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cardiac arrest pregnancy

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https://www.readbyqxmd.com/read/28079767/primary-gastric-choriocarcinoma-presenting-as-a-pregnancy-of-unknown-location
#1
Alyssa Larish, Amanika Kumar, Sarah Kerr, Carrie Langstraat
BACKGROUND: Pregnancy of unknown location presents a diagnostic challenge, in rare occasions leading to the diagnosis of malignancy. We describe a case of β-hCG-secreting nongestational primary gastric choriocarcinoma presenting as a pregnancy of unknown location. CASE: A 37-year-old woman, gravida 4 para 3013, presented with several days of vaginal bleeding and rising β-hCG level without ultrasound localization of pregnancy. The diagnosis of pregnancy of unknown location was made and methotrexate administered at a β-hCG level of 7,779 milli-international units/mL...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28079556/cardiac-arrest-obstetric-cpr-acls
#2
Benjamin Cobb, Steven Lipman
In contrast with other high-resource countries, maternal mortality has seen an increase in the United States. Caring for pregnant women in cardiac arrest may prove uniquely challenging given the rarity of the event coupled by the physiological changes of pregnancy. Optimization of resuscitative efforts warrants special attention as described in the 2015 American Heart Association's "Scientific Statement on Maternal Cardiac Arrest." Current recommendations address a variety of topics ranging from the basic components of chest compressions and airway management to some of the logistical complexities and operational challenges involved in maternal cardiac arrest...
January 10, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28017511/out-of-hospital-cardiac-arrest-in-pregnancy-with-good-neurological-outcome-for-mother-and-infant
#3
S Pecher, E Williams
Cardiac arrest in pregnancy is rare (about 1:30000 pregnancies) and out-of-hospital cardiac arrests are even less frequent. Resuscitation of the pregnant mother is challenging and requires attention to the altered physiology, specific pathologies and the presence and well-being of the fetus. Once circulation has been restored, the lack of high-grade evidence regarding delivery of the baby and post-resuscitation care makes decision making complex. We present a case of out-of-hospital maternal cardiac arrest with successful resuscitation and good neurological outcome for mother and infant...
November 15, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27933173/a-rare-case-of-gestational-thyrotoxicosis-as-a-cause-of-acute-myocardial-infarction
#4
Varalaxmi Bhavani Nannaka, Dmitry Lvovsky
: Angina pectoris in pregnancy is unusual and Prinzmetal's angina is much rarer. It accounts for 2% of all cases of angina. It is caused by vasospasm, but the mechanism of spasm is unknown but has been linked with hyperthyroidism in some studies. Patients with thyrotoxicosis-induced acute myocardial infarction are unusual and almost all reported cases have been associated with Graves' disease. Human chorionic gonadotropin hormone-induced hyperthyroidism occurs in about 1.4% of pregnant women, mostly when hCG levels are above 70-80 000 IU/L...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27926646/treatment-of-a-pregnant-patient-in-a-persistent-vegetative-state
#5
Matthew P Romagano, William E Scorza, Stephen E Lammers, Carole Dorr, John C Smulian
BACKGROUND: Brain injury leading to a persistent vegetative state during pregnancy involves difficult medical and ethical decisions. CASE: A 21-year-old multigravid woman entered a persistent vegetative state at 20 1/7 weeks of gestation after cardiac arrest with postanoxic brain injury from a suspected drug overdose. The clinical disciplines responsible for her case formed a collaborative care plan involving ventilator, nutrition, and medication support of the mother and regular fetal monitoring and ultrasound testing...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27913770/cor-triatriatum-a-review
#6
REVIEW
Ajay Kumar Jha, Neeti Makhija
Cor triatriatum is a rare congenital cardiac anomaly defined by an abnormal septation within the atrium (left or right) leading to inflow obstruction to the respective ventricles. It exists either in isolated classical form or may be associated with simple to complex congenital cardiac anomalies. Several anatomical variants exist even in the classical form, and therefore, it may require multimodal diagnostic modalities to characterize and differentiate for better percutaneous interventional or surgical planning...
