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thrombocytopenia in pregnancy

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https://www.readbyqxmd.com/read/29792359/adverse-effect-analysis-of-high-intensity-focused-ultrasound-in-the-treatment-of-benign-uterine-diseases
#1
Yunchang Liu, Wendy Wenyi Zhang, Min He, Chunmei Gong, Bin Xie, Xiangxia Wen, Dandan Li, Lian Zhang
OBJECTIVE: To retrospectively analyze the adverse effects of high-intensity focused ultrasound (HIFU) in management of benign uterine diseases. MATERIALS AND METHODS: From 2011 to 2017, 27,053 patients with benign uterine diseases were treated with HIFU in 19 centers in China. Among them, 17,402 patients had uterine fibroids, 8434 had adenomyosis, 876 had caesarean scar pregnancies, and 341 had placenta accreta. RESULTS: The median age, height, weight, BMI of the patients was 42 years, 158 mm, 56 kg, 22...
May 24, 2018: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/29747664/adverse-effects-in-children-exposed-to-maternal-hiv-and-antiretroviral-therapy-during-pregnancy-in-brazil-a-cohort-study
#2
Adriane M Delicio, Giuliane J Lajos, Eliana Amaral, Fernanda Cavichiolli, Marina Polydoro, Helaine Milanez
BACKGROUND: Antiretroviral therapy (ART) in pregnancy was associated with a drastic reduction in HIV mother-to-child transmission (MTCT), although it was associated with neonatal adverse effects. The aim of this study was to evaluate the neonatal effects to maternal ART. METHODS: This study was a cohort of newborns from HIV pregnant women followed at the CAISM/UNICAMP Obstetric Clinic from 2000 to 2015. The following adverse effects were evaluated: anemia, thrombocytopenia, liver function tests abnormalities, preterm birth, low birth weight and congenital malformation...
May 10, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29717700/-establishing-a-screening-programme-in-denmark-for-foetal-and-neonatal-alloimmune-thrombocytopenia
#3
Caroline Madsen, Kira Philipsen Prahm, Cecilia Nilsson, Lars Henning Pedersen, Morten Hanefeld Dziegiel, Morten Hedegaard
Foetal and neonatal alloimmune thrombocytopenia (FNAIT) can cause cerebral haemorrhage in newborns. FNAIT occurs in women, who do not have the thrombocyte type human platelet antigen (HPA)-1a and are carrying an HPA-1a positive foetus. Maternal antibodies can cause thrombocytopenia in the foetus or newborn. Antenatal screening for FNAIT can easily be integrated in the already existing national screening programme for rhesus immunisation. Prophylactic treatment with immunoglobulines for pregnancies at risk can prevent neonatal complications...
April 23, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29702988/enteritis-as-initial-manifestation-of-systemic-lupus-erythematosus-in-early-pregnancy-a-case-report
#4
Anna Maria Bellou, Dominik Bös, Guido Kukuk, Ulrich Gembruch, Waltraut Maria Merz
RATIONAL: Lupus enteritis is a rare, severe complication of systemic lupus erythematosus (SLE). We report of a patient who presented with enteritis as manifestation of new-onset SLE during the first trimester of pregnancy. PATIENTS CONCERNS: The 23-year nulliparous patient was admitted to a district hospital with abdominal pain, nausea, vomiting and bloody diarrhea at a gestational age (GA) of 10 weeks. Her symptoms improved with symptomatic treatment and she was discharged a few days later...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29697666/-the-clinical-and-anatomical-aspects-of-preeclampsia-current-features-of-its-course
#5
L M Mikhaleva, N A Gracheva, A E Biryukov
Preeclampsia is the most menacing complication of pregnancy and childbirth worldwide and remains one of the leading causes of maternal and perinatal morbidity and mortality. It is characterized by a complex etiopathogenesis with specific clinical and laboratory changes (hypertension, proteinuria and edema), as well as by the morphological pattern of target organ damage and uteroplacental blood vascular lesions. However, the triad of clinical signs of preeclampsia is not encountered in all cases now. OBJECTIVE: to study the clinical and anatomical aspects of preeclampsia at the present stage...
