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Critical illness in pregnancy

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https://www.readbyqxmd.com/read/28891535/doppler-sonographic-evaluation-of-venogenic-extremity-swellings-analysis-of-170-patients-from-kano-nigeria
#1
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
#2
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. We review 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 asthma management 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...
August 31, 2017: Chest
https://www.readbyqxmd.com/read/28782392/model-of-obstetric-attention-based-on-critical-care-in-latin-america
#3
María F Escobar, Javier A Carvajal, Albaro J Nieto, Adriana Messa, Juan M Burgos, Maria P Echavarría, Marcela Granados
Purpose of this article. 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 7, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28743311/hypercapnic-respiratory-failure-during-pregnancy-due-to-polymyositis-related-respiratory-muscle-weakness-a-case-report
#4
Husain Shabbir Ali, Ibrahim Fawzy Hassan, Saibu George, Abdalrazig Elsadig Fadlelmula
BACKGROUND: Polymyositis is a rare medical disorder complicating pregnancy. Ventilatory muscle weakness leading to respiratory failure is an uncommon manifestation of this autoimmune disease. We report a case of life-threatening hypercapnic respiratory failure due to polymyositis-related respiratory muscle weakness in a pregnant woman. CASE PRESENTATION: A 31-year-old, African woman in her second trimester of pregnancy presented to the emergency department with fever, shortness of breath and muscle weakness...
July 26, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28699029/access-to-pharmacotherapy-amongst-women-with-bipolar-disorder-during-pregnancy-a-preliminary-study
#5
Nancy Byatt, Lucille Cox, Tiffany A Moore Simas, Kathleen Biebel, Padma Sankaran, Holly A Swartz, Linda Weinreb
Bipolar disorder among pregnant women has deleterious effects on birth and child outcomes and is currently under-detected, not addressed effectively, or exacerbated through inappropriate treatment. The goal of this study was to identify perspectives of pregnant and postpartum women with bipolar disorder on barriers and facilitators to psychiatric treatment during pregnancy. In-depth interviews were conducted with pregnant and postpartum women who scored ≥ 10 on the Edinburgh Postnatal Depression Scale and met DSM-IV criteria for bipolar disorder I, II or not otherwise specified using the Mini International Neuropsychiatric Interview version 5...
July 11, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28654010/effects-of-pup-separation-on-stress-response-in-postpartum-female-rats
#6
Manu Kalyani, Phyllis Callahan, James M Janik, Haifei Shi
There is a complex collection of neuroendocrine function during the postpartum period. Prolactin (PRL) released by suckling stimulus and its PRL receptors (PRL-R) in the central nervous system (CNS) are involved in hyporesponsiveness of the hypothalamic-pituitary-adrenal (HPA) axis in lactating mammals including rodents and humans. It is not clear how long it takes to reestablish the attenuated HPA axis activity of lactating rats to a pre-pregnancy state after pup separation. We first tested the hypothesis that HPA axis activity in response to an acute stress in postpartum rats would return to a pre-pregnancy state after pup separation...
June 27, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28584736/maternal-near-miss-audit-lessons-to-be-learnt
#7
REVIEW
Meenakshi Kalhan, Srishti Singh, Anita Punia, Jai Prakash
Mother and child constitute a large, vulnerable, and a priority group as the risk is involved with childbearing in women and of growth and development in children. For every woman who dies from pregnancy or childbirth-related causes, it is estimated that twenty more suffer from pregnancy-related illness or experience other severe complications. These women who nearly escape death are categorized under "near miss" which has been defined as "a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy...
April 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28584433/critically-ill-obstetric-patients-in-a-general-critical-care-unit-a-5-years-retrospective-study-in-a-public-teaching-hospital-of-eastern-india
#8
Sugata Dasgupta, Tulika Jha, Priyojit Bagchi, Shipti Sradha Singh, Ramprasad Gorai, Sourav Das Choudhury
BACKGROUND: Critical care services are essential for the subset of obstetric patients suffering from severe maternal morbidity. Studies on obstetric critical care are important for benchmarking the issues which need to be addressed while managing critically ill obstetric patients. Although there are several published studies on obstetric critical care from India and abroad, studies from Eastern India are limited. The present study was conducted to fill in this lacuna and to audit the obstetric critical care admissions over a 5 years' period...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28561243/pulmonary-disease-and-critical-illness-in-pregnancy
#9
Ghada Bourjeily, Andrew Levinson
No abstract text is available yet for this article.
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28416778/steroid-pulse-therapy-for-de-novo-minimal-change-disease-during-pregnancy
#10
Hiroshi Sato, Yuna Asami, Reona Shiro, Masato Aoki, Miki Yasuda, Saeko Imai, Rie Sakai, Kenji Oida, Kanako Kawaharamura, Hiroko Yano, Nao Taguchi, Takako Suzuki, Masaya Hirose
BACKGROUND Nephrotic syndrome occurs very rarely, in only about 0.01%-0.02% of all pregnancies, and de novo minimal change disease during pregnancy is especially rare. Nephrotic syndrome and, especially, minimal change disease are highly responsive to steroids, and preterm labor may be avoidable if the maternal condition is improved with steroid therapy. Therefore, prompt diagnosis and proper management are critical to maternal and fetal outcome when severe proteinuria occurs during pregnancy. CASE REPORT A 30-year-old pregnant Japanese woman presented with systemic edema, oliguria, and severe proteinuria and hypoalbuminemia at 25 weeks of gestation, although she was normotensive...
