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Medical complications in pregnancy

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https://www.readbyqxmd.com/read/28426127/postpartum-hypertension-etiology-diagnosis-and-management
#1
Kathryn J Sharma, Sarah J Kilpatrick
Importance: Postpartum hypertension complicates approximately 2% of pregnancies and, similar to antepartum severe hypertension, can have devastating consequences including maternal death. Objective: This review aims to increase the knowledge and skills of women's health care providers in understanding, diagnosing, and managing hypertension in the postpartum period. Results: Hypertension complicating pregnancy, including postpartum, is defined as systolic blood pressure 140 mm Hg or greater and/or diastolic blood pressure 90 mm Hg or greater on 2 or more occasions at least 4 hours apart...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28424445/management-of-tachyarrhythmia-during-pregnancy
#2
Emily Ann Enderlin, Khaldia Taufiq Khaled, Luke Oke, Mohammed Madmani, Hakan Paydak
Maternal tachyarrhythmia is a common complication during pregnancy due to hormonal changes that enhance pre-existing arrhythmias or induce new arrhythmias in the presence of congenital heart defects in pregnant females. Presence of tachyarrhythmia during pregnancy poses risk to the mother and fetus, calling for proper treatment with medications. Use of antiarrhythmic drugs in cases of maternal tachyarrhythmia must give due consideration of potential teratogenic side effects. Utilization of antiarrhythmic drugs during pregnancy has been well studied; some result in minimal fetal harm or none at all...
March 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28424040/challenges-of-takayasu-arteritis-in-pregnancy-a-case-report
#3
Sarah Soo-Hoo, Jenny Seong, Brandon R Porten, Nedaa Skeik
Takayasu arteritis is a rare, chronic vasculitis of unknown etiology characterized by inflammation of the aorta and its main branches. Although Takayasu arteritis mostly affects women of childbearing age, there is a paucity in the literature on pregnancy associated with Takayasu arteritis. Pregnant patients are at increased risk of cardiovascular complications, including hypertension and congestive heart failure, which may jeopardize both maternal and fetal outcomes. Furthermore, optimal management has not yet been established for pregnant patients with Takayasu arteritis, posing a clinical challenge...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28420497/radical-trachelectomy-for-early-stage-cervical-cancer-a-case-series-and-literature-review
#4
Chin-Jui Wu, Wen-Chun Chang, Chi-Hau Chen, Chi-An Chen, Su-Cheng Huang, Bor-Ching Sheu
OBJECTIVE: Radical trachelectomy (RT) is an alternative treatment for preserving fertility in patients with cervical cancer. Because women with operable cervical cancer opting for fertility preservation are scarce, few cases have been reported in Taiwan. Here we report our cases series. MATERIALS AND METHODS: We retrospectively evaluated seven patients who underwent vaginal RT and three patients who underwent abdominal RT in a single medical institute for a median follow-up period of 5 years...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28419708/willingness-to-pay-for-a-maternity-waiting-home-stay-in-zambia
#5
Taryn Vian, Emily E White, Godfrey Biemba, Kaluba Mataka, Nancy Scott
INTRODUCTION: Complications of pregnancy and childbirth can pose serious risks to the health of women, especially in resource-poor settings. Zambia has been implementing a program to improve access to emergency obstetric and neonatal care, including expansion of maternity waiting homes-residential facilities located near a qualified medical facility where a pregnant woman can wait to give birth. Yet it is unclear how much support communities and women would be willing to provide to help fund the homes and increase sustainability...
March 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28417064/adenocarcinoma-of-the-lung-presenting-as-thrombotic-thrombocytopenic-purpura
#6
Ahmed Dirweesh, Waqas Siddiqui, Muhammad Khan, Praneet Iyer, Marc Seelagy
Acquired thrombotic thrombocytopenic purpura (TTP) usually presents as severe microangiopathic hemolytic anemia (MAHA) and thrombocytopenia in a previously healthy individual. It occurs in approximately three in one million adults and 1 in 10 million children annually. The incidence is increased in females and blacks. Diagnosing TTP and initiating therapy with plasma exchange is a must to avoid preventable complications. Acquired thromotic microangiopathy has been linked to collagen vascular diseases, use of certain medications, organ transplants, infections, pregnancy and cancer...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28411456/urinary-bladder-injury-during-cesarean-delivery-maternal-outcome-from-a-contemporary-large-case-series
#7
Lina Salman, Shachar Aharony, Anat Shmueli, Arnon Wiznitzer, Rony Chen, Rinat Gabbay-Benziv
BACKGROUND: Urinary bladder injury is a rare complication during cesarean delivery. Little is known on maternal outcome following this injury. OBJECTIVE: To evaluate short and long-term maternal outcome following bladder injury during cesarean delivery. STUDY DESIGN: A retrospective case series of all pregnancies complicated by full-thickness bladder injury during cesarean delivery in a single university affiliated tertiary medical center (August 2007-June 2016)...
