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Critical illness in pregnancy

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https://www.readbyqxmd.com/read/29739630/extracorporeal-life-support-as-salvage-therapy-for-massive-pulmonary-embolus-and-cardiac-arrest-in-pregnancy
#1
Michael E Takacs, Kristina E Damisch
BACKGROUND: Massive pulmonary embolus (PE) with prolonged cardiac arrest in the setting of pregnancy has few treatment options. Selections are further restricted if there are contraindications to the standard therapies of embolectomy and thrombolysis. We report a case of extracorporeal life support (ECLS) used as salvage therapy for a critically ill pregnant patient. CASE REPORT: A 21-year-old woman presented to a small rural hospital with chest pain, dyspnea, hypoxia, and syncope...
May 5, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29709055/interventions-for-investigating-and-identifying-the-causes-of-stillbirth
#2
REVIEW
Aleena M Wojcieszek, Emily Shepherd, Philippa Middleton, Glenn Gardener, David A Ellwood, Elizabeth M McClure, Katherine J Gold, Teck Yee Khong, Robert M Silver, Jan Jaap Hm Erwich, Vicki Flenady
BACKGROUND: Identification of the causes of stillbirth is critical to the primary prevention of stillbirth and to the provision of optimal care in subsequent pregnancies. A wide variety of investigations are available, but there is currently no consensus on the optimal approach. Given their cost and potential to add further emotional burden to parents, there is a need to systematically assess the effect of these interventions on outcomes for parents, including psychosocial outcomes, economic costs, and on rates of diagnosis of the causes of stillbirth...
April 30, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29661353/recurrent-pyroglutamic-acidosis-related-to-therapeutic-acetaminophen
#3
REVIEW
Hazem M Alhourani, Aneel Kumar, Lekha K George, Tahira Sarwar, Barry M Wall
Pyroglutamic acid, an intermediate in glutathione metabolism, can lead to elevated anion gap metabolic acidosis as rare complication of acetaminophen therapy in adults. Acquired pyroglutamic acidosis has been observed primarily in settings associated with glutathione deficiency. Risk factors for glutathione deficiency include critical illness, chronic liver or kidney disease, advanced age, female gender, alcohol abuse, malnutrition, pregnancy, antiepileptic drugs, and chronic acetaminophen use. Diagnosis of pyroglutamic acidosis requires both the exclusion of common etiologies of increased anion gap metabolic acidosis and a high index of suspicion...
April 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29621007/disseminated-intravascular-coagulation-is-it-fact-or-fancy
#4
Jae C Chang
: 'Disseminated intravascular coagulation (DIC)' occurs commonly in critical illnesses such as sepsis, trauma, cancer, and complications of surgery and pregnancy. Mortality is very high. The pathogenesis has been ascribed to tissue factor-initiated coagulation disorder, resulting in disseminated microblood clots that are made of platelets, plasma factors, fibrins, and blood cells. True DIC depletes coagulation factors and consumes platelets, and activates fibrinolysis. 'DIC' is assumed to orchestrate thrombocytopenia, microangiopathic hemolytic anemia and hypoxic multiorgan dysfunction syndrome, and causes hemorrhagic disorder due to depleted coagulation factors...
April 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29578985/acog-committee-opinion-no-732-influenza-vaccination-during-pregnancy
#5
(no author information available yet)
Influenza vaccination is an essential element of prepregnancy, prenatal, and postpartum care because influenza can result in serious illness, including a higher chance of progressing to pneumonia, when it occurs during the antepartum or postpartum period. In addition to hospitalization, pregnant women with influenza are at increased risk of intensive care unit admission and adverse perinatal and neonatal outcomes. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists recommend that all adults receive an annual influenza vaccine and that women who are or will be pregnant during influenza season receive an inactivated influenza vaccine as soon as it is available...
April 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29578983/acog-committee-opinion-no-732-summary-influenza-vaccination-during-pregnancy
#6
(no author information available yet)
Influenza vaccination is an essential element of prepregnancy, prenatal, and postpartum care because influenza can result in serious illness, including a higher chance of progressing to pneumonia, when it occurs during the antepartum or postpartum period. In addition to hospitalization, pregnant women with influenza are at increased risk of intensive care unit admission and adverse perinatal and neonatal outcomes. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists recommend that all adults receive an annual influenza vaccine and that women who are or will be pregnant during influenza season receive an inactivated influenza vaccine as soon as it is available...