December 2, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27835031/cardiogenic-shock-in-pregnancy-analysis-from-the-national-inpatient-sample
#7
Jennifer Banayan, Sarosh Rana, Ariel Mueller, Avery Tung, Hadi Ramadan, Zoltan Arany, Junaid Nizamuddin, Victor Novack, Barbara Scavone, Samuel M Brown, Sajid Shahul
OBJECTIVE: Cardiogenic shock (CS) may occur during pregnancy and dramatically worsen peripartum outcomes. METHODS: We analyzed the National Inpatient Sample from 2002 to 2013 to describe the incidence of, risk factors for and outcomes of CS during pregnancy. RESULTS: Of the 53,794,192 hospitalizations analyzed, 2044 were complicated by CS. The mortality rate in peripartum women with CS was 18.81% versus 0.02% without. It occurs more often during postpartum (58...
November 11, 2016: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/27816162/cardiac-arrest-and-resuscitation-unique-to-pregnancy
#8
REVIEW
Terri-Ann Bennett, Vern L Katz, Carolyn M Zelop
Maternal cardiopulmonary arrest (MCPA) is a catastrophic event that can cause significant morbidity and mortality. A prepared, multidisciplinary team is necessary to perform basic and advanced cardiac life support specific to the anatomic and physiologic changes of pregnancy. MCPA is a challenging clinical scenario for any provider. Overall, it is an infrequent occurrence that involves 2 patients. However, key clinical intervention performed concurrently can save the life of both mother and baby.
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27728485/cardiac-arrest-in-pregnancy-refractory-hypokalemia-is-it-gitelman-or-type-3-bartters-syndrome
#9
Sabarinath, Sanket Shah, Lavanya, Rama Bhat
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27644095/optimizing-survival-outcomes-for-adult-patients-with-nontraumatic-cardiac-arrest
#10
Julianna Jung
Patient survival after cardiac arrest can be improved significantly with prompt and effective resuscitative care. This systematic review analyzes the basic life support factors that improve survival outcome, including chest compression technique and rapid defibrillation of shockable rhythms. For patients who are successfully resuscitated, comprehensive postresuscitation care is essential. Targeted temperature management is recommended for all patients who remain comatose, in addition to careful monitoring of oxygenation, hemodynamics, and cardiac rhythm...
October 2016: Emergency Medicine Practice
https://www.readbyqxmd.com/read/27555967/management-of-maternal-cardiac-arrest-in-the-third-trimester-of-pregnancy-a-simulation-based-pilot-study
#11
Jacquelyn Adams, Jose R Cepeda Brito, Lauren Baker, Patrick G Hughes, M David Gothard, Michele L McCarroll, Jocelyn Davis, Angela Silber, Rami A Ahmed
Objective. To evaluate confidence, knowledge, and competence after a simulation-based curriculum on maternal cardiac arrest in an Obstetrics & Gynecologic (OBGYN) residency program. Methods. Four simulations with structured debriefing focusing on high yield causes and management of maternal cardiac arrest were executed. Pre- and post-individual knowledge tests (KT) and confidence surveys (CS) were collected along with group scores of critical performance steps evaluated by content experts for the first and final simulations...
2016: Critical Care Research and Practice
https://www.readbyqxmd.com/read/27484758/-chest-pain-at-32%C3%A2-weeks-gestation-pregnancy-related-spontaneous-coronary-artery-dissection
#12
A Schmutz, P Quaas, S Grundmann
A 32-year-old woman at 32 weeks gestation presented with cardiac arrest due to ventricular tachycardia following acute chest pain at home. After immediate defibrillation with return of spontaneous circulation (ROSC), an ST segment elevation myocardial infarction due to coronary artery dissection was confirmed. Two drug-eluting stents were implanted and she was placed on dual antiplatelet therapy (DAPT). The echocardiogram showed akinesis of the apex and anterior wall. The patients risk for stent thrombosis was considered high and therefore DAPT was continued until cesarean section at 35 weeks gestation...
