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Medical complications in pregnancy

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https://www.readbyqxmd.com/read/28538012/antiphospholipid-syndrome-an-update-for-clinicians-and-scientists
#1
Andrew P Vreede, Paula L Bockenstedt, Jason S Knight
PURPOSE OF REVIEW: Antiphospholipid syndrome (APS) is a leading acquired cause of thrombosis and pregnancy loss. Upon diagnosis (which is unlikely to be made until at least one morbid event has occurred), anticoagulant medications are typically prescribed in an attempt to prevent future events. This approach is not uniformly effective and does not prevent associated autoimmune and inflammatory complications. The goal of this review is to update clinicians and scientists on mechanistic and clinically relevant studies from the past 18 months, which have especially focused on inflammatory aspects of APS pathophysiology...
May 22, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28532513/barriers-to-utilisation-of-antenatal-care-services-in-south-sudan-a-qualitative-study-in-rumbek-north-county
#2
Calistus Wilunda, Chiara Scanagatta, Giovanni Putoto, Francesca Montalbetti, Giulia Segafredo, Risa Takahashi, Serge André Mizerero, Ana Pilar Betrán
BACKGROUND: Access to adequate antenatal care (ANC) is critical in ensuring a good maternal health and in preventing maternal and neonatal morbidity and mortality. South Sudan has one of the world's poorest health indicators due to a fragile health system and a combination of socio-cultural, economic, and political factors. This study was conducted to identify barriers to utilisation of ANC services in Rumbek North County. METHODS: Using a qualitative design, data were collected through 14 focus group discussions with 169 women and 45 men and 12 key informant interviews with community leaders, staff working in health facilities, and the staff of the County Health Department...
May 22, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28530086/-trial-of-labor-after-cesarean-in-twin-gestations-does-it-increase-maternal-or-neonatal-complications
#3
Hagit Diamant, Rania Okby, Majdi Imterat, Ruslan Sergienko, Eyal Sheiner
OBJECTIVES: To investigate the rate, success and pregnancy outcome following a trial of labor after cesarean (TOLAC) in twin gestations. Study design: A retrospective study including all twin pregnancies with a single prior cesarean delivery between the years 2006 to 2011 was performed. Women with medical indications for cesarean delivery (CD) were excluded. Maternal and neonatal outcomes were compared between women who delivered by CD to those who underwent TOLAC. Stratified analysis using a multiple logistic regression model was performed to control for confounders...
September 2016: Harefuah
https://www.readbyqxmd.com/read/28523440/assessing-and-modifying-coronary-artery-disease-risk-in-women
#4
REVIEW
Amy Sarma, Nandita S Scott
Despite continued advances in the field, cardiovascular disease remains the leading cause of death in women in the USA with an annual mortality rate that has remained higher for women as compared to men. The factors leading to this sex difference remain incompletely understood. Likely contributors include atypical symptoms at presentation and lack of recognition of cardiovascular risk by women and their providers alike. In addition, women have a higher burden of comorbidities at the time of disease diagnosis and can have differential pathophysiological mechanisms of their acute events...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28523313/correlation-of-clinical-and-biological-evidence-a-dominant-therapeutic-element-of-succeeding-in-ectopic-pregnancy
#5
Simona Daniela NeamŢu, Damian DiŢescu, Maria ForŢofoiu, Liliana Stanca, Cristian Tigae, Mihaela Niculescu, Cristian Ovidiu NeamŢu, Maria Magdalena Manolea, Mirela Anişoara Siminel, Leontina Eugenia Şurtea, Adela Valeria NeamŢu, Marius Bogdan Novac, Liviu Vasile, Adrian Gluhovschi
Tubal pathology, smoking, pelvic inflammatory disease, miscarriage, medical or surgical abortion, usage of intrauterine devices (IUDs) for women with salpingitis latent injuries, older than 40 years, are risk factors for ectopic pregnancy. The objective of this study concerns the correlation of the clinical and biological evidence for the early diagnosis of the ectopic pregnancy and, as soon as possible, for the estimation for eventual risk of complications that may appear. The transvaginal ultrasound test, minimal increases in serum beta-human chorionic gonadotropin (β-hCG) dynamics and blood counts are investigations of choice in achieving our objective...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28523061/duel-stage-treatment-for-biliary-cysts-with-cholangitis-during-pregnancy