April 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29548301/psychological-issues-and-construction-of-the-mother-child-relationship-in-women-with-cancer-during-pregnancy-a-perspective-on-current-and-future-directions
#7
Federica Ferrari, Flavia Faccio, Fedro Peccatori, Gabriella Pravettoni
BACKGROUND: Cancer during pregnancy is a rare event. However, knowledge about treatment has progressed in recent years with improved maternal and neonatal outcomes. The number of women who decide to continue their pregnancy and undergo cancer treatment is increasing. MAIN BODY: Women face two critical events simultaneously; oncological illness and pregnancy, with different and conflicting emotions. In addition, the last trimester of gestation sets the ground for construction of the mother-child relationship, which is of great importance for the child's development...
March 16, 2018: BMC Psychology
https://www.readbyqxmd.com/read/29540421/impact-of-violence-against-women-on-severe-acute-maternal-morbidity-in-the-intensive-care-unit-including-neonatal-outcomes-a-case-control-study-protocol-in-a-tertiary-healthcare-facility-in-lima-peru
#8
Beatriz Paulina Ayala Quintanilla, Wendy E Pollock, Susan J McDonald, Angela J Taft
INTRODUCTION: Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality...
March 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29417010/reproductive-behavior-of-newly-married-women-in-rural-punjab-india-a-longitudinal-study
#9
Anurag Chaudhary, Mahesh Satija, Sarit Sharma, Surinderpal Singh, Sangeeta Girdhar
Introduction: In India, little is known about the reproductive behavior during earlier years of married life of women, when they are more vulnerable to reproductive ill health and early child bearing with very few interventions available. Objective: The objective of this study is to follow a cohort of newly married women immediately after marriage until their first pregnancy outcome to gain an insight into their reproductive behavior so that important opportunities could be identified for intervention...
July 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29361255/prevalence-of-augmented-renal-clearance-and-performance-of-glomerular-filtration-estimates-in-indigenous-australian-patients-requiring-intensive-care-admission
#10
D Tsai, A A Udy, P C Stewart, S Gourley, N M Morick, J Lipman, J A Roberts
Augmented renal clearance (ARC) refers to the enhanced renal excretion of circulating solute commonly demonstrated in numerous critically ill subgroups. This study aimed to describe the prevalence of ARC in critically ill Indigenous Australian patients and explore the accuracy of commonly employed mathematical estimates of glomerular filtration. We completed a single-centre, prospective, observational study in the intensive care unit (ICU), Alice Springs Hospital, Central Australia. Participants were critically ill adult Indigenous and non-Indigenous Australian patients with a urinary catheter in situ...
January 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29319760/acute-kidney-injury-in-critically-ill-obstetric-patients-a-cross-sectional-study-in-an-intensive-care-unit-in-northeast-brazil
#11
Geraldo Bezerra da Silva Junior, Suzanne Vieira Saintrain, Gabriel de Castro Castelo, Vanessa Ribeiro de Vasconcelos, Juliana Gomes Ramalho de Oliveira, Amanda Maria Timbó Rocha, Adolfo Gomes Vasconcelos Júnior, Maria Vieira de Lima Saintrain, Elizabeth De Francesco Daher
INTRODUCTION: Acute kidney injury (AKI) is a complication still poorly studied in the setting of obstetric patients, which is associated with increased mortality. Objective: The aim of this study was to investigate the frequency and risk factors of AKI among critically ill obstetric patients. METHODS: A cross-sectional study was conducted with all patients admitted to an intensive care unit (ICU) due to obstetric complications, in Fortaleza, Brazil, in the period between January 2012 and December 2014...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29310986/multidisciplinary-obstetric-critical-care-delivery-the-concept-of-the-virtual-intensive-care-unit
#12
REVIEW
Michael P Leovic, Hailey N Robbins, Roman S Starikov, Michael R Foley
With an increasing prevalence of chronic medical conditions and the associated potential for decompensation to critical illness among modern day parturients, we present here the concept of the "virtual" intensive care unit. We challenge the traditional association of the word "unit" to extend beyond a fixed physical setting to portray an individualized, predetermined patient care team capable of managing these complex patients in a variety of settings. In this model, obstetric critical care is provided through a multidisciplinary patient care team, with emphasis on early identification of complicated pregnancies, detailed antepartum planning, anticipation of complications, and retrospective review of clinical outcomes aimed at continued quality improvement...
February 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29297839/reproductive-parameters-and-birth-statistics-for-a-herd-of-asian-elephants-elephas-maximus-in-north-america-over-a-20-year-period
#13
Wendy K Kiso, Ellen Wiedner, Ramiro Isaza, William Lindsay, Janice Aria, Gary Jacobson, Kathy Jacobson, Dennis Schmitt
We reviewed medical records documenting 28 pregnancies occurring within a herd of Asian elephants ( Elephas maximus) over a 20-yr (1994-2014) period at a private facility in the southeastern United States. Twenty-six pregnancies resulted in live calves and two ended in stillbirths. The 26 live births represented the offspring of 11 cows and 5 bulls. Twenty-four calves survived their first year, including two critically ill calves born after dystocias. Male and female calves occurred in almost equal numbers...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29150304/are-the-estrogenic-hormonal-effects-of-environmental-toxins-affecting-small-intestinal-bacterial-and-microfilaria-overgrowth
#14
Edward Lichten
The important role of microfilaria (worms) in human and animal disease remains an area of key disagreement between the naturopathic and allopathic physicians. While microfilaria infections are rampart in undeveloped countries, they rarely rise to identification as a cause of disease in Western countries. New research studies in the diagnosis and treatment of SIBO (Small Intestinal Bacterial Overgrowth) and (IBD) Inflammatory Bowel Diseases of ulcerative colitis, Crohn's Disease and microcytic colitis may make both sides equally correct...
