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thrombocytopenia in pregnancy

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https://www.readbyqxmd.com/read/29331477/atypical-presentation-of-pregnancy-related-hemolytic-uremic-syndrome
#1
Salim Baghli, Catherine Abendroth, Umar Farooq, Jennifer A Schaub
The cause of acute kidney injury during pregnancy and in the postpartum period can be particularly challenging to diagnose, especially when it is necessary to differentiate among preeclampsia; eclampsia; hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome; and thrombotic microangiopathies (TMAs). All these disease entities can present with kidney failure, microangiopathic hemolytic anemia, and thrombocytopenia. We present a teaching case of atypical hemolytic uremic syndrome in the postpartum period in a young woman who was found to have mutations of uncertain clinical significance in the complement cascade, including in C3, CFH, and CFI...
January 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29324461/efficacy-of-treatment-immune-thrombocytopenic-purpura-in-pregnancy-with-corticosteroids-and-intravenous-immunoglobulin-a-prospective-follow-up-of-suggested-practice
#2
Gisela Wegnelius, Katarina Bremme, Pelle G Lindqvist
: The current study is performed to assess a routine for treatment of immune thrombocytopenic purpura in pregnancy. A prospective programme for monitoring and treatment with intravenous immunoglobulin or cortisone in pregnancies with immune thrombocytopenic purpura was suggested to all delivery units in Sweden. Treatment should be avoided if platelet counts were more than 20 × 10/l during pregnancy with no bleeding complications and with a target of 100 × 10/l at delivery. Descriptive statistics and logistic regression analysis were used...
January 10, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29305253/chronic-hypertension-first-trimester-blood-pressure-control-and-likelihood-of-severe-hypertension-preeclampsia-and-small-for-gestational-age
#3
Diane Nzelu, Dan Dumitrascu-Biris, Kypros H Nicolaides, Nikos A Kametas
BACKGROUND: There is extensive evidence that pre-pregnancy chronic hypertension is associated with high risk of development of severe hypertension and preeclampsia and birth of small for gestational age neonates. However, previous studies have not reported whether anti-hypertensive use, blood pressure control or normalization of blood pressure during early pregnancy influence the rates of these pregnancy complications. OBJECTIVE: To stratify women with pre-pregnancy chronic hypertension according to the use of antihypertensive medications and level of blood pressure control at the first hospital visit during the first-trimester of pregnancy and examine the rates of severe hypertension, preeclampsia and birth of small for gestational age neonates according to such stratification...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29239070/clinical-features-of-new-onset-systemic-lupus-erythematosus-in-pregnant-patients
#4
Chong Zhang, Mei-Ying Liang, Xue Xu, Xue-Wu Zhang, Shi Chen
AIM: This study was conducted to examine the clinical characteristics of new-onset systemic lupus erythematosus (SLE) during pregnancy. METHODS: We performed a retrospective study of all pregnancies in patients with SLE managed at The People's Hospital of Peking University from 2008 to 2015. In total, 97 pregnancies were identified and studied, 22 of which were first diagnosed with SLE during pregnancy or puerperium. RESULTS: New-onset SLE mainly occurred during the first and second pregnancy trimesters...
December 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29222249/thrombocytopenia-in-pregnancy
#5
REVIEW
Douglas B Cines, Lisa D Levine
Thrombocytopenia develops in 5% to 10% of women during pregnancy or in the immediate postpartum period. A low platelet count is often an incidental feature, but it might also provide a biomarker of a coexisting systemic or gestational disorder and a potential reason for a maternal intervention or treatment that might pose harm to the fetus. This chapter reflects our approach to these issues with an emphasis on advances made over the past 5 to 10 years in understanding and managing the more common causes of thrombocytopenia in pregnancy...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29188582/a-low-birth-weight-infant-with-no-malformations-delivered-by-a-primary-immune-thrombocytopenia-patient-treated-with-eltrombopag
#6
Naruko Suzuki, Junji Hiraga, Yumi Hariyama, Yusuke Takagi, Haruhiko Ohashi, Yasuyuki Kishigami, Hidenori Oguchi, Yoshitoyo Kagami
Primary immune thrombocytopenia (ITP) is defined by a low platelet count secondary to antibody-mediated platelet destruction or reductions in platelet production. Although eltrombopag is a thrombopoietin receptor agonist that increases platelet production in refractory or relapsed ITP, the influence on pregnancy is limited. We present the case of a pregnant 25-year-old ITP patient referred to our hospital with a history of two induced abortions. After eradication of Helicobacter pylori and with oral prednisolone at 8 mg/day, platelet count remained below 10,000/µl...
November 29, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/29187254/acute-disseminated-melioidosis-giving-rise-to-pneumonia-and-renal-abscesses-complicated-with-thrombotic-thrombocytopenic-purpura-in-a-post-partum-woman-a-case-report
#7
Piyumi Sachindra Alwis Wijewickrama, Rohini Weerakoon
BACKGROUND: Melioidosis is an established endemic infection in Sri Lanka, caused by Burkholderia pseudomallei, a gram negative bacterium distributed in saprophytes in soil and surface water. Main mode of transmission is via percutaneous inoculation. Pneumonia is the most common presentation in acute disease. CASE PRESENTATION: We report a 33 year old previously healthy Sinhalese female with an occupational exposure to surface water in paddy fields, who was on postpartum day 6 following an uncomplicated pregnancy and delivery via an elective caesarian section...
