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Critical illness in pregnancy

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
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
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
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
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
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...
January 5, 2018: Seminars in Perinatology
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
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
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
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
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
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
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
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
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
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
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
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
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
Ghada Bourjeily, Andrew Levinson
No abstract text is available yet for this article.
April 2017: Seminars in Respiratory and Critical Care Medicine
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