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fetal pain

Ayaka Kawabe, Liangcheng Wang, Atsuko Kikugawa, Yuko Shibata, Kenichi Kuromaki, Akiyoshi Takagi
OBJECTIVE: Uterine rupture is a rare but serious obstetric complication. However, prediction and diagnosis at an early stage remain difficult. Herein, we report a case of primary uterine rupture found earlier by a specific symptom. CASE REPORT: A 29-year-old patient was scheduled to undergo a cesarean section (CS) due to placenta previa. However, at Week 35, she began experiencing abdominal pain and uterine contractions. Subsequently, she began experiencing severe pain, which was enhanced by fetal movements...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
John J Mccarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid dependent pregnant women delivering babies at risk for neonatal abstinence syndrome (NAS) prompted a General Accountability Office (GAO) report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are three general sources of dependence: untreated opioid use disorder (OUD), pain management, and medication assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
Khaled A Shibany, Sabine Tötemeyer, Stefanie L Pratt, Stuart W Paine
Despite reports of the successful isolation of primary equine hepatocytes, there are no published data regarding the successful cryopreservation of these isolated cells. In this study, a detailed description of the procedures for isolation, cryopreservation, and recovery of equine hepatocytes are presented. Furthermore, the intrinsic clearance (Clint) and production of metabolites for three drugs were compared between freshly isolated and recovered cryopreserved hepatocytes. Primary equine hepatocytes were isolated using a two-step collagenase perfusion method, with an average cell yield of 2...
October 2016: Pharmacology Research & Perspectives
McI Lier, R F Malik, Jhtm van Waesberghe, J W Maas, D A van Rumpt-van de Geest, S F Coppus, J P Berger, B B van Rijn, P F Janssen, M A de Boer, Jip de Vries, F W Jansen, I A Brosens, C B Lambalk, V Mijatovic
OBJECTIVE: To report pregnancy outcomes of SHiP (spontaneous haemoperitoneum in pregnancy) and the association with endometriosis. DESIGN: Retrospective case note review. SETTING: Dutch referral hospitals for endometriosis. SAMPLE: Eleven women presenting with 15 events of SHiP. METHODS: In collaboration with the Dutch Working Group on Endometriosis, unpublished cases of SHiP that occurred in the Netherlands between 2010 and 2015 were retrieved...
October 5, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Meeta Pathak, O K Olstad, Liv Drolsum, Morten C Moe, Natalia Smorodinova, Sarka Kalasova, Katerina Jirsova, Bjørn Nicolaissen, Agate Noer
Patients with limbal stem cell deficiency (LSCD) often experience pain and photophobia due to recurrent epithelial defects and chronic inflammation of the cornea. Successfully restoring a healthy corneal surface in these patients by transplantation of ex vivo expanded human limbal epithelial cells (LECs) may alleviate these symptoms and significantly improve their quality of life. The clinical outcome of transplantation is known to be influenced by the quality of transplanted cells. Presently, several different protocols for cultivation and transplantation of LECs are in use...
October 1, 2016: Experimental Eye Research
Qingmei Nie, Baohua Su, Jianping Wei
Epilepsy is one of the few neurologic disorders that requires a constant treatment during pregnancy. Epilepsy affects 0.3-0.8% of pregnant women. Prescription of antiepileptic drugs (AEDs) to pregnant women with epilepsy requires monitoring and maintaining a balance between limiting seizures and decreasing fetal exposure to the potential teratogenic effects. AEDs are also commonly used for psychiatric disorders, pain disorders, and migraines. The types of malformations that can result in fetuses exposed to AEDs include minor anomalies, major congenital malformations, intrauterine growth retardation, cognitive dysfunction, low IQ, microcephaly, and infant mortality...
October 2016: Experimental and Therapeutic Medicine
Zahra Dehbashi, Mahmood Moosazadeh, Mahdi Afshari
BACKGROUND: Each year, more than forty million abortions are occurred whole of the world. Misoprostol is a prostaglandin analogue with a strong uterotonic effect. The present study aimed to compare the efficacy of Misoprostol in first trimester abortion through two sublingual and vaginal routes of administration. METHODS: This randomized clinical trial was conducted on 52 consecutive women in first trimester candidate for pregnancy termination because of fetal IUFD or missed abortion in sonography reports...