April 5, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28403961/vascular-endothelial-growth-factor-antagonist-reduces-the-early-onset-and-the-severity-of-ovarian-hyperstimulation-syndrome
#8
S Jellad, A Haj Hassine, M Basly, A Mrabet, M Chibani, R Rachdi
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) is the most serious complication of controlled ovarian stimulation (COH) during assisted reproductive technology (ART) protocols. This syndrome is a result of ovarian expression of vascular endothelial growth factor (VEGF), which increases vascular permeability. OBJECTIVES: To evaluate the efficiency of prophylactic and therapeutic use of cabergoline in women with higher risk of developing OHSS. MATERIALS AND METHODS: In this prospective randomized study, 146 women undergoing in vitro fertilization (IVF) cycles with GnRH agonist protocols with a higher risk of OHSS diagnosed during the HCG day administration (more than 18 follicles observed larger than 12mm in diameter during COH and/or estradiol levels of 3000-3500pg/ml, previous episodes of OHSS)...
January 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28399813/the-netherlands-chlamydia-cohort-study-neccst-protocol-to-assess-the-risk-of-late-complications-following-chlamydia-trachomatis-infection-in-women
#9
B M Hoenderboom, A A M van Oeffelen, B H B van Benthem, J E A M van Bergen, N H T M Dukers-Muijrers, H M Götz, C J P A Hoebe, A A Hogewoning, F R M van der Klis, D van Baarle, J A Land, M A B van der Sande, M G van Veen, F de Vries, S A Morré, I V F van den Broek
BACKGROUND: Chlamydia trachomatis (CT), the most common bacterial sexually transmitted infection (STI) among young women, can result in serious sequelae. Although the course of infection is often asymptomatic, CT may cause pelvic inflammatory disease (PID), leading to severe complications, such as prolonged time to pregnancy, ectopic pregnancy, and tubal factor subfertility. The risk of and risk factors for complications following CT-infection have not been assessed in a long-term prospective cohort study, the preferred design to define infections and complications adequately...
April 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28399640/associations-of-maternal-testosterone-and-cortisol-levels-with-health-outcomes-of-mothers-and-their-very-low-birth-weight-infants
#10
June Cho, Xiaogang Su, Diane Holditch-Davis
OBJECTIVE: Although the roles of testosterone and cortisol in various health problems have been extensively investigated, little is known about their associations with health outcomes in mothers and their very-low-birth weight (VLBW) infants when maternal testosterone and cortisol are examined together during the postpartum period. METHOD: The 101 mother-VLBW infant pairs were recruited from the neonatal intensive care unit of a tertiary medical center in the southeastern United States...
January 1, 2017: Biological Research for Nursing
https://www.readbyqxmd.com/read/28398707/fetal-exposure-to-montelukast-and-congenital-anomalies-a-population-based-study-in-denmark
#11
Clara Cavero-Carbonell, Anne Vinkel-Hansen, Mª José Rabanque-Hernández, Carmen Martos, Ester Garne
BACKGROUND: The objective was to study pregnancy outcomes between groups of Danish women, with pregnancy ending between 1998 and 2009, according to their exposure to montelukast. METHODS: Cross-sectional observational study in Danish women, selecting live births and stillbirths (Birth Registry) and spontaneous abortions and induced terminations (Patient Registry). Montelukast exposure was obtained from the Prescription Registry (ATC code R03DC03). Exposure period was from 3 months before the last menstrual period until the end of the first trimester...
April 3, 2017: Birth Defects Res
https://www.readbyqxmd.com/read/28397444/catheter-ablation-of-cardiac-arrhythmias-in-pregnancy-without-fluoroscopy-a-case-control-retrospective-study
#12
Edward Koźluk, Agnieszka Piątkowska, Marek Kiliszek, Piotr Lodziński, Sylwia Małkowska, Paweł Balsam, Dariusz Rodkiewicz, Radosław Piątkowski, Dorota Zyśko, Grzegorz Opolski
BACKGROUND: Cardiac arrhythmias are common in pregnant women. In most cases, they do not require treatment other than rest, electrolyte supplementation and avoidance of strong coffee and tea. Persistent arrhythmia or the ventricular rate running at a high frequency may cause hemodynamic deterioration in the fetus or in both the fetus and the mother. OBJECTIVES: The aim of this study was to assess the prevalence and characteristics of arrhythmias in pregnant women who qualified for ablation as well as the feasibility and specific features of these interventions...
January 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28394223/gestational-outcomes-in-patients-with-neuropsychiatric-systemic-lupus-erythematosus
#13
G R de Jesus, B C Rodrigues, M I Lacerda, F C Dos Santos, N R de Jesus, E M Klumb, R A Levy
This study analyzed maternal and fetal outcomes of pregnancies of neuropsychiatric systemic lupus erythematosus patients followed in a reference unit. This retrospective cohort study included 26 pregnancies of patients seen between 2011 and 2015 included with history and/or active neuropsychiatric systemic lupus erythematosus among 135 pregnancies. Three patients had active neuropsychiatric systemic lupus erythematosus at conception, but only one remained with neurological activity during gestation, characteristically related to the inadvertent suspension of medications...