#6
Baoxing Jia, Ludong Tan, Zhe Jin, Yahui Liu
BACKGROUND & OBJECTIVE: Biliary cysts in pregnant women are a complex medical issue, especially when complicated with cholangitis. It is a serious and life-threatening diagnosis that can seriously endanger both the expectant mother and the fetus. However, during pregnancy, surgical treatment would lead to further complications and higher fetal mortality. Here, we propose a novel therapeutic approach that would be safe for both mother and child during pregnancy, with a definitive treatment postponed until after delivery...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28515945/exposure-to-occupational-hazards-for-pregnancy-and-sick-leave-in-pregnant-workers-a-cross-sectional-study
#7
Jean-Bernard Henrotin, Monique Vaissière, Maryline Etaix, Mathieu Dziurla, Stéphane Malard, Dominique Lafon
BACKGROUND: This study aimed to investigate the association between exposure to occupational hazards for pregnancy and sick leave (SL) in pregnant workers. METHODS: A cross-sectional study was performed in French occupational health services in 2014. Occupational hazards for pregnancy were assessed by occupational health physicians (OHPs). After delivery and at the time of returning to work, 1,495 eligible workers were interviewed by OHPs. Information on SL was self-reported...
2017: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28512085/self-reported-outcomes-and-adverse-events-after-medical-abortion-through-online-telemedicine-population-based-study-in-the-republic-of-ireland-and-northern-ireland
#8
Abigail R A Aiken, Irena Digol, James Trussell, Rebecca Gomperts
Objectives To assess self reported outcomes and adverse events after self sourced medical abortion through online telemedicine.Design Population based study.Setting Republic of Ireland and Northern Ireland, where abortion is unavailable through the formal healthcare system except in a few restricted circumstances.Population 1000 women who underwent self sourced medical abortion through Women on Web (WoW), an online telemedicine service, between 1 January 2010 and 31 December 2012.Main outcome measures Successful medical abortion: the proportion of women who reported ending their pregnancy without surgical intervention...
May 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28506952/retrospective-evaluation-of-pregnant-women-with-celiac-disease
#9
Kemal Beksaç, Gökçen Örgül, Murat Çağan, Ergun Karaağaoğlu, Serap Arslan, Mehmet Sinan Beksaç
OBJECTIVE: To show celiac disease (CD) and its poor pregnancy outcome relationship, and to demonstrate the importance of a gluten-free diet together with low-dose low-molecular-weight heparin (LMWH) and low-dose corticosteroid (LDC) in the management of pregnancies with CD. MATERIAL AND METHODS: This study consisted of 2 groups of patients. Six patients with CD (control group) on a gluten-free diet were monitored during their first pregnancies within the framework of antenatal care program and their pregnancy outcomes were compared with eight poorly-treated pregnant patients with CD (study group) who were referred from other medical institutions...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28506946/maternal-mortality-due-to-hypertensive-disorders-in-pregnancy-childbirth-and-the-puerperium-between-2012-and-2015-in-turkey-a-nation-based-study
#10
Bekir Keskinkılıç, Yaprak Engin-Üstün, Sema Sanisoğlu, Dilek Şahin Uygur, Hüseyin Levent Keskin, Selma Karaahmetoğlu, Ayşe Özcan, Meral Esen, Afra Alkan, Aysun Kabasakal, İrfan Şencan
OBJECTIVE: To analyze maternal deaths in Turkey due to hypertensive disorders. MATERIAL AND METHODS: In this retrospective study 812 maternal deaths were analyzed. Maternal demographic features, presence of antenatal care, medical and obstetric history, mode of delivery, and use emergency antihypertensive therapy were recorded. The delay model for each case was investigated. RESULTS: Hypertensive disorders accounted for 15.5% (n=126) out of all maternal mortality...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28506531/parkinson-s-disease-and-pregnancy-an-updated-review
#11
REVIEW
Mara Seier, Amie Hiller
Pregnancy does not often occur in the setting of Parkinson's disease (PD) as the most common age of onset is beyond the childbearing years, yet management of these two conditions is crucial for the health of both mother and child. Here we review treatment data of PD during pregnancy, primarily from case reports and drug registries, and focus on available evidence regarding the pregnancy risks for patient and fetus. Historically, it was reported that many women had worsening of symptoms during pregnancy but this may be because anti-parkinsonian medications were not recommended or were under dosed...