2018: Arkhiv Patologii
https://www.readbyqxmd.com/read/29674195/thrombotic-microangiopathies-of-pregnancy-differential-diagnosis
#6
REVIEW
M Gupta, B B Feinberg, R M Burwick
Thrombotic microangiopathy (TMA) disorders are characterized by microangiopathic hemolytic anemia, thrombocytopenia and end-organ injury. In pregnancy and postpartum, TMA is most commonly encountered with HELLP (hemolysis, elevated liver enzymes, low platelet count syndrome) or preeclampsia with severe features, but rarely TMA is due to thrombotic thrombocytopenic purpura (TTP) or atypical hemolytic uremic syndrome (aHUS). Due to overlapping clinical and laboratory features, TTP and aHUS are often mistaken for preeclampsia or HELLP...
February 16, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29669399/the-impact-of-systemic-lupus-erythematosus-on-the-clinical-phenotype-of-antiphospholipid-antibody-positive-patients-results-from-antiphospholipid-syndrome-alliance-for-clinical-trials-and-international-networking-aps-action-clinical-database-and-repository
#7
Ozan Unlu, Doruk Erkan, Medha Barbhaiya, Danieli Andrade, Iana Nascimento, Renata Rosa, Alessandra Banzato, Vittorio Pengo, Amaia Ugarte, Maria Gerosa, Lanlan Ji, Maria Efthymiou, D Ware Branch, Guilherme Raires de Jesus, Angela Tincani, H Michael Belmont, Paul R Fortin, Michelle Petri, Esther Rodriguez, Guillermo J Pons-Estel, Jason S Knight, Tatsuya Atsumi, Rohan Willis, Stephane Zuily, Maria G Tektonidou
OBJECTIVE: Although systemic lupus erythematosus (SLE) is the most common autoimmune disease associated with antiphospholipid antibodies (aPL), limited data exist on the impact of SLE on the clinical phenotype of aPL-positive patients. The primary objective was to compare the clinical, laboratory, and treatment characteristics of aPL-positive patients with or without SLE. METHODS: A secure web-based data capture system stores patient demographics, and aPL-related clinical and laboratory characteristics...
April 18, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29669341/management-and-neonatal-outcomes-of-pregnancies-with-fetal-neonatal-alloimmune-thrombocytopenia-a-single-center-retrospective-cohort-study
#8
Stefania Ronzoni, Johannes Keunen, Prakeshkumar S Shah, Edmond N Kelly, Rory Windrim, P Gareth Seaward, Greg Ryan
BACKGROUND: There is no consensus regarding the optimal antenatal treatment of fetal/neonatal alloimmune thrombocytopenia (F/NAIT). We aimed to review the fetal blood sampling (FBS)-related risk, fetal response to maternal intravenous immunoglobulin (IVIG), and cesarean section (CS) rate in pregnancies with a history of F/NAIT. METHODS: Maternal demographics, alloantibodies, pregnancy management, fetal and neonatal outcomes, and index case characteristics were collected...
April 18, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29665758/the-efficacy-of-adjunct-tacrolimus-treatment-in-pregnancy-outcomes-in-patients-with-systemic-lupus-erythematosus
#9
K Ichinose, S Sato, Y Kitajima, Y Horai, K Fujikawa, M Umeda, S Fukui, A Nishino, T Koga, S Y Kawashiri, N Iwamoto, M Tamai, H Nakamura, T Origuchi, I Yasuhi, H Masuzaki, A Kawakami
Systemic lupus erythematosus (SLE) involves multiple organ systems and primarily affects women during their reproductive years. Pregnancy in a woman with SLE may lead to higher rates of disease flares. Little is known regarding which medications are safe to maintain remission and/or treat flares throughout such pregnancies. Here we retrospectively analyzed the efficacy of tacrolimus (TAC) in the pregnancy outcomes of SLE patients. We studied the 54 deliveries of 40 SLE patients over an eight-year period from 2008 to 2016...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29662916/intracranial-hemorrhage-and-autoimmune-thrombocytopenia-in-a-neonate-a-rare-unpredictable-event
#10
Andrea Becocci, Cristina Felice-Civitillo, Méryle Laurent, Françoise Boehlen, Roberta De Luca, Joel Fluss
Neonatal thrombocytopenia is a rare complication of maternal autoimmune thrombocytopenia, and no maternal predictors of its gravity and potential complications have been identified. Neonatal cerebral hemorrhage, a feared event in the setting of autoimmune thrombocytopenia, is fortunately uncommon, but it can occur in utero or in the perinatal period, with potentially serious consequences. The authors report the case of a boy born to a mother affected by autoimmune thrombocytopenia, who presented with severe thrombocytopenia at birth and developed intracranial hemorrhage despite mild maternal thrombocytopenia at delivery and a prompt preventive treatment of the newborn...