November 29, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29177397/-not-everything-is-zika-congenital-toxoplasmosis-still-prevalent-in-colombia
#8
Jorge L Alvarado-Socarras, Keyla Meneses-Silvera, Andrea Carolina Zarate-Vergara, Carlos Guerrero-Gomez, Alfonso J Rodriguez-Morales
Congenital toxoplasmosis continues to be a public health threat. Even existing guidelines, publicly known, its implementation and lack of appropriate interpretation of serological tests in pregnancy is often observed. This leds to failure in opportunities for positive and known interventions to decrease the fetal risk due to Toxoplasma gondii infection. We reported herein a case series, with variable neurological and systemic compromise (respiratory distress, hepatosplenomegaly, enterocolitis, brain calcifications, thrombocytopenia, ascites, shock), even fatal, calling for awareness about the fact that despite the Zika epidemics in 2015-2016 in Brazil, Colombia and other countries, precisely toxoplasmosis, is a differential diagnosis still prevalent in these territories, that can leds to severe consequences, with neurological disability and risk of ocular damage, even lately...
April 2017: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/29123569/diagnostic-dilemma-severe-thrombotic-microangiopathy-in-pregnancy
#9
Sarah Birkhoelzer, Alexandra Belcher, Helen Peet
A diagnostic dilemma occurred when thrombotic microangiopathy developed during pregnancy. The diagnostic criteria of thrombotic microangiopathy include thrombocytopenia (platelets <100) and microangiopathic haemolytic anaemia (including thrombotic thrombocytopenic purpura and haemolytic-uraemic syndrome). An urgent interdisciplinary approach is required to treat thrombotic microangiopathy in pregnancy to differentiate between thrombotic microangiopathy and HELLP syndrome (haemolysis, elevated liver enzymes, low platelets)...
November 2017: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29075073/moderate-to-severe-thrombocytopenia-during-pregnancy-a-single-institutional-experience
#10
Bum Jun Kim, Hyeong Su Kim, Jung Han Kim, Keun Young Lee
Most of thrombocytopenic pregnant women present mild decrease of platelet counts and have favorable outcome. However, small portion of these cases can show moderate to severe thrombocytopenia and may increase the risk of bleeding during delivery. We investigated the prevalence, causes, and outcomes of pregnancies complicated by moderate to severe thrombocytopenia. We reviewed medical records of pregnant women who were diagnosed with moderate to severe thrombocytopenia (<100 × 10(9)/L) during their pregnancies...
December 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/29031020/fetal-mri-lower-acceptance-by-women-in-research-vs-clinical-setting
#11
Bloeme J van der Knoop, Roland J Vermeulen, Jonathan I M L Verbeke, Lourens R Pistorius, Johanna I P de Vries
AIM: To determine acceptance of pregnant women to undergo fetal magnetic resonance imaging (MRI) examination in research and clinical setting. METHODS: A prospective study included a research group [part of a study comparing brain ultrasound (US) to MRI in fetuses at risk for acquired brain damage] and a clinical group [fetuses with suspected (brain) anomalies after structural US examination] from 2011 to 2014. All women were advised to use sedatives. MRI declinations, use of sedation, MRI duration and imaging quality were compared between both groups...
October 14, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29028104/the-influence-of-ovulation-induction-and-assisted-conception-on-maternal-and-perinatal-outcomes-of-twin-pregnancies
#12
G Bordi, A D'Ambrosio, I Gallotta, L Di Benedetto, A Frega, F Torcia, M Schimberni, M Bonito, D Caserta
OBJECTIVE: To compare obstetrical and neonatal outcomes of twin pregnancies conceived via assisted reproductive technology (ART) with those of naturally conceived ones and to investigate the influence of the ART procedure type on these parameters. PATIENTS AND METHODS: This observational study included 450 ART and 647 spontaneous twin pregnancies delivered over 15 years at a single university-based hospital of Rome, Italy. Logistic and linear regression models adjusted for confounding factors were used to evaluate the effect of ART and the type of assisted conception (IVF/ICSI, ovulation induction ± intrauterine insemination, egg/embryo donation) on maternal and perinatal outcomes...
September 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29020871/tolerability-and-safety-of-the-intravenous-immunoglobulin-octagam-%C3%A2-10-in-patients-with-immune-thrombocytopenia-a-post-authorisation-safety-analysis-of-two-non-interventional-phase-iv-trials
#13
Stefan Wietek, Daniel Svorc, Anette Debes, Tor-Einar Svae
OBJECTIVES: To provide detailed data on the tolerability and safety of octagam(®) 10%, a ready-to-use intravenous immunoglobulin, in a subgroup of patients with immune thrombocytopenia (ITP) involved in an integrated analysis of post-authorisation safety surveillance (PASS) studies. METHODS: A subgroup analysis was conducted using data collected from two non-interventional studies that included patients with ITP treated with octagam(®) 10%. Patients were observed and monitored for possible adverse drug reactions (ADRs) during or after administration of octagam(®) 10%, with a particular focus on thromboembolic events (TEEs)...
