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thrombocytopenia in pregnancy

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https://www.readbyqxmd.com/read/28101432/atypical-hemolytic-uremic-syndrome-in-first-trimester-pregnancy-successfully-treated-with-eculizumab
#1
Gabriela Andries, Michael Karass, Srikanth Yandrapalli, Katherine Linder, Delong Liu, John Nelson, Rahul Pawar, Savneek Chugh
BACKGROUND: Atypical hemolytic uremic syndrome is a rare disorder which is known to cause acute thrombotic microangiopathy during pregnancy with poor maternal and fetal outcomes. Atypical hemolytic uremic syndrome is caused mostly by dysregulation of alternative complement pathway secondary to genetic mutations. Most of the cases reported have been in the post-partum period. We report a rare case of a patient who presents with thrombotic microangiopathy in the first trimester of her eleventh pregnancy and was successfully treated with eculizumab...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28097780/a-man-made-disease-fetal-neonatal-alloimmune-thrombocytopenia-due-to-incompatibility-between-oocyte-donor-and-gestational-mother
#2
Assaf Arie Barg, Aviya Dvir Ifrah, Tzipi Strauss, Michal J Simchen, Raoul Orvieto, Nurit Rosenberg, Gili Kenet
The incompatibility causing fetal and neonatal alloimmune thrombocytopenia (FNAIT) results from a fetus inheriting a paternal human platelet antigen (HPA), which is different from the maternal HPA. We present a unique case of FNAIT in a pregnancy involving an oocyte recipient mother with Turner syndrome. This is the first report of FNAIT in which the suggested mechanism involves antibodies produced by a gestational mother against the incompatible HPA of the oocyte donor.
January 18, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28065221/meta-analysis-of-aspirin-heparin-therapy-for-un-explained-recurrent-miscarriage
#3
Tong Ling, Wei Xian-Jiang
Objective This study was designed to evaluate the efficacy and safety of aspirin-heparin treatment for un-explained recurrent spontaneous abortion (URSA). Methods Literatures reporting the studies on the aspirin-heparin treatment of un-explained recurrent miscarriage with randomized controlled trials (RCTs) were collected from the major publication databases. The live birth rate was used as primary indicator, preterm delivery, preeclampsia, intrauterine growth restriction, and adverse reactions (thrombocytopenia ) were used as the secondary indicators...
November 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28013100/the-impact-of-highly-active-antiretroviral-therapy-on-obstetric-conditions-a-review
#4
REVIEW
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28009646/lupus-anticoagulant-hypoprothrombinemia-syndrome-a-rare-cause-of-intracranial-bleeding
#5
Sreejesh Sreedharanunni, Jasmina Ahluwalia, Narender Kumar, Sunil K Bose, Rishi Dhawan, Pankaj Malhotra
We report a 14-year-old girl who presented with subdural hematoma and a deranged coagulation profile suggestive of an inhibitor. Investigations revealed prothrombin deficiency along with positivity for antiphospholipid antibodies, which improved with steroid therapy. Bleeding diathesis in children and adolescents commonly results from thrombocytopenia, platelet function disorders, or coagulation factor deficiency; whereas bleeding because of coagulation factor inhibitors are extremely rare in this age group...
December 22, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/27998318/management-of-severe-dengue-hemorrhagic-fever-and-bleeding-complications-in-a-primigravida%C3%A2-patient-a-case-report
#6
Hori Hariyanto, Corry Quando Yahya, Primartanto Wibowo, Oloan E Tampubolon
BACKGROUND: The incidence of dengue hemorrhagic fever is increasing among the adult population living in endemic areas. The disease carries a 0.73% fatality rate for the general population, but what happens when the disease strikes a special subpopulation group, the obstetrics? Perhaps the important question specific to this special subpopulation revolves around the right time and mode of delivery under severe coagulopathy and plasma leakage in conditions of imminent delivery. CASE PRESENTATION: A 24-year-old primigravid Sundanese woman presented to our intensive care unit due to acute pulmonary edema secondary to massive plasma leakage caused by severe dengue...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27995667/liver-dysfunction-in-women-with-pregnancy-induced-antithrombin-deficiency
#7
Mamoru Morikawa, Kosuke Kawabata, Emi Kato-Hirayama, Yasunari Oda, Hiroto Ueda, Soromon Kataoka, Takashi Yamada, Kazuhiko Okuyama, Kazuo Sengoku, Hisanori Minakami
AIM: The aim of this study was to determine whether women with pregnancy-induced antithrombin deficiency (PIATD) had higher risk of liver dysfunction in the absence of thrombocytopenia. METHODS: We carried out a retrospective observational study at five centers in all 129 women with incidentally found PIATD among 5249 maternities and 129 control women without PIATD matched for number of fetuses and gestational week at delivery. PIATD was diagnosed in women with antenatal antithrombin (AT) activities of ≤75% followed by a further decrease to ≤65% peripartum...