May 11, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28500781/pregnancy-outcomes-in-simultaneous-pancreas-and-kidney-transplant-recipients-a-national-french-survey-study
#12
G Normand, F Brunner, L Badet, F Buron, M Catton, J Massardier, L Esposito, P Grimbert, G Mourad, J E Serre, S Caillard, G Karam, D Cantarovich, E Morelon, O Thaunat
Simultaneous pancreas and kidney transplantation (SPK) is currently the best therapeutic option for patients with type-1 diabetes and terminal renal failure. Renal transplantation restores fertility enabling women to pursue pregnancies. However, scarcity of available data on pregnancy outcomes in SPK impedes fair medical counseling. Medical files of all pregnancies that lasted ≥3 months among recipients of functional SPK performed between 1990 and 2015 in France were retrospectively analyzed. Twenty-six pregnancies in 22 SPK recipients were identified...
May 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28498817/epigenetic-dynamics-and-interplay-during-spermatogenesis-and-embryogenesis-implications-for-male-fertility-and-offspring-health
#13
REVIEW
Shao-Qin Ge, Sheng-Li Lin, Zheng-Hui Zhao, Qing-Yuan Sun
Mapping epigenetic modifications and identifying their roles in the regulation of spermatogenesis and embryogenesis are essential for gaining fundamental medical understandings and for clinical applications. More and more evidence has shown that specific epigenetic modifications are established during spermatogenesis, which will be transferred into oocyte via fertilisation, and play an important role in the early embryo development. Defects in epigenetic patterns may increase the risk of abnormal spermatogenesis, fertilisation failure, early embryogenesis abnormality and several other complications during pregnancy...
April 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28498066/atrial-fibrillation-in-pregnancy-a-growing-challenge
#14
Vasiliki Katsi, Georgios Georgiopoulos, Maria Marketou, Dimitrios Oikonomou, Fragiskos Parthenakis, Thomas Makris, Petros Nihoyannopoulos, P Vardas, Dimitris Tousoulis
Atrial fibrillation (AF) constitutes a relatively infrequent pregnancy complication, which may be a therapeutic Gordian knot. Indeed, sparse data exist regarding the prevalence, prognosis and management of AF during pregnancy. In general, AF occurs as a benign, self-limited arrhythmia but occasionally may have severe hemodynamic consequences in pregnant patients suffering from heart failure, congenital heart disease, or other comorbidities. Extra-cardiac causes of AF should always be meticulously excluded. Treatment decisions are difficult, since medications may cross placental barrier and potentially affect fetal growth and organogenesis or even result in fetal bradyarrhythmias...