July 24, 2016: Materia Socio-medica
Fen Wang, Yun-Xia Cao, Shan-Gao Ke, Tao-Hua Zhu, Miao Zhang
OBJECTIVE: To determine whether combined spinal-epidural analgesia (CSEA) during labor increases the frequency of emergency cesarean delivery among Chinese nulliparous women. METHODS: In a retrospective study, the medical records of nulliparous women with a singleton fetus in cephalic presentation who delivered at term at Tongling Maternity Hospital, China, between January 2012 and December 2014 were reviewed. Information about CSEA, mode of delivery, labor duration, oxytocin augmentation, and neonatal outcome was obtained...
August 24, 2016: International Journal of Gynaecology and Obstetrics
Yi Young Kim, Ivan Roubal, Youn Soo Lee, Jin Seok Kim, Michael Hoang, Nathan Mathiyakom, Yong Kim
Adverse effect of alcohol on neural function has been well documented. Especially, the teratogenic effect of alcohol on neurodevelopment during embryogenesis has been demonstrated in various models, which could be a pathologic basis for fetal alcohol spectrum disorders (FASDs). While the developmental defects from alcohol abuse during gestation have been described, the specific mechanisms by which alcohol mediates these injuries have yet to be determined. Recent studies have shown that alcohol has significant effect on molecular and cellular regulatory mechanisms in embryonic stem cell (ESC) differentiation including genes involved in neural development...
2016: PloS One
Deanna Gigliotti, Jeff R S Leiter, Peter B MacDonald, Jason Peeler, Judy E Anderson
BACKGROUND: Rotator-cuff injury (RCI) is common and painful; even after surgery, joint stability and function may not recover. Relative contributions to atrophy from disuse, fibrosis, denervation, and satellite-cell responsiveness to activating stimuli are not known. METHODS AND FINDINGS: Potential contributions of denervation and disrupted satellite cell responses to growth signals were examined in supraspinatus (SS) and control (ipsilateral deltoid) muscles biopsied from participants with RCI (N = 27)...
2016: PloS One
Shruti Agrawal, Nandita Maitra
BACKGROUND: This study was conducted to evaluate how the preeclampsia integrated estimate of risk (fullPIERS) model performs in the prediction of adverse maternal outcomes when the predictor variables are all obtained within 24-h of admission for preeclampsia. METHODS: A prospective cohort study on 323 women who fulfilled definite inclusion and exclusion criteria was conducted. Subjects were monitored for clinical symptoms of preeclampsia, biochemical parameters, and adverse maternal and neonatal outcomes...
October 2016: Journal of Obstetrics and Gynaecology of India
Hock Chin Chong, Feng Yih Chai, Dhayal Balakrishnan, Siti Mohd Desa Asilah, Irene Nur Ibrahim Adila, Khuzaimah Zahid Syibrah
Subhepatically located caecum and appendix is a very rare entity. It occurs due to the anomaly in fetal gut rotation that results in an incomplete rotation and fixation of the intestine. Appendicitis, which is a common surgical emergency, in combination with the abnormal subhepatic location, presents a great challenge in its diagnosis and management. Here, we describe a 42-year-old male with chronic dyspepsia who presented with sepsis and severe pain at his right hypochondriac and epigastric region. The final diagnosis was acute appendicitis of the subhepatic appendix...
2016: Case Reports in Surgery
Ida Dzifa Dey, Jerry Coleman, Harriet Kwarko, Michael Mate-Kole
OBJECTIVE: To study maternal and fetal outcomes in Ghanaian women with systemic lupus erythematosus (SLE). METHODS: Retrospective study of pregnancies in women with SLE in a single centre in Ghana. RESULTS: The mean age was 30.1 years and all were nulliparous. Two out of the seven pregnancies were in disease remission at the time of booking. Nephritis without renal impairment was present in 7 pregnancies (6 women). One woman developed intrapartum eclampsia...