December 19, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27976561/congenital-malaria-importance-of-diagnosis-and-treatment-in-pregnancy
#8
Selvi Gülaşı, Nureddin Özdener
Congenital malaria, in which infants are directly infected with malaria parasites from their mother prior to or during birth, is a potentially life-threatening condition that occurs at relatively low rates in malaria endemic regions. We report an unusual case of a 23-day-old girl with neonatal Plasmodium vivax malaria, suspected primarily on the basis of positive maternal history that her mother had malaria during her pregnancy and was cured with chloroquine therapy. Infant presented with fever, thrombocytopenia and a significant parasitemia...
2016: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/27969556/severe-staphylococcus-aureus-endocarditis-presenting-as-peripartum-thrombotic-thrombocytopenic-purpura
#9
Kieran L Quinn, Mark Osmond, Mitesh Badiwala, Mathew Sermer, Stephen E Lapinsky
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a life-threatening illness that occurs in both pregnant and non-pregnant women. Several other conditions can mimic the disease, which makes the diagnosis challenging. CASE: We describe a case of severe Staphylococcus aureus endocarditis that initially presented as peripartum TTP in a 39-year-old woman at 29+6 weeks' gestation. We give an overview of the diagnostic considerations and management of thrombocytopenia in pregnancy and review the literature related to TTP and peripartum infective endocarditis...
November 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27958258/case-of-twin-pregnancy-complicated-by-idiopathic-thrombocytopenic-purpura-treated-with-intravenous-immunoglobulin-review-of-the-literature
#10
W X Zhao, X F Yang, J H Lin
Idiopathic thrombocytopenic purpura (ITP) is an acquired thrombocytopenia without other clear cause of thrombocytopenia. It is not common in a singleton pregnancy and less common in twin pregnancy. We report a 33-year-old ITP pluripara whose first pregnancy was uneventful. She carried twin pregnancy, complicated by recurrent very low platelets, and gave birth to preterm twins. This patient received multiple courses of intravenous immunoglobulin (IVIG) and showed a significant platelet count improvement with IVIG therapy...
January 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/27939492/prevalence-of-pregnancy-hypertensive-disorders-in-mongolia
#11
Nathalie E Marchand, Ganmaa Davaasambuu, Thomas F McElrath, Enkhmaa Davaasambuu, Tsedmaa Baatar, Rebecca Troisi
OBJECTIVE: To estimate the prevalence of preeclampsia in a contemporary population of Mongolian women living in urban and rural areas. We determined the sensitivity and specificity of diagnosis based on established diagnostic criteria and assessed whether local diagnostic criteria were similar to those used in the US. STUDY DESIGN: Cross-sectional study of urban and nomadic pregnant women recruited in Ulaanbaatar (n=136) and rural provinces (n=85). MAIN OUTCOME MEASURES: Preeclampsia defined as hypertension new to pregnancy after 20weeks and proteinuria (or protein creatinine ratio ⩾0...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27920020/repeated-failed-non-invasive-prenatal-testing-in-a-woman-with-immune-thrombocytopenia-and-antiphospholipid-syndrome-lessons-learnt
#12
C Y Y Hui, W C Tan, E L Tan, L K Tan
We present a case of a 37-year-old Chinese woman (gravida 4 para 0) with a history of immune thrombocytopenia and type IIb antiphospholipid syndrome. She was started on 100 mg of aspirin, 20 mg of prednisolone and 20 mg of subcutaneous low-molecular-weight heparin daily for her fourth pregnancy. She opted for non-invasive prenatal testing for aneuploidy screening but had failed results three times consecutively from insufficient fetal cfDNA initially or high variance in cfDNA counts on redraws. She declined invasive karyotyping...
December 5, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27913749/belimumab-in-primary-antiphospholipid-syndrome
#13
A Yazici, B Yazirli, D Erkan
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by thrombosis and/or pregnancy morbidity with persistently positive antiphospholipid antibodies (aPL). Patients with aPL may also experience thrombocytopenia, cardiac valve disease, nephropathy, skin ulcer, or cognitive dysfunction, which are collectively known as non-criteria manifestations of APS. A description is provided of two primary APS patients who received belimumab (10 mg/kg) for an aPL-related manifestation.
December 2, 2016: Lupus
https://www.readbyqxmd.com/read/27908907/importance-of-diagnostic-work-up-of-guillain-barr%C3%A3-syndrome-in-pregnancy
#14
Elza Pollak-Christian, Kyong-Soon Lee
We report a full-term neonate presenting with symptomatic congenital cytomegalovirus (CMV) infection with hepatosplenomegaly, 'blueberry muffin' rash, intracranial calcifications, thrombocytopenia and respiratory distress. Maternal history was relevant for Guillain-Barré syndrome (GBS) during the first trimester of pregnancy. CMV infection is an important cause of GBS; thus, women presenting GBS during pregnancy should be screened for CMV infection. If positive, they may benefit from specialised monitoring and treatment in the antenatal period, which may decrease the risk of major neurodevelopmental sequelae of congenital CMV in the neonate...
