis
#18
Ashley E Skeith, Brenda Niu, Amy M Valent, Methodius G Tuuli, Aaron B Caughey
OBJECTIVE: To investigate the cost-effectiveness of adding azithromycin to standard cephalosporin regimens of cesarean delivery prophylaxis by considering the maternal outcomes in the current and potential subsequent pregnancies. METHODS: A cost-effectiveness model was created using TreeAge to compare the outcomes of using azithromycin-cephalosporin with cephalosporin alone in a theoretical cohort of 700,000 women, the approximate number of nonelective cesarean deliveries annually in the United States that occur during labor or after membrane rupture...
December 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29112543/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-during-pregnancy-and-the-immediate-postpartum-period
#19
Anne-Sophie Ducloy-Bouthors, Andrea Baldini, Rezan Abdul-Kadir, Jacky Nizard
: Thromboembolic events in the pregnant and postpartum patient remain rare but potentially fatal complications. The aim of this section was to analyse the few prospective studies addressing the issue of thromboprophylaxis following a surgical procedure during and immediately after pregnancy, as well as national guidelines, and to propose European guidelines on this specific condition. Thromboprophylaxis is broadly recommended due to the combined risks of surgery and pregnancy or the postpartum period, regardless of the mode of delivery...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29111146/medical-contraindications-to-estrogen-and-contraceptive-use-among-women-veterans
#20
Colleen P Judge, Xinhua Zhao, Florentina E Sileanu, Maria K Mor, Sonya Borrero
BACKGROUND: Women veterans have high rates of medical comorbidities and may be particularly vulnerable to adverse health outcomes associated with unintended pregnancy. OBJECTIVES: The objective of the study was to estimate the prevalence of medical contraindications to estrogen-containing combined hormonal contraception among women veterans of reproductive age and to evaluate the relationship between contraindications and contraceptive use. STUDY DESIGN: This was a secondary analysis of data from a cross-sectional, telephone-based survey with a national sample of 2302 female veterans, aged 18-45 years, who use the Veterans Administration Healthcare System for primary care...
October 27, 2017: American Journal of Obstetrics and Gynecology
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