November 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29114416/outcomes-of-antepartum-and-postpartum-obstetric-admissions-to-the-intensive-care-unit-of-a-tertiary-university-hospital-an-8-year-review
#15
Menekşe Özçelik, Sanem Turhan, Onat Bermede, Ali Abbas Yılmaz, Necmettin Ünal, Mustafa Kemal Bayar
Objective: Although their rates are decreasing, pregnancy-related mortality and morbidity are problems worldwide. In this study, we aimed to review the characteristics, diagnoses, required interventions and outcomes of obstetric patients admitted between 2006 and 2014 to the Intensive Care Unit (ICU) of a tertiary university hospital to provide an indicator for improving the management of critically ill obstetric patients. Methods: A retrospective study of hospital records of obstetric admissions to the ICU was conducted...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29109640/obstetric-critical-care-requirements-felt-by-the-obstetricians-an-experience-based-study
#16
Mohan Deep Kaur, Jyoti Sharma, Prasoon Gupta, Tarun Deep Singh, Saurav Mitra Mustafi
Background and Aims: Pregnancy is a state of physiological stress to a woman's health. Concomitant complications and infections during pregnancy may necessitate intensive monitoring and management of such patients in critical care settings. This study aims to determine the perceptions about the requirement of obstetric critical care based on the experience of obstetricians. Material and Methods: An observational, questionnaire-based study was conducted in 200 obstetricians working in various settings, who were approached during obstetric conferences...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29099558/antidepressant-exposure-during-pregnancy-and-risk-of-autism-in-the-offspring-2-do-the-new-studies-add-anything-new
#17
Chittaranjan Andrade
BACKGROUND: During the past year, at least 5 new studies, all observational in design, examined the risk of autism spectrum disorder (ASD) in children exposed to antidepressant medication in utero. These studies had not found inclusion in the many systematic reviews and meta-analyses that had also been published in the past year. METHODS: Noteworthy methods and findings of the new studies are summarized. One of these studies is examined in detail to help the reader understand methodological and conceptual issues that are critical in the field...
September 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28891535/doppler-sonographic-evaluation-of-venogenic-extremity-swellings-analysis-of-170-patients-from-kano-nigeria
#18
A Ismail, A M Tabari, K Isyaku
INTRODUCTION: Deep venous thrombosis (DVT) is a serious problem that can potentially lead to many complications including life-threatening pulmonary arterial thrombosis. Screening and confirmation of the diagnosis are critical in the care of this condition. OBJECTIVES: The objective of this study was to evaluate the role of Doppler sonography in diagnosing DVT and to illustrate the pattern in 170 suspected cases from our local environment. MATERIALS AND METHODS: This study was conducted at our department over 18 months...
August 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28867295/asthma-outcomes-and-management-during-pregnancy
#19
REVIEW
Catherine A Bonham, Karen C Patterson, Mary E Strek
Asthma during pregnancy poses a common, increasingly prevalent threat to the health of women and their children. The present article reviews recent insights gained from the epidemiology of asthma during pregnancy, demonstrating the many short- and long-term risks to mother and fetus incurred by poorly controlled maternal asthma. We further discuss emerging evidence that active management of asthma during pregnancy can positively influence and perhaps completely mitigate these poor outcomes. Recent high-quality trials examining best methods for asthma treatment are reviewed and synthesized to offer an evidence-based pathway for comprehensive treatment of asthma in the outpatient setting...
February 2018: Chest
https://www.readbyqxmd.com/read/28782392/model-of-obstetric-attention-based-on-critical-care-in-latin-america
#20
María F Escobar, Javier A Carvajal, Albaro J Nieto, Adriana Messa, Juan M Burgos, Maria P Echavarría, Marcela Granados
PURPOSE: Report the results obtained following the implementation of an OCC (Obstetric Critical Care) model. MATERIALS AND METHODS: This is an observational prospective study in obstetric population with high complexity illness attended in a safety and quality model of attention in a specific unit supporting the concept of obstetric critical care. Records were used as the primary source for collecting information, using the standards of the Center for Clinical Research...
August 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
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