December 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27882754/-fetal-alloimmune-thrombocytopenia-in-pregnant-woman-with-anti-hpa-1a-antibodies
#15
K Sobíšková, J Matěcha
OBJECT: Description of the pregnancy in patient with anti-HPA-1a antibodies. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital. CASE REPORT: Report of cases of neonatal alloimune thrombocytopenia in a patient with proven anti-HPA 1a antibodies. The immunization developed during the first pregnancy, accompanied with fetal thrombocytopenia which recurred in every subsequent pregnancy with greater severity...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27882749/-severe-immune-thrombocytopenia-diagnosed-in-pregnancy
#16
K Bláhová
OBJECTIVE: The aim of this article is present a patient with severe immune thrombocytopenia in pregnancy. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, University Hospital Olomouc, Faculty of Medicine, Palacký Univerzity Olomouc. CASE REPORT: Presents a patient with immune thrombocytopenia diagnosed in pregnancy. Severe thrombocytopenia was diagnosed incidentally. CONCLUSION: Severe immune thrombocytopenia is rare and substantial complication in pregnancy...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27871460/placental-histological-lesions-in-fetal-and-neonatal-alloimmune-thrombocytopenia-a-retrospective-cohort-study-of-21-cases
#17
Estelle Dubruc, Frédérique Lebreton, Catherine Giannoli, Muriel Rabilloud, Cyril Huissoud, Mojgan Devouassoux-Shisheboran, Fabienne Allias
BACKGROUND: Alloimmunization against human platelet antigens (HPAs) can occur prenatally and induce fetal/neonatal alloimmune thrombocytopenia (FNAIT). The aim of this study was to identify placental histological features associated with platelet alloimmunization and their clinical significance. METHODS: This study examined 21 placentas from FNAIT-affected pregnancies and 42 age-matched control cases, all collected from pathology departments in the Rhône-Alpes region...
December 2016: Placenta
https://www.readbyqxmd.com/read/27868334/consensus-on-the-standardization-of-terminology-in-thrombotic-thrombocytopenic-purpura-and-related-thrombotic-microangiopathies
#18
M Scully, S Cataland, P Coppo, J de la Rubia, K D Friedman, J Kremer Hovinga, B Lämmle, M Matsumoto, K Pavenski, E Sadler, R Sarode, H Wu
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) are two important acute conditions to diagnose. Thrombotic Microangiopathy is a broad pathophysiological process that leads to microangiopathic hemolytic anemia, thrombocytopenia and involves capillary and small vessel platelet aggregates. The most common cause being disseminated intravascular coagulation (DIC), which may be differentiated by abnormal coagulation. Clinically, a number of conditions present with microangiopathic hemolytic anemia and thrombocytopenia (MAHAT), including cancer, infection, transplantation, drugs, autoimmune disease and pre-eclampsia and HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome in pregnancy...
November 21, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27852374/-clinical-features-and-adverse-pregnancy-outcomes-of-new-onset-systemic-lupus-erythematosus-during-pregnancy
#19
Z P Zhan, Y Yang, Y F Zhan, D Y Chen, L Q Liang, X Y Yang
Objective: To investigate the clinical characteristics and adverse pregnancy outcomes in pregnant women with new onset systemic lupus erythematosus (SLE) during pregnancy. Methods: The clinical data of 263 pregnancies with SLE in the First Affiliated Hospital of Zhongshan University from 2001 to 2015 were collected and analyzed retrospectively. Results: Of all the 263 pregnancies, 188 were diagnosed before pregnancy and 75 were newly diagnosed during pregnancy. Among the 75 new onset SLE, 27, 31, 14 and 3 cases were diagnosed during first trimester, second trimester, third trimester and puerperium, respectively...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27848915/heparin-monitoring-clinical-outcome-and-practical-approach
#20
Noémie Despas, Anne-Sophie Larock, Hugues Jacqmin, Jonathan Douxfils, Bernard Chatelain, Marc Chatelain, François Mullier
Traditional anticoagulant agents such as unfractionated heparin (UFH), low molecular weight heparins (LMWHs), fondaparinux, danaparoid and bivalirudine are used in the prevention and treatment of thromboembolic diseases. However, these agents have limitations: their constraining parenteral route of administration and the need for regular coagulation monitoring for HNF. The LMWHs, with their more predictable anticoagulant response, don't require a systematic monitoring. The usefulness of LMWHs monitoring in several clinical situations such as pregnancy, obesity and renal insufficiency is a matter of debate...
December 1, 2016: Annales de Biologie Clinique
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