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Shock in Obstetrics

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https://www.readbyqxmd.com/read/28533582/angular-ectopic-pregnancy-presenting-as-rupture-of-lateral-wall-of-the-uterus-late-presentation-in-gestation-week-20
#1
Malihe Hasanzadeh, Salme Dadgar, Yalda Arian, Yousef Yousefi
The differential diagnosis of acute abdominal pain in pregnancy is broad and can be complicated by atypical manifestations that are due to the anatomic distortions and physiologic changes of pregnancy. Due to the lack of clinical understanding, angular pregnancy does not appear to be recognized as a clinical entity and many cases are likely to go undiagnosed. This is a case report of a 34-year-old woman who was referred to the obstetrics emergency department with sudden abdominal pain and in a state of hypovolemic shock...
May 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28522320/risks-and-consequences-of-puerperal-uterine-inversion-in-the-united-states-2004-2013
#2
Sarah L Coad, Leanne S Dahlgren, Jennifer A Hutcheon
BACKGROUND: Puerperal uterine inversion is a rare, potentially life-threatening obstetrical emergency. The current literature consists of small case series and a single nationwide study from Europe with only 15 cases. OBJECTIVE: We aimed to define the incidence, temporal trends and outcomes in women with uterine inversion using a nationally representative United States (US) cohort. STUDY DESIGN: We used the Nationwide Inpatient Sample, a 20% sample of US hospital admissions, to identify all deliveries from 2004 to 2013...
May 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28511469/clinical-profile-and-outcome-of-newborns-with-acute-kidney-injury-in-a-level-3-neonatal-unit-in-western-india
#3
Satvik Chaitanya Bansal, Archana Somashekhar Nimbalkar, Amit R Kungwani, Dipen Vasudev Patel, Ankur Rajinder Sethi, Somashekhar Marutirao Nimbalkar
INTRODUCTION: Acute Kidney Injury (AKI) is a serious condition in neonatal care. It complicates the management necessitating the restrictive use of medications. AIM: To evaluate clinical profile, identify associated and prog-nostic factors in newborns with AKI. MATERIALS AND METHODS: This was a case control study done between January 2008 to January 2010. Total 1745 newborns were admitted, of which 74 babies had AKI. It was defined as serum creatinine >1...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28499381/experience-in-the-use-of-non-pneumatic-anti-shock-garment-nasg-in-the-management-of-postpartum-haemorrhage-with-hypovolemic-shock-in-the-fundaci%C3%A3-n-valle-del-lili-cali-colombia
#4
María Fernanda Escobar, Carlos Eduardo Füchtner, Javier Andrés Carvajal, Albaro José Nieto, Adriana Messa, Sara Sofía Escobar, Angélica María Monroy, Angélica María Forero, José David Casallas, Marcela Granados, Suellen Miller
BACKGROUND: The aim of this case series is to describe the experience of using the non-pneumatic anti-shock garment (NASG) in the management of severe Postpartum hemorrhage (PPH) and shock, and the value of implementing this concept in high-complexity obstetric hospitals. METHODS: Descriptive case series of 77 women that received NASG in the management of PPH with severe hypovolemic shock from June 2014 to December 2015. Vital signs, shock index (SI), the lactic acid value and the base deficit were compared before and after NASG application...
May 12, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28398913/sepsis-in-obstetrics-treatment-prognosis-and-prevention
#5
Sheryl E Parfitt, Mary L Bogat, Cheryl Roth
Sepsis during pregnancy is one of the five leading causes of maternal mortality worldwide. Early recognition and prompt treatment of maternal sepsis is necessary to improve patient outcomes. Patient education on practices that reduce infections may be helpful in decreasing rates of sepsis. Education of nurses about early signs and symptoms of sepsis in pregnancy and use of obstetric-specific tools can assist in timely identification and better outcomes. Although the Surviving Sepsis Campaign (SSC) criteria for diagnosis of sepsis in the general population are not pertinent for obstetric patients, their treatment bundles (guidelines) are applicable and can be used to guide care of obstetric patients who develop sepsis...
April 10, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28301336/sepsis-in-obstetrics-clinical-features-and-early-warning-tools
#6
Sheryl E Parfitt, Mary L Bogat, Sandra L Hering, Charlotte Ottley, Cheryl Roth
Morbidity and mortality associated with sepsis has gained widespread attention on a local, state, and national level, yet, it remains a complicated disorder that can be difficult to identify in a timely manner. Sepsis in obstetric patients further complicates the diagnosis as alterations in physiology related to pregnancy can mask sepsis indicators normally seen in the general population. If early signs of sepsis go unrecognized, septic shock can develop, leading to organ dysfunction and potential death. Maternal early warning tools have been designed to assist clinicians in recognizing early indications of illness...