October 11, 2017: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/28970962/ivig-associated-maternal-pancytopenia-during-treatment-for-neonatal-alloimmune-thrombocytopenia
#14
Alyssa Herrmann, Benjamin J Samelson-Jones, Sami Brake, Renee Samelson
Background  Treatment for neonatal alloimmune thrombocytopenia (NAIT) primarily involves maternal administration of intravenous immunoglobulin (IVIG) therapy and prednisone according to protocols based on risk stratification. While IVIG is generally well tolerated, hematologic side effects are a potential complication. Case  We present the successful management of a rare complication of maternal pancytopenia following standard IVIG treatment. Diagnosis was made during routine obstetric exams. Management included reducing IVIG dosage and adding daily prednisone...
July 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#15
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28892906/changes-in-haematological-parameters-in-newborns-born-to-preeclamptic-mothers-a-case-control-study-in-a-rural-hospital
#16
Kalavakuru Mouna, Shilpa Manigatta Doddagowda, Krishnappa Junjegowda, Latha Krishnamurthy
INTRODUCTION: Pregnancy is a physiological phenomenon. However, some women develop problems during pregnancy period, which puts both the mother's and the foetus health at risk. Hypertensive disorders of pregnancy are the type of the maternal diseases that can cause the most detrimental effects to the mother and foetus. AIMS: To determine the haematological parameters in neonates born to preeclamptic mothers. MATERIALS AND METHODS: It was a prospective case control study carried out on neonates born to preeclamptic mothers in our institute from March 2016 to November 2016...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28866693/a-15-year-single-centre-retrospective-study-of-antiphospholipid-syndrome-patients-from-northern-malaysia
#17
M A Islam, F Alam, S H Gan, T H Sasongko, W S Wan Ghazali, K K Wong
BACKGROUND: Antiphospholipid syndrome (APS) is an autoimmune disorder characterised by thrombosis and/or pregnancy morbidity in the presence of antiphospholipid antibodies (aPLs) based on the Sydney criteria. We aimed to explore the clinico-laboratory features and treatment strategies of APS patients retrospectively. METHODOLOGY: The medical records of APS patients registered under Hospital Universiti Sains Malaysia (Kelantan state) between 2000 and 2015 were reviewed...
August 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28837832/factors-associated-with-adverse-pregnancy-outcomes-in-women-with-antiphospholipid-syndrome-a-multicenter-study
#18
Masashi Deguchi, Hideto Yamada, Mayumi Sugiura-Ogasawara, Mamoru Morikawa, Daisuke Fujita, Akinori Miki, Shintaro Makino, Atsuko Murashima
The aim of this study was to understand the clinical features of antiphospholipid syndrome (APS)-complicated pregnancies and evaluate risk factors for the adverse pregnancy outcomes. This multicenter study evaluated live-birth rates according to therapy modality for APS and risk factors of pregnancy loss in 81 pregnancies. Risk factors for pregnancy complications, including premature delivery before 34 gestational weeks, hypertensive disorders of pregnancy, thrombocytopenia, and light-for-date neonate, were evaluated in 51 women who received low dose aspirin (LDA) plus unfractionated heparin (UFH) and delivered after 24 GW...
August 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/28837581/fetal-exposure-to-maternal-human-platelet-antigen-1a-does-not-induce-tolerance-an-analytical-observational-study
#19
Mette Kjær, Heidi Tiller, Gøril Heide, Jens Kjeldsen-Kragh, Bjørn Skogen, Anne Husebekk
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a disease that may cause severe bleeding complications with risk of perinatal death or lifelong disability. The main cause of FNAIT is maternal antibodies against human platelet antigen (HPA)-1a. Both fetomaternal bleeding and transplacental trafficking of fetal cells during pregnancy could be the cause of alloimmunization. Persistence of fetal cells in the mother (fetal microchimerism) and maternal cells in the child (maternal microchimerism) are well-recognized phenomena...
2017: PloS One
https://www.readbyqxmd.com/read/28795988/eltrombopag-to-treat-thrombocytopenia-during-last-month-of-pregnancy-in-a-woman-with-myh9-related-disease-a-case-report
#20
Remi Favier, Celine De Carne, Elisabeth Elefant, Ruxanda Lapusneanu, Vasiliki Gkalea, Agnès Rigouzzo
MYH9-related disease (MYH9-RD) is an inherited rare autosomal dominant macrothrombocytopenia. Patients with MYH9-RD have giant platelets and leukocyte inclusion bodies caused by mutations in the MYH9 gene encoding the non-muscle myosin heavy chain II-A. Before identification of the causative gene, patients were diagnosed as Epstein or Fechtner or Sebastian syndromes or May-Hegglin anomaly. As with other inherited thrombocytopenias, the risk of increased bleeding during perioperative period or delivery is a major concern...
August 8, 2017: A & A Case Reports
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