2018: Child Neurology Open
https://www.readbyqxmd.com/read/29621007/disseminated-intravascular-coagulation-is-it-fact-or-fancy
#11
Jae C Chang
: 'Disseminated intravascular coagulation (DIC)' occurs commonly in critical illnesses such as sepsis, trauma, cancer, and complications of surgery and pregnancy. Mortality is very high. The pathogenesis has been ascribed to tissue factor-initiated coagulation disorder, resulting in disseminated microblood clots that are made of platelets, plasma factors, fibrins, and blood cells. True DIC depletes coagulation factors and consumes platelets, and activates fibrinolysis. 'DIC' is assumed to orchestrate thrombocytopenia, microangiopathic hemolytic anemia and hypoxic multiorgan dysfunction syndrome, and causes hemorrhagic disorder due to depleted coagulation factors...
April 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29620680/triptorelin-for-fertility-preservation-in-adolescents-treated-with-chemotherapy-for-cancer
#12
Mariaclaudia Meli, Manuela Caruso-Nicoletti, Milena La Spina, Luca Lo Nigro, Piera Samperi, Salvatore D'Amico, Francesco Bellia, Vito Miraglia, Maria Licciardello, Emanuela Cannata, Silvia Marino, Carla Cimino, Federica Puglisi, Laura Lo Valvo, Agnese Pezzulla, Giovanna Russo, Andrea Di Cataldo
BACKGROUND: Triptorelin, a gonadotropin releasing hormone analogue, can be administered to postpubertal female individuals with cancer who receive chemotherapy to obtain menstrual suppression and decrease the risk of hemorrhage caused by thrombocytopenia. Our goal was to assess whether triptorelin also has a protective role against the gonadotoxicity of chemotherapy. PATIENTS AND METHODS: This retrospective observational study includes all postmenarchal female patients who presented to our Unit from 2000 to 2015 and received chemotherapy for cancer...
April 3, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29610181/neonatal-alloimmune-thrombocytopenia-with-amegakaryocytosis-b-lymphopenia-and-villitis
#13
Arthur Dony, Annie Buenerd, Corinne Pondarre
Neonatal alloimmune thrombocytopenia (NAIT) is a common but significant challenge for neonatologists and a potentially devastating disease that may lead to intracranial bleeding. The underlying mechanism of thrombocytopenia is expected to be mediated by accelerated clearance of antibody-opsonized fetal platelets. We report severe recurrent NAIT related to human platelet antigen (HPA)-15 systems in 2 consecutive siblings. The first child presented with intracranial hemorrhage at birth and subsequently died. The diagnosis of NAIT, although initially suspected, was ruled out after negative investigation of only HPA-1, HPA-3, and HPA-5 systems...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29606012/adverse-outcomes-in-obstetric-atypical-haemolytic-uraemic-syndrome-a-case-series-analysis
#14
Natalia L Kozlovskaya, Yulia V Korotchaeva, Larisa A Bobrova
OBJECTIVE: The aim of this case series is to raise awareness of obstetric-related atypical haemolytic uraemic syndrome (aHUS) amongst obstetricians and gynaecologists. STUDY DESIGN: Data from 20 consecutive patients, aged 19-38, with obstetric-aHUS manifestation during or immediately after pregnancy are reported. Patients were diagnosed and treatment was initiated between 2012 and 2016. RESULTS: Presentation of aHUS was mainly preceded by preeclampsia and/or haemolysis, elevated liver enzymes and low platelet count syndrome, other obstetric complications, or by diarrhoea...
April 1, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29582550/consensus-opinion-on-diagnosis-and-management-of-thrombotic-microangiopathy-in-australia-and-new-zealand
#15
REVIEW
Lucy C Fox, Solomon J Cohney, Joshua Y Kausman, Jake Shortt, Peter D Hughes, Erica M Wood, Nicole M Isbel, Theo de Malmanche, Anne Durkan, Pravin Hissaria, Piers Blombery, Thomas D Barbour
Thrombotic microangiopathy (TMA) arises in a variety of clinical circumstances with the potential to cause significant dysfunction of the kidneys, brain, gastrointestinal tract and heart. TMA should be considered in all patients with thrombocytopenia and anaemia, with an immediate request to the haematology laboratory to look for red cell fragments on a blood film. Whilst TMA of any aetiology generally demands prompt treatment, this is especially so in thrombotic thrombocytopenic purpura (TTP) and atypical haemolytic uraemic syndrome (aHUS), where organ failure may be precipitous, irreversible and fatal...