March 15, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28148289/a-rare-case-of-dengue-encephalopathy-complicating-a-term-pregnancy
#7
Lavanya Rajagopala, Ravindra L Satharasinghe, Madhava Karunarathna
BACKGROUND: Dengue fever has an expanded clinical spectrum ranging from an asymptomatic infection to life threatening dengue hemorrhagic fever and refractory shock. Dengue infection in pregnancy can be a diagnostic dilemma, particularly considering the physiological changes in pregnancy and the obstetric complications encountered in clinical practice. Hence the knowledge of its diagnosis and management in its atypical presentations is of paramount importance. Here we report an unusual case of uncomplicated dengue encephalopathy in a term mother, probably the first to be reported from the Indian subcontinent...
February 2, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28099637/factors-associated-with-maternal-death-in-an-intensive-care-unit
#8
Suzanne Vieira Saintrain, Juliana Gomes Ramalho de Oliveira, Maria Vieira de Lima Saintrain, Zenilda Vieira Bruno, Juliana Lima Nogueira Borges, Elizabeth De Francesco Daher, Geraldo Bezerra da Silva
Objective: To identify factors associated with maternal death in patients admitted to an intensive care unit. Methods: A cross-sectional study was conducted in a maternal intensive care unit. All medical records of patients admitted from January 2012 to December 2014 were reviewed. Pregnant and puerperal women were included; those with diagnoses of hydatidiform mole, ectopic pregnancy, or anembryonic pregnancy were excluded, as were patients admitted for non-obstetrical reasons...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28078172/gastric-rupture-in-pregnancy-case-series-from-a-tertiary-institution-in-rwanda-and-review-of-the-literature
#9
David Ntirushwa, Stephen Rulisa, Febronie Muhorakeye, Lisa Bazzett-Matabele, Theogene Rurangwa, Maria Small
Background Gastric rupture is a rare, life-threatening condition during pregnancy. Case study We present three cases of gastric perforation during pregnancy and the puerperium. The first patient presented with gastric perforation 4 days following an uncomplicated cesarean delivery for obstetric indications. She initially complained of epigastric pain; however, those symptoms resolved. She later demonstrated worsening abdominal distension, intra-abdominal free fluid, and signs of peritonitis. At laparotomy, an ascariasis-associated gastric rupture was diagnosed...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28003676/a-case-of-refractory-systemic-capillary-leak-syndrome-clarkson-s-disease-during-pregnancy
#10
Yukiko Hikasa, Masao Hayashi, Satoshi Suzuki, Hiroshi Morimatsu
A 32-year-old woman, pregnant with twins, presented with a chief complaint of general fatigue. Her general condition had rapidly deteriorated since her last visit to the primary obstetrician; the patient was then referred to our hospital because of suspected fetal death. She underwent emergency cesarean section because fetal death had indeed occurred, and she was then admitted to the intensive care unit (ICU). On ICU admission, she was found to be in shock. Laboratory analysis revealed extreme hemoconcentration and a low albumin level, and initially, septic shock with obstetric complications was suspected...
December 2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/27998318/management-of-severe-dengue-hemorrhagic-fever-and-bleeding-complications-in-a-primigravida%C3%A2-patient-a-case-report
#11
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/27997586/determination-of-normal-ranges-of-shock-index-and-other-haemodynamic-variables-in-the-immediate-postpartum-period-a-cohort-study
#12
Hannah L Nathan, Kate Cottam, Natasha L Hezelgrave, Paul T Seed, Annette Briley, Susan Bewley, Lucy C Chappell, Andrew H Shennan
OBJECTIVE: To determine the normal ranges of vital signs, including blood pressure (BP), mean arterial pressure (MAP), heart rate (HR) and shock index (SI) (HR/systolic BP), in the immediate postpartum period to inform the development of robust obstetric early warning scores. STUDY DESIGN: We conducted a secondary analysis of a prospective observational cohort study evaluating vital signs collected within one hour following delivery in women with estimated blood loss (EBL) <500ml (316 women) delivering at a UK tertiary centre over a one-year period...