June 2016: Ghana Medical Journal
Yayoi Ohashi, Leyla Baghirzada, Hiroyuki Sumikura, Mrinalini Balki
Japan has seen significant developments in obstetric anesthesia in recent years, including the establishment of the Japanese Society of Obstetric Anesthesia and Perinatology. However, labor pain, which is one of the most important issues in obstetric practice, is still not treated aggressively. The rate of epidural administration for labor analgesia is very low in Japan as compared to other developed countries. Remifentanil has been used for labor analgesia, as part of general anesthesia for cesarean delivery, as well as for various fetal procedures around the world...
September 12, 2016: Journal of Anesthesia
Jacob Mørup Schlütter, Gry Johansen, Rikke Bek Helmig, Olav Bjørn Petersen
We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the first case labor was induced at 37 + 4 weeks of gestation. However, due to sudden fetal distress and maternal abdominal pain, an emergency Caesarean section was performed during labor, and 3 liters of intra-peritoneal blood were encountered upon laparotomy, secondary to a ruptured uterine artery aneurysm...
September 13, 2016: Gynecologic and Obstetric Investigation
Lori M Gawron, Katie Watson
OBJECTIVES: We explored whether the decision-making process of women aborting a pregnancy for a fetal indication fit common medical ethical frameworks. STUDY DESIGN: We applied 3 ethical frameworks (principlism, care ethics, and narrative ethics) in a secondary analysis of 30 qualitative interviews from women choosing 2nd trimester abortion for fetal indications. RESULTS: All thirty women offered reasoning consistent with one or more ethical frameworks...
September 6, 2016: Contraception
Richelle Vlenterie, Mollie E Wood, Ragnhild Eek Brandlistuen, Nel Roeleveld, Marleen M H J van Gelder, Hedvig Nordeng
BACKGROUND: Previous studies showed that children exposed to paracetamol during fetal life might have an increased risk of neurodevelopmental problems. Since paracetamol is one of the most commonly used medications during pregnancy, even small increases in the risk of neurodevelopmental problems may have considerable implications for public health. METHODS: Using data from the Norwegian Mother and Child Cohort Study, we applied propensity score (PS) matching to examine associations between prenatal paracetamol exposure and neurodevelopmental problems among children at 18 months of age...
August 31, 2016: International Journal of Epidemiology
Deborah Constant, Jane Harries, Thokozile Malaba, Landon Myer, Malika Patel, Gregory Petro, Daniel Grossman
OBJECTIVE: To document clinical outcomes and women's experiences following the introduction of mifepristone into South African public sector second-trimester medical abortion services, and compare with historic cohorts receiving misoprostol-only. METHODS: Repeated cross-sectional observational studies documented service delivery and experiences of women undergoing second-trimester medical abortion in public sector hospitals in the Western Cape, South Africa. Women recruited to the study in 2008 (n = 84) and 2010 (n = 58) received misoprostol only...
2016: PloS One
Yukiko Chinen, Tadatsugu Kinjo, Hayase Nitta, Yui Kinjo, Hitoshi Masamoto, Yoichi Aoki
It was demonstrated that second- and third-trimester therapeutic termination of pregnancy (TOP) is feasible in cases with placenta previa. We report a 34-year-old woman with complex fetal malformations associated with placenta previa. An ultrasound examination at 21 weeks of gestation revealed fetal growth restriction (FGR) and complex fetal malformations associated with a placenta previa. After extensive information, the parents opted for careful observation. Thereafter, FGR gradually progressed and we observed arrest of end-diastolic velocity of the umbilical artery...
2016: Case Reports in Obstetrics and Gynecology
Xiuhua Dong, Jiakai Lu, Weiping Cheng, Chengbin Wang
Aortic dissection is a rare but devastating disease during pregnancy, usually presenting with sharp pains on the chest or back. We report a pregnant woman suffering from chronic Stanford type A aortic dissection presented with atypical symptoms without pain in the third trimester with markedly dilated aortic root and congestive heart failure, who received concomitant cesarean delivery and aortic repair with good maternal and fetal outcomes. Multidisciplinary approach and tight hemodynamic control are very important...
September 2016: Journal of Clinical Anesthesia
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