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Obstetric haematology

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
T Binder, P Salaj, V Komrska
THE AIM OF THE STUDY: To highlight the risks associated with pregnancy at women with von Willebrand´s disease or hemophilia. Introduce the rules of multidisciplinary prenatal and peripartal care to minimalize these risks. The article is accompanied by case report where maladministration led to fatal consequences for the newborn. DESIGN: Review and case report.Seatings: Department Obstetric and Gynecology UJEP and Masaryk´s Hospital Ústí n/Labem, Institute Haematology and Blood Transfer Prague, Children´s Haemato-onkology Clinic University Hospital Prague Motol...
2016: Ceská Gynekologie
Hari Shankar, Neeta Kumar, Rajat Sandhir, Suneeta Mittal, Santosh Kurra, Lakhbir Dhaliwal, Gurjit Kaur, Nomita Chandhiok, B S Dhillon, D N Rao
: Anaemia during pregnancy is most commonly observed and highly prevalent in South-East Asia. Various effective programmes have been laid down for its management, mainly daily supplementation of iron folic acid (IFA) tablets. Following the same, standard obstetrical practice has included the IFA supplementation without requiring the determination of iron deficiency. In this study, a total of 120 primigravida (N = 60; non-anaemic (Hb > 11 g/dl) and N = 60 anaemic (Hb = 8-11 g/dl)) were selected among those attending the Antenatal Clinic in Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India...
November 2016: Saudi Journal of Biological Sciences
Lydia Yusuf, Srivasavi Dukka, Etienne Ciantar
Hermansky-Pudlak syndrome is a rare autosomal recessive disorder estimated to affect 1 in 500,000 to 1,000,000 individuals worldwide. Clinically, it presents as oculocutaneous albinism combined with bleeding diathesis. This is due to the absence of dense bodies in platelets causing a delayed secondary response resulting in prolonged bleeding time despite normal platelet count and coagulation factors. This has consequences for major bleeding, the risk of which is high at delivery. In the longer term, the condition is also associated with the development of pulmonary fibrosis, inflammatory bowel disorders caused by granulomatous colitis and renal failure...
December 2016: Obstetric Medicine
Virginia A Aparicio, Olga Ocón, Carmen Padilla-Vinuesa, Alberto Soriano-Maldonado, Lidia Romero-Gallardo, Milkana Borges-Cósic, Irene Coll-Risco, Pilar Ruiz-Cabello, Pedro Acosta-Manzano, Fernando Estévez-López, Inmaculada C Álvarez-Gallardo, Manuel Delgado-Fernández, Jonatan R Ruiz, Mireille N Van Poppel, Julio J Ochoa-Herrera
BACKGROUND: During pregnancy, a sedentary lifestyle may have negative consequences on maternal and foetal health status. The main objective of this project is to assess the effects of an exercise intervention in overweight and grade I obese pregnant on maternal and foetal health markers. METHODS/DESIGN: The present study aims to recruit 60 overweight and grade I obese women interested in participating in an exercise intervention program from the 17th gestational week until delivery...
September 29, 2016: BMC Pregnancy and Childbirth
S Morris, M H Yudin, J Callum, A Alam, J Herold, Y Lin
OBJECTIVES: To evaluate the current state of transfusion medicine (TM) knowledge among obstetricians using a valid assessment tool. BACKGROUND: Transfusion issues are common in obstetrical patients. METHODS: Knowledge topics were identified and rated by experts in obstetrics, anaesthesia, haematology and TM using a modified Delphi method. A knowledge assessment tool was developed and validated during pilot testing. The assessment tool, consisting of 15 multiple choice questions, was administered electronically to members of the Society of Obstetricians and Gynaecologists of Canada (SOGC)...
December 2016: Transfusion Medicine
Asrar Ahmad, Monica Kohli, Anita Malik, Megha Kohli, Jaishri Bogra, Haider Abbas, Rajni Gupta, B B Kushwaha
PURPOSE: In this study, we aimed to correlate thromboelastography (TEG) variables versus conventional coagulation profile in all patients presenting with pre-eclampsia/eclampsia and to see whether TEG would be helpful for evaluating coagulation in parturients before regional anaesthesia. MATERIALS AND METHODS: This was a prospective study on 100 pre-eclampsia/eclampsia patients undergoing lower-segment caesarean section under regional anaesthesia. Two blood samples were collected...
October 2016: Journal of Obstetrics and Gynaecology of India
Colleen D Acosta, David A Harrison, Kathy Rowan, D Nuala Lucas, Jennifer J Kurinczuk, Marian Knight
OBJECTIVES: To describe the incidence, characteristics and risk factors for critical care admission with severe maternal sepsis in the UK. DESIGN: National cohort study. SETTING: 198 critical care units in the UK. PARTICIPANTS: 646 pregnant and recently pregnant women who had severe sepsis within the first 24 hours of admission in 2008-2010. PRIMARY AND SECONDARY OUTCOME MEASURES: Septic shock, mortality...