2016: PloS One
https://www.readbyqxmd.com/read/27897027/-acute-uterine-inversion-after-delivery
#13
E Pechová, I Bydžovská, M Krausová, M Lubušký
OBJECTIVE: A case of acute inversion of the uterus after childbirth, in which we successfully perform a manual vaginal reposition of the uterus. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, Krajská nemocnice Liberec, a.s.; Department of Obstetrics and Gynaecology, Palacky University Hospital, Olomouc. OBSERVATION: Our case report describes acute post-partum uterine inversion of the second degree, which developed after delivery in a 36-year-old primigravida...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27882764/-acute-pancreatitis-in-pregnancy-complicated-by-rupture-of%C3%A2-aneurysm-of-artery-lienalis
#14
E Hostinská, K Huml, R Pilka
OBJECTIVE: We present a case of pregnant woman with acute pacreatitis in 38th week comlicated by acute rupture of aneurysm of artery lienalis. DESIGN: Case report. SETTING: Department of Gynaecology and Obstetrics, Faculty Hospital and Palacky University, Olomouc. CASE REPORT: 28-years-old primipara in 38th week of gestation was admitted to our department for acute pancreatitis caused by gallstones. Subsequent conservative treatment was complicated by rupture of aneurysm of lienal artery and haemorrhagic shock...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27882751/-septic-shock-in-pregnancy-on-the-basis-of-an-acute-pyelonephritis
#15
Z Kokrdová, A Pařízek, M Koucký, A Pašková, B Boudová
OBJECTIVE: According to the World Health Organisation, sepsis is one of the four main causes of pregnancy-related mortality worldwide, together with hemorrhage, hypertensive disease and abortion. The main goal of this paper is an analysis of one case of septic shock in pregnancy. DESIGN: A case report. SETTING: Department of Obstetrics and Gynaecology of the First Faculty of Medicine and General Teaching Hospital, Prague. METHODS AND RESULTS: Authors would like to draw attention to the pitfalls of diagnosis and treatment of septic shock which developed in 25th week of pregnancy on the basis of pyelonephritis due to E...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27871315/management-of-uterine-rupture-a-case-report-and-review-of-the-literature
#16
Thomas Obinchemti Egbe, Gregory Edie Halle-Ekane, Charlotte Nguefack Tchente, Jacques Ernest Nyemb, Eugene Belley-Priso
BACKGROUND: Maternal morbidity and mortality has been a major World Health Organization concern over the years, especially in sub-Saharan Africa. This paper reports uterine rupture with severe hypovolemic shock managed at the Douala General Hospital, Cameroon. Early clinical diagnosis is paramount to maternal survival. CASE PRESENTATION: Mrs. MM aged 25 years, G3P2012, of the Bamileke tribe in Cameroon was admitted to our Department in hypovolemic shock BP = 70/40 mmHg, pulse 120 beats per minute, with altered consciousness (Glasgow Coma Scale = 13)...
November 21, 2016: BMC Research Notes
https://www.readbyqxmd.com/read/27819791/-effectiveness-of-a-rapid-response-team-rrt-in-a-case-of-ruptured-ectopic-pregnancy
#17
José Miguel Campechano-López, María Lourdes Carranza-Bernal, Guillermina Juanico-Morales, María Rayo Reyes-Gil
BACKGROUND: An ectopic pregnancy happens when a fertilized egg attaches somewhere outside the endometrial surface. This sort of pregnancy has an estimated incidence of 1.6 to 2 each 100 births. The main objective was to expose the effective answer of a Rapid Response Team in a case of ruptured cervical ectopic pregnancy. We also describe a clinical case of this sort of pregnancy. CLINICAL CASE: 37-year-old female with a two-month history of amenorrhea. The patient entered the Labor & Delivery department with hypovolemic shock secondary to vaginal bleeding...
November 2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27793427/clinical-and-microbiological-features-of-maternal-sepsis-a-retrospective-study
#18
G Abir, S Akdagli, A Butwick, B Carvalho
BACKGROUND: Identifying pregnant women with sepsis is challenging because diagnostic clinical and laboratory criteria overlap with normal pregnant physiologic indices. Our primary study aim was to describe clinical and laboratory characteristics of women diagnosed with sepsis, severe sepsis and septic shock. Our secondary aim was to determine positive predictive values for International Classification of Disease (ICD)-9 billing codes for sepsis, severe sepsis, and septic shock. METHODS: After gaining Institutional Review Board approval, we identified women with ICD-9 codes for sepsis, severe sepsis and septic shock who were admitted to a single tertiary obstetric center from 2007-2013...
February 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27762469/medical-emergency-team-may-reduce-obstetric-intensive-care-unit-admissions
#19
Moon Seong Baek, Jeongsuk Son, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Hye-Sung Won, Jae-Yoon Shim, Sang-Bum Hong
AIM: Some recent studies have reported that early intervention by a medical emergency team (MET) for clinical deterioration before intensive care unit (ICU) admission was associated with a survival benefit in critically ill cancer patients. We hypothesized that early MET intervention for an obstetric crisis in the general wards would be related to favorable outcomes in critically ill obstetric patients. METHODS: Data of obstetric patients who were managed by a MET were collected retrospectively from 1 March 2008 to 30 April 2015...
January 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27651610/ligating-internal-iliac-artery-success-beyond-hesitation
#20
Abha Singh, Ruchi Kishore, Saveri Sarbhai Saxena
AIM: To study the outcomes, benefits and complications of internal iliac artery ligation in both obstetric and gynecological cases. OBJECTIVE: To study the outcomes, effectiveness and complications of internal iliac artery ligation (IIAL). METHOD: This is an analytical longitudinal study done among women who have undergone internal iliac artery ligation in Dr. BRAMH a tertiary referral center from July 2013 to June 2015. Follow-up was done through color Doppler analysis of pelvic arteries before discharge, after 6 weeks and after 6 months...
October 2016: Journal of Obstetrics and Gynaecology of India
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