April 18, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28377467/safety-with-echocardiographic-contrast-agents
#11
REVIEW
Preetham R Muskula, Michael L Main
In October 2007, the Food and Drug Administration mandated significant revisions to product labeling for the commercially available echocardiographic contrast agents (ECA) Definity and Optison after spontaneous healthcare provider reports of 4 patient deaths and ≈190 severe cardiopulmonary reactions occurring in close temporal relationship to ECA administration. Since then, multiple large ECA safety studies have been published and have included outpatients, hospitalized patients (including the critically ill), patients undergoing stress echocardiography, and patients with pulmonary hypertension...
April 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#12
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28190440/neurologic-complications-in-critically-ill-pregnant-patients
#13
W L Wright
Neurologic complications in a critically ill pregnant woman are uncommon but some of the complications (such as eclampsia) are unique to pregnancy and the puerperal period. Other neurologic complications (such as seizures in the setting of epilepsy) may worsen during pregnancy. Clinical signs and symptoms such as seizure, headache, weakness, focal neurologic deficits, and decreased level of consciousness require careful consideration of potential causes to ensure prompt treatment measures are instituted to prevent ongoing neurologic injury...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28178063/detecting-pulmonary-edema-in-obstetric-patients-through-point-of-care-lung-ultrasonography
#14
Sarah Pachtman, Seth Koenig, Natalie Meirowitz
BACKGROUND: Point-of-care lung ultrasonography is used in critical care settings for evaluating respiratory symptoms. Lung ultrasonography is sensitive and specific for the diagnosis of pulmonary edema in nonpregnant patients but is not well-studied in pregnancy. TECHNIQUE: Lung ultrasonography was performed using a portable ultrasound machine with a 2- to 5-MHz curvilinear probe that is available on many labor and delivery units. EXPERIENCE: Lung ultrasonography guided management decisions in a case of shortness of breath after induction of labor for preeclampsia and a case of hemolysis, elevated liver enzymes, and low platelet count syndrome complicated by pulmonary edema...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28125983/fathers-views-and-experiences-of-their-own-mental-health-during-pregnancy-and-the-first-postnatal-year-a-qualitative-interview-study-of-men-participating-in-the-uk-born-and-bred-in-yorkshire-baby-cohort
#15
Z Darwin, P Galdas, S Hinchliff, E Littlewood, D McMillan, L McGowan, S Gilbody
BACKGROUND: The prevalence of fathers' depression and anxiety in the perinatal period (i.e. from conception to 1 year after birth) is approximately 5-10%, and 5-15%, respectively; their children face increased risk of adverse emotional and behavioural outcomes, independent of maternal mental health. Critically, fathers can be protective against the development of maternal perinatal mental health problems and their effects on child outcomes. Preventing and treating paternal mental health problems and promoting paternal psychological wellbeing may therefore benefit the family as a whole...
January 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28098573/managing-maternal-sepsis-early-warning-criteria-to-ecmo
#16
Cesar Padilla, Arvind Palanisamy
Maternal sepsis is now a leading cause of direct maternal death during pregnancy. This review addresses the latest advances in the identification and management of critically ill parturients. Specifically, this review will focus on the vulnerability of pregnant women to sepsis, the utility of early warning criteria in the identification of the septic parturient, emphasize the immediate antibiotic management of suspected sepsis, and elaborate upon the latest understanding in the ventilatory management of parturients with sepsis...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28079560/prenatal-exposures-and-the-development-of-childhood-wheezing-illnesses
#17
REVIEW
Christian Rosas-Salazar, Tina V Hartert
PURPOSE OF REVIEW: To critically evaluate and summarize studies published between July 2015 and June 2016 linking prenatal exposures and the onset of childhood wheezing illnesses and to discuss future research directions in this field. RECENT FINDINGS: The aggregated evidence indicates a consistent detrimental effect of prenatal exposure to parental smoking, outdoor air pollution, and maternal stress on childhood wheezing illnesses. Less consistent evidence suggests an adverse impact of maternal obesity during pregnancy and prenatal exposure to antibiotics on these outcomes...
April 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27995360/a-european-society-of-paediatric-and-neonatal-intensive-care-espnic-survey-of-european-critical-care-management-of-young-people
#18
R Tuckwell, D Wood, S Mansfield-Sturgess, J Brierley
Adolescents have specific healthcare needs distinct from adults or younger children secondary to anatomical, physiological and socio-behavioural differences. Healthcare providers have been slow to address this, leading the UK Department of Health (2011) to publish 'You're Welcome' quality criteria for services for young people. (In the UK, the term young people is preferred to adolescent.) These generic criteria poorly fit the critical care environment, omitting key issues whilst insisting upon irrelevant standards...
February 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27969556/severe-staphylococcus-aureus-endocarditis-presenting-as-peripartum-thrombotic-thrombocytopenic-purpura
#19
Kieran L Quinn, Mark Osmond, Mitesh Badiwala, Mathew Sermer, Stephen E Lapinsky
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a life-threatening illness that occurs in both pregnant and non-pregnant women. Several other conditions can mimic the disease, which makes the diagnosis challenging. CASE: We describe a case of severe Staphylococcus aureus endocarditis that initially presented as peripartum TTP in a 39-year-old woman at 29+6 weeks' gestation. We give an overview of the diagnostic considerations and management of thrombocytopenia in pregnancy and review the literature related to TTP and peripartum infective endocarditis...
November 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
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