April 2017: Lupus
https://www.readbyqxmd.com/read/28391337/managing-glomerular-disease-in-pregnancy
#14
Michelle A Hladunewich, Kate Bramham, Belinda Jim, Sharon Maynard
Glomerular disease, especially lupus nephritis, is common in young women of childbearing age. As such, practicing nephrologists must have adequate knowledge and expertise to prepare these women for pregnancy, to diagnose and manage the numerous pregnancy-associated complications that are common in this vulnerable patient population and finally to support these young women who often struggle to manage both their young children along with an often onerous chronic disease. In this article we will review the pre-pregnancy counseling these women should ideally receive to allow them to make an informed decision about proceeding with a pregnancy, an approach to the diagnosis of pregnancy-associated worsening of kidney function and proteinuria as well as pregnancy-safe management strategies, including immunosuppression, antihypertensive agents and other medications necessary for the management of nephrotic syndrome...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28390566/vasculitis-and-pregnancy
#15
REVIEW
Leah Machen, Megan E B Clowse
Vasculitis is more often a disease of women beyond their reproductive years, leaving the challenges of pregnancy management difficult to study. Pregnancy complications, including pregnancy loss and preterm birth, are higher among women with all forms of vasculitis. It seems that controlling the disease before pregnancy may improve the chances of pregnancy success. Many medications used for vasculitis are considered low risk in pregnancy, including prednisone, colchicine, azathioprine, and tumor necrosis factor inhibitors...
May 2017: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/28390224/maternal-anxiety-related-to-prenatal-diagnoses-of-fetal-anomalies-that-require-surgery
#16
Abigail B Wilpers, Holly Powell Kennedy, Diane Wall, Marjorie Funk, Mert Ozan Bahtiyar
OBJECTIVES: To investigate maternal anxiety in women with pregnancies complicated by fetal anomalies that require surgery. DESIGN: Prospective comparison pilot study. SETTING: A fetal care center in a Northeastern U.S. academic medical center. PARTICIPANTS: Women in their second or early third trimesters of pregnancy; 19 with pregnancies complicated by fetal anomalies and 25 without. METHODS: After ultrasonography, all participants completed the Spielberger State-Trait Anxiety Inventory and a sociodemographic questionnaire...
April 5, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28389884/gestational-diabetes-mellitus-is-a-significant-risk-factor-for-long-term-ophthalmic-morbidity
#17
Ofer Beharier, Ruslan Sergienko, Roy Kessous, Irit Szaingurten-Solodkin, Asnat Walfisch, Eden Shusterman, Erez Tsumi, Eyal Sheiner
PURPOSE: To investigate whether patients with a history of gestational diabetes mellitus (GDM) have an increased risk for long-term ophthalmic morbidity. METHODS: Design a population-based study compared the incidence of long-term maternal ophthalmic morbidity in a cohort of women with and without a history of GDM. Setting Soroka University Medical Center. PARTICIPANTS: All singleton pregnancies of women who delivered between 1988 and 2013...
April 7, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28384785/maternal-body-mass-index-in-early-pregnancy-and-risk-of-epilepsy-in-offspring
#18
Neda Razaz, Kristina Tedroff, Eduardo Villamor, Sven Cnattingius
Importance: There is growing concern about the long-term neurologic effects of prenatal exposure to maternal overweight and obesity. The causes of epilepsy are poorly understood and, in more than 60% of the patients, no definitive cause can be determined. Objectives: To investigate the association between early pregnancy body mass index (BMI) and the risk of childhood epilepsy and examine associations between obesity-related pregnancy and neonatal complications and risks of childhood epilepsy...
April 3, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28384539/follow-up-after-early-medical-abortion-comparing-clinical-assessment-with-self-assessment-in-a-rural-hospital-in-northern-norway
#19
Carl-Gustav Mählck, Torbjörn Bäckström
OBJECTIVES: A follow-up study was performed on women who had requested medical abortions in a rural hospital in northern Norway to compare clinical assessment with self-assessment of early medical abortion in terms of safety. STUDY DESIGN: During the three-year study period, 392 women requested termination of pregnancy. After excluding those who changed their mind, those who had a spontaneous miscarriage, those who were referred to a central hospital for a two-stage abortion, and those who had the abortion performed surgically, 242 cases remained, and all the medical files were reviewed...
March 29, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28383546/mosaic-trisomy-16-what-are-the-obstetric-and-long-term-childhood-outcomes
#20
Teresa N Sparks, Kao Thao, Mary E Norton
PURPOSE: To evaluate obstetric and neonatal outcomes as well as long-term neurodevelopmental outcomes and quality of life among prenatally detected cases of mosaic trisomy (MT16) and confined placental mosaicism (CPM) for trisomy 16. METHODS: We recruited participants for this cross-sectional study through an international registry of families with children diagnosed with MT16 or CPM. Parents were interviewed about expectations based on prenatal counseling as well as about actual perinatal outcomes, congenital anomalies, medical conditions, and school progress...
April 6, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
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