May 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28491128/non-communicable-diseases-during-pregnancy-in-low-and-middle-income-countries
#15
Julia Hussein
Apart from the risks of obstetric complications like haemorrhage and eclampsia, a large number of medical conditions affect pregnancy and result in adverse outcomes for both the mother and offspring. Non-communicable diseases in pregnancy are becoming increasingly important in contributing to death and poor health. Changes in the patterns and distribution of these conditions mean that we need new perspectives and ways of dealing with these challenges for the future. This article reviews the burden of ill-health due to non-communicable diseases during pregnancy in low and middle income countries and presents some paradigms relevant to public health and health system needs of the future...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28486373/medical-and-obstetric-complications-among-pregnant-women-with-liver-cirrhosis
#16
Anna Palatnik, Mary E Rinella
OBJECTIVE: To evaluate clinical characteristics and obstetric outcomes in pregnant women with liver cirrhosis. METHODS: This was a retrospective matched cohort study of women with liver cirrhosis between January 2005 and January 2016 in a university hospital. Women in a case group were matched to women in a control group according to year of delivery, age, body mass index, and parity in a 1:4 ratio. Bivariable and multivariable analyses were performed to compare the prevalence of the primary composite outcome, which included any one of the following: fetal or neonatal demise, placental abruption, preeclampsia, preterm delivery at less than 37 weeks of gestation, and small-for-gestational age neonate between women in the case group and those in the control group...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28482438/-secular-trends-of-institutional-delivery-rate-in-china-from-1996-to-2015
#17
Y Zhang, Y B Zhou, H T Li, Y Q Gao, Y L Zhang, S S Luo, C Y Kang, J M Liu
Objective: To describe the secular trends of institutional delivery (ID) rate in China from 1996 to 2015, and to assess the impacts of national health policies on the ID rate. Methods: Data on the number of live births and IDs for districts/counties in 31 provinces of China was annually collected by the Office for National Maternal & Child Health Statistics of China. Information concerning the relevant policies was from official governmental websites, including the programme to reduce maternal mortality and eliminate neonatal tetanus (2000 to 2008), and ID subsidy programme in rural China (2009 to present)...
May 9, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28467766/was-the-military-operation-protective-edge-a-risk-factor-for-pregnancy-complications
#18
Ohad Gluck, Yossi Mizrachi, Sophia Leytes, Jacob Bar, Michal Kovo
OBJECTIVE: During July-August 2014, the military operation "Protective Edge" presented Israel with a threat of missile attacks. We aimed to investigate the influence of the "Protective Edge" operation on the rate of pregnancy complications among the population exposed to missile attacks, compared to the population not exposed. STUDY DESIGN: This was a retrospective study. Pregnancy outcomes were compared between women who during pregnancy were exposed to the stress of the military operation (exposed group, n=4,673) and gave birth at the Wolfson Medical Center, and women who gave birth in the previous year (unexposed group, n=4,735)...
April 28, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28467617/mode-of-first-delivery-and-severe-maternal-complications-in-the-subsequent-pregnancy
#19
Lotte B Colmorn, Lone Krebs, Kari Klungsøyr, Maija Jakobsson, Anna-Maija Tapper, Mika Gissler, Pelle G Lindqvist, Karin Källen, Karin Gottvall, Per E Bordahl, Ragnheiður I Bjarnadóttir, Jens Langhoff-Roos
INTRODUCTION: Severe obstetric complications increase by the number of previous cesarean deliveries. In the Nordic countries most women have two children. We present the risk of severe obstetric complications at the delivery following a first elective or emergency cesarean and the risk by intended mode of second delivery. MATERIAL AND METHOD: A two-year population-based data-collection of severe maternal complications in women with two deliveries in the Nordic countries (n=213 518)...
May 3, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28467149/is-preterm-placental-calcification-related-to-adverse-maternal-and-foetal-outcome
#20
Ashraf Jamal, Maryam Moshfeghi, Saeedreza Moshfeghi, Nooshin Mohammadi, Elahe Zarean, Nadia Jahangiri
This prospective cohort study aimed to evaluate the role of premature placental calcification in adverse pregnancy outcomes and identify its associated potential risk factors. We consecutively enrolled 293 women who presented to three academic medical centres from September 2011 to March 2013. Participants underwent transabdominal sonographies between 28-36 weeks of gestation in an attempt to determine placental maturity. We compared maternal and foetal outcomes between two groups of women, those with grade III placenta (n = 69) and those without grade III placenta (n = 224)...
May 3, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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