March 27, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29571592/risk-of-maternal-mortality-in-women-with-severe-anaemia-during-pregnancy-and-post-partum-a-multilevel-analysis
#16
Jahnavi Daru, Javier Zamora, Borja M Fernández-Félix, Joshua Vogel, Olufemi T Oladapo, Naho Morisaki, Özge Tunçalp, Maria Regina Torloni, Suneeta Mittal, Kapila Jayaratne, Pisake Lumbiganon, Ganchimeg Togoobaatar, Shakila Thangaratinam, Khalid S Khan
BACKGROUND: Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. METHODS: We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia...
May 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29546926/-perinatal-dengue-a-case-report
#17
Ramiro Manzano Núñez, James Alejandro Zapata, Herney A García-Perdomo, Diego A Gomez, Mónica A Solís Velasco
INTRODUCTION: Few reports are available about perinatal dengue, with controversial results in regards the risk of perinatal outcome. OBJECTIVE: To report a case of perinatal dengue as a differential diagno sis with neonatal sepsis, which must be considered in endemic areas. CLINICAL CASE: Male newborn of a 23 year-old female, who presented a Non-Structural Protein 1 (NS1) antigen positive to dengue at 36 weeks of gestation and negative anti-dengue antibodies...
December 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29523280/can-thrombophilia-worsen-maternal-and-perinatal-outcomes-in-cases-of-severe-preeclampsia
#18
Fernanda Spadotto Baptista, Maria Rita de Figueiredo Lemos Bortolotto, Fabiola Roberta Marim Bianchini, Vera Lucia Jornada Krebs, Marcelo Zugaib, Rossana Pulcinelli Vieira Francisco
OBJECTIVE: To evaluate whether thrombophilia worsens maternal and foetal outcomes among patients with severe preeclampsia (PE). METHOD: From October 2009 to October 2014, an observational retrospective cohort study was performed on pregnant women with severe PE diagnosed before 34 weeks of gestation and their newborns hospitalized at the Clinics Hospital, FMUSP. Patients who had no heart disease, nephropathies, pre-gestational diabetes, gestational trophoblastic disease, foetal malformation, or twin pregnancy and who underwent thrombophilia screening during the postnatal period were included...
January 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29518067/update-noncongenital-zika-virus-disease-cases-50-u-s-states-and-the-district-of-columbia-2016
#19
Victoria Hall, William L Walker, Nicole P Lindsey, Jennifer A Lehman, Jonathan Kolsin, Kimberly Landry, Ingrid B Rabe, Susan L Hills, Marc Fischer, J Erin Staples, Carolyn V Gould, Stacey W Martin
Zika virus is a flavivirus primarily transmitted to humans by Aedes aegypti mosquitoes (1). Zika virus infections also have been documented through intrauterine transmission resulting in congenital infection; intrapartum transmission from a viremic mother to her newborn; sexual transmission; blood transfusion; and laboratory exposure (1-3). Most Zika virus infections are asymptomatic or result in mild clinical illness, characterized by acute onset of fever, maculopapular rash, arthralgia, or nonpurulent conjunctivitis; Guillain-Barré syndrome, meningoencephalitis, and severe thrombocytopenia rarely have been associated with Zika virus infection (1)...
March 9, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29470181/prevention-and-management-of-thromboembolism-in-pregnancy-when-heparins-are-not-an-option
#20
Andra H James
Heparins, unfractionated heparin, and low molecular weight heparin, are the preferred anticoagulants in pregnancy. There are circumstances, however, in which an alternative to heparin should be considered. These circumstances include, the presence of heparin resistance, a heparin allergy manifesting as heparin-induced skin reactions or heparin-induced thrombocytopenia, and the presence of a mechanical heart valve. From time to time, the obstetrician is called on to make recommendations about anticoagulants in pregnancy, including in circumstances in which an alternative to heparin has been suggested or is necessary...
June 2018: Clinical Obstetrics and Gynecology
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