August 23, 2016: BMJ Open
T Svěrák, K Skrivanova, L Anderkova, M Bendová, D Brancikova, N Elfmarková, H Peterkova, J Jarkovský, K Benesova, L Minar, L Dusek, J Nedvěd, M Protivánková
BACKGROUND: Survival rate of breast cancer patients has improved significantly in recent years. Cancer diagnosis represents a great psychological distress for patients which may not stem solely from the disease itself. Patients may experience higher distress even several years after treatment. PATIENTS AND METHODS: The study was carried out at the Department of Obstetrics and Gynecology and Department of Internal Medicine, Haematology and Oncology, Faculty Hospital Brno...
2016: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
Minakshi Rohilla, Rakhi Rai, Uday Yanamandra, Neelam Chaudhary, Pankaj Malhotra, Neelam Varma, Vanita Jain, G R V Prasad, Jasvinder Kalra, Subhash C Varma
Chronic myeloid leukaemia (CML) is amongst the most common haematological malignancies encountered in adults. The younger age of onset and increased incidence of CML in Indians leads to higher chances of encountering it in pregnancy. Pregnancy in CML is a complex situation as first line therapy with tyrosine kinase inhibitors (TKI), is fraught with multiple fetal safety issues. The fetal aspects have been elucidated in literature, but there is scarcity of information on the obstetric outcome per se in presence of CML, excluding the influence of TKI...
March 2016: Indian Journal of Hematology & Blood Transfusion
Betül Tavil, Ayşe Korkmaz, Turan Bayhan, Selin Aytaç, Sule Unal, Baris Kuskonmaz, Sule Yigit, Mualla Cetin, Murat Yurdakök, Fatma Gumruk
In this study, we aimed to evaluate the incidence, risk factors, causes and clinical management of intracranial haemorrhage (ICH) diagnosed during foetal life or in the first month of life in term neonates with a discussion of the role of haematological risk factors. This study included term neonates (gestational age 37-42 weeks) with ICH diagnosed, treated and followed up in the Neonatal Intensive Care Unit of Hacettepe University, Ankara, Turkey, between January 1994 and January 2014. Medical follow-up was obtained retrospectively from hospital files and prospectively from telephonic interviews and/or clinical visits...
March 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Laura Green, Marian Knight, Frances Seeney, Cathy Hopkinson, Peter W Collins, Rachel E Collis, Nigel A B Simpson, Andrew Weeks, Simon J Stanworth
Understanding the coagulopathy of major-obstetric-haemorrhage (MOH) that leads to massive-transfusion (MT) is fundamental to improving outcomes. This study reports on the haematological features and transfusion management of women experiencing MT [defined as transfusion of ≥8 units of red blood cells (RBC) within 24 h of delivery]. One hundred and eighty-one cases [median (interquartile range; IQR) age 33 years (29-36)] were identified from all UK hospitals, using the UK Obstetric Surveillance System between July 2012 and June 2013...
February 2016: British Journal of Haematology
Patricia Winckler, Anna Vanazzi, Maddalena Bozzo, Giovanna Scarfone, Fedro A Peccatori
Chronic lymphocytic leukaemia (CLL) is the most common leukaemia in the Western world. Despite this fact, its coexistence with pregnancy is extremely rare, with few cases reported in the literature. Given the rarity of this event, it is difficult to conduct large prospective trials to evaluate diagnostic, management, and outcome aspects. The existing evidence is limited to the few published cases and scarce data from reviews on haematological malignancies and pregnancy. Here, we report a case of a 36-year-old patient who had already finished treatment for CLL and was under surveillance when she got pregnant...
2015: Ecancermedicalscience
V Husarova, G Donnelly, A Doolan, M Garstka, F Ni Ainle, C McCaul
BACKGROUND: Jehovah's Witnesses have been shown to be at increased risk of mortality and morbidity as a consequence of obstetric haemorrhage and refusal of blood products. Since 2004, however, Jehovah's Witnesses have been allowed to accept minor fractions of blood at their own discretion. We sought to determine the preferences of pregnant Jehovah's Witnesses regarding haematological supports since this policy change. METHODS: This is a retrospective observational study of consecutive Jehovah's Witnesses attending a university-affiliated tertiary referral centre between 1 January 2007 and 31 December 2013...