September 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27386763/intensive-care-and-pregnancy-epidemiology-and-general-principles-of-management-of-obstetrics-icu-patients-during-pregnancy
#13
Laurent Zieleskiewicz, Anne Chantry, Gary Duclos, Aurelie Bourgoin, Alexandre Mignon, Catherine Deneux-Tharaux, Marc Leone
In developed countries, the rate of obstetric ICU admissions (admission during pregnancy or the postpartum period) is between 0.5 and 4 per 1000 deliveries and the overall case-fatality rate is about 2%. The most two common causes of obstetric ICU admissions concerned direct obstetric pathologies: obstetric hemorrhage and hypertensive disorders of pregnancy. This review summarized the principles of management of critically ill pregnant patient. Its imply taking care of two patients in the same time. A coordinated multidisciplinary team including intensivists, anesthesiologists, obstetricians, pediatricians and pharmacists is therefore necessary...
October 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27372376/care-of-the-critically-ill-pregnant-patient-and-perimortem-cesarean-delivery-in-the-emergency-department
#14
Megan E Healy, Dana E Kozubal, Amanda E Horn, Gary M Vilke, Theodore C Chan, Jacob W Ufberg
BACKGROUND: Maternal resuscitation in the emergency department requires planning and special consideration of the physiologic changes of pregnancy. Perimortem cesarean delivery (PMCD) is a rare but potentially life-saving procedure for both mother and fetus. Emergency physicians should be aware of the procedure's indications and steps because it needs to be performed rapidly for the best possible outcomes. OBJECTIVE: We sought to review the approach to the critically ill pregnant patient in light of new expert guidelines, including indications for PMCD and procedural techniques...
August 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27276444/peripartum-cardiomyopathy-challenges-in-diagnosis-and-management
#15
James D Fett
INTRODUCTION: Peripartum cardiomyopathy (PPCM) is one of the leading causes of maternal mortality all over the world. Fortunately, some of the most important answers to the "PPCM puzzle" are emerging: AREAS COVERED: This is an update that includes current and recent research results. These developments hold promise to importantly decrease mortality from PPCM and increase recovery rates. Expert commentary: Increasing risks for the development and severity of PPCM include a genetic predisposition and the presence of any form of hypertension in pregnancy...
September 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27216402/a-fatal-combination-of-situs-inversus-pregnancy-and-cardiac-arrest-treated-with-an-automated-external-defibrillator
#16
S Calle, M De Leeuw, N Mpotos, P Calle, B De Turck
No abstract text is available yet for this article.
May 23, 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27216401/a-fatal-combination-of-situs-inversus-pregnancy-and-cardiac-arrest-treated-with-an-automated-external-defibrillator
#17
S Calle, M De Leeuw, N Mpotos, P Calle, B De Turck
No abstract text is available yet for this article.
May 23, 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27111645/costs-associated-with-anesthesia-related-adverse-events-during-labor-and-delivery-in-new-york-state-2010
#18
Tristan D Hunt, Jean Guglielminotti, Guohua Li
BACKGROUND: The safety of anesthetic care provided during childbirth has improved during the past 2 decades in the United States, with a marked decrease in the rate of anesthesia-related adverse events (ARAEs). To date, there is little research on the costs of ARAEs in obstetrics. This study aims to assess the excess cost and cost per admission associated with ARAEs during labor and delivery. METHODS: Data came from the New York State Inpatient Database 2010. Discharge records indicating labor and delivery and ARAEs were identified with International Classification of Diseases, Ninth Revision, Clinical Modification codes...
June 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27103543/perimortem-caesarean-deliveries
#19
REVIEW
A J Eldridge, R Ford
Although cardiac arrest in pregnancy is rare, it is important that all individuals involved in the acute care of pregnant women are suitably trained, because the outcome for both mother and fetus can be affected by the management of the arrest. Perimortem caesarean delivery was first described in 715 BC. Initially the procedure was performed principally for religious or political reasons. Although the potential for fetal survival was proposed, it was rarely successful, probably because the delivery was delayed until maternal death was established...
August 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27032434/-perimortem-caesarean-section-and-timely-decision-making
#20
Zofia Maria Piosik, Henrik Alstrøm, Anna Aabakke, Jens Svare
Perimortem caesarean section can be decisive for the outcome of a cardiac arrest in pregnancy for both mother and fetus. We describe a case story of the management of cardiac arrest in early labour where perimortem caesarean section proved to be life-saving for both mother and child. The child was delivered alive seven minutes after recorded cardiac arrest, and the mother had return of spontaneous circulation one minute after delivery. The mother recovered well with no serious sequelae to the resuscitation...
March 21, 2016: Ugeskrift for Laeger
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