February 2016: International Journal of Obstetric Anesthesia
Andreas du Bois, Gunnar Kristensen, Isabelle Ray-Coquard, Alexander Reuss, Sandro Pignata, Nicoletta Colombo, Ursula Denison, Ignace Vergote, Jose M Del Campo, Petronella Ottevanger, Martin Heubner, Thomas Minarik, Emmanuel Sevin, Nikolaus de Gregorio, Mariusz Bidziński, Jacobus Pfisterer, Susanne Malander, Felix Hilpert, Mansoor R Mirza, Giovanni Scambia, Werner Meier, Maria O Nicoletto, Line Bjørge, Alain Lortholary, Martin Oliver Sailer, Michael Merger, Philipp Harter
BACKGROUND: Angiogenesis is a target in the treatment of ovarian cancer. Nintedanib, an oral triple angiokinase inhibitor of VEGF receptor, platelet-derived growth factor receptor, and fibroblast growth factor receptor, has shown activity in phase 2 trials in this setting. We investigated the combination of nintedanib with standard carboplatin and paclitaxel chemotherapy in patients with newly diagnosed advanced ovarian cancer. METHODS: In this double-blind phase 3 trial, chemotherapy-naive patients (aged 18 years or older) with International Federation of Gynecology and Obstetrics (FIGO) IIB-IV ovarian cancer and upfront debulking surgery were stratified by postoperative resection status, FIGO stage, and planned carboplatin dose...
January 2016: Lancet Oncology
Waseem Pasha, Waqar Ali, Abdul Latif Khattak, Nayyer Ahmed, Muhammad Idris, Zameer Ahmad Nayyer
BACKGROUND: Normal values of complete blood counts show variation from region to region and between different ethnic groups. It is important to establish reference range for these values in our population for clinical use by our physicians. This descriptive cross sectional study aimed at establishing the normal reference values of complete blood counts in physically normal full term new-borns of Panu Aqil, Rural Sind, Pakistan. METHODS: The study was conducted at Combined Military Hospital, Panu Aqil Cantonment, from January 2010 to March 2011, on 316 term normal neonates selected on the basis of gestational age of 37 weeks or more with uneventful antenatal period...
April 2015: Journal of Ayub Medical College, Abbottabad: JAMC
L Acquah, R Burton
Medical problems account for almost 50% of all maternal deaths in South Africa. The most recent report of the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD) (2008 - 2010) stated that 40.5% of deaths were due to non-pregnancy-related infections, which are mostly HIV-related, and 8.8% were due to medical or surgical disorders. Obstetric physicians have a specific role in managing pregnant and postpartum women with medical problems and, in partnership with obstetricians, can contribute to reducing maternal morbidity and mortality...
September 2014: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Hans Duyvejonck, Piet Cools, Johan Decruyenaere, Kristien Roelens, Lucien Noens, Stefan Vermeulen, Geert Claeys, Ellen Decat, Els Van Mechelen, Mario Vaneechoutte
AIM: Candida species are known as opportunistic pathogens, and a possible cause of invasive infections. Because of their species-specific antimycotic resistance patterns, reliable techniques for their detection, quantification and identification are needed. We validated a DNA amplification method for direct detection of Candida spp. from clinical samples, namely the ITS2-High Resolution Melting Analysis (direct method), by comparing it with a culture and MALDI-TOF Mass Spectrometry based method (indirect method) to establish the presence of Candida species in three different types of clinical samples...
2015: PloS One
Piera Versura, Marina Buzzi, Giuseppe Giannaccare, Adriana Terzi, Michela Fresina, Claudio Velati, Emilio C Campos
BACKGROUND: Epitheliotrophic growth factors (GF) can be supplied topically to patients with severe keratopathy through a variety of blood-derived products. We compared GF content in adult peripheral blood serum (PB-S) and cord blood serum (CB-S) as potential sources of GF. To limit inter-individual variability the assessment was performed in maternal-child pairs at the time of delivery. MATERIAL AND METHODS: The amounts of epidermal GF (EGF), insulin-like GF (IGF), transforming GF-beta (TGF-β), vascular endothelial GF (VEGF) in CB units collected from the umbilical vein and PB from mothers (each group n=30) were estimated by enzyme-linked immunosorbent assays...
March 2016: Blood Transfusion, Trasfusione del Sangue
Gerard Espinosa, Ricard Cervera
For patients with antiphospholipid syndrome (APS), the consensus is to treat those who develop thrombosis with long-term oral anticoagulation therapy and to prevent obstetric manifestations by use of aspirin and heparin. These recommendations are based on data from randomized controlled trials and observational studies. Despite this body of knowledge, areas of uncertainty regarding the management of APS exist where evidence is scarce or nonexistent. In other words, for a subset of patients the course of management is unclear...
October 2015: Nature Reviews. Rheumatology
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