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guidelines cholestasis of pregnancy

Diane Nzelu, Dan Dumitrascu-Biris, Katharine F Hunt, Mark Cordina, Nikos A Kametas
OBJECTIVES: In pregnant women with previous gestational hypertension: to compare the prevalence of preeclampsia as defined by the 2001 versus the 2014 International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria, to determine the rates of fetal growth restriction (FGR) as defined, not only by birthweight centile, but in combination with fetal ultrasound studies and, finally, to determine rates of other related outcomes such as gestational diabetes (GDM) and obstetric cholestasis (OC)...
November 4, 2017: Pregnancy Hypertension
Andreas E Kremer, Barbara Namer, Ruth Bolier, Michael J Fischer, Ronald P Oude Elferink, Ulrich Beuers
Pruritus is a preeminent symptom in patients with chronic cholestatic liver disorders such as primary biliary cirrhosis and primary sclerosing cholangitis. More than two-thirds of these patients experience itching during the course of their disease. This symptom is also frequently observed in patients with other causes of cholestasis such as cholangiocarcinoma, inherited forms of cholestasis and intrahepatic cholestasis of pregnancy, but may accompany almost any other liver disease. The pathogenesis of pruritus of cholestasis remains largely elusive...
2015: Digestive Diseases
M Doret
OBJECTIVES: To propose guidelines for clinical practice for routine postnatal visit and after pathological pregnancies. MATERIALS AND METHODS: Bibliographic searches were performed with PubMed and Cochrane databases, and within international guidelines references. RESULTS: Postpartum visit should be planned 6 to 8 weeks after delivery and can be performed by an obstetrician, a gynecologist, a general practitioner or a midwife, when after normal pregnancy and delivery (Professional consensus)...
December 2015: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Hongbo Qi, Xinghui Liu
No abstract text is available yet for this article.
July 2015: Zhonghua Fu Chan Ke za Zhi
(no author information available yet)
No abstract text is available yet for this article.
July 2015: Zhonghua Fu Chan Ke za Zhi
A Khalil, Asma Khalil, Argyro Syngelaki, Juliana Rezende, Kypros H Nicolaides
INTRODUCTION: Women who develop pregnancy complications are more likely to develop cardiovascular disorders later in life. A history of pre-eclampsia (PE) is associated with a four-fold increased risk of hypertension and twice the risk of future ischaemic heart disease and stroke. Early identification of women at risk of developing pregnancy complications is likely to facilitate targeted antenatal surveillance and possibly intervention. Maternal ethnicity affects the risk of developing some of these complications, and so is likely to be an important variable in the risk assessment...
July 2012: Pregnancy Hypertension
A Bilger, J Pottecher, M Greget, E Boudier, P Diemunsch
We report the case of a 36-year-old woman with an inferior vena cava thrombosis and extensive pulmonary embolism six days after a severe postpartum haemorrhage. She had undergone caesarean section with bleeding managed by massive transfusion, hysterectomy, and two attempts at uterine artery embolization. Systemic thrombolysis and catheter-directed thrombolysis in intensive care were abandoned due to recent and incomplete uterine artery embolization. A temporary inferior vena cava filter was chosen because of significant risk of massive pulmonary embolism...
November 2014: International Journal of Obstetric Anesthesia
Andreas E Kremer, Ruth Bolier, Remco van Dijk, Ronald P J Oude Elferink, Ulrich Beuers
Chronic pruritus is a burdensome feature of numerous hepatobiliary disorders such as primary biliary cirrhosis, primary sclerosing cholangitis, cholangiocarcinoma, inherited forms of cholestasis and intrahepatic cholestasis of pregnancy. Bile salts, μ-opioids, serotonin, histamine and steroids have been controversially discussed in the pathogenesis of cholestatic pruritus. However, for these substances neither a correlation with itch severity nor a causative link has ever been established. Recent findings indicate that the potent neuronal activator lysophosphatidic acid and autotaxin, the enzyme forming lysophosphatidic acid, may play a key element in the pathogenesis of cholestatic pruritus...
2014: Digestive Diseases
Ulrich Beuers, Andreas E Kremer, Ruth Bolier, Ronald P J Oude Elferink
Pruritus is a common symptom in patients with cholestatic liver diseases such as primary biliary cirrhosis, primary sclerosing cholangitis, intrahepatic cholestasis of pregnancy, or hereditary pediatric cholestatic disorders and may accompany, although less frequently, many other liver diseases. Recent findings indicate that lysophosphatidic acid (LPA), a potent neuronal activator, and autotaxin (ATX; ectonucleotide pyrophosphatase/phosphodiesterase 2), the enzyme which forms LPA, may form a key element of the long-sought pruritogenic signaling cascade in cholestatic patients suffering from itch...
July 2014: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Hina Kato, Sakiko Fujii, Mika Takahashi, Mariko Matsumoto, Mutsuko Hirata-Koizumi, Atsushi Ono, Akihiko Hirose
Perfluoroalkyl carboxylic acids (PFCAs) are a series of environmental contaminants that have received attention because of their possible adverse effects on wildlife and human health. Although many toxicological studies have been performed on perfluorooctanoic acid with carbon chain length C8, available toxicity data on PFCAs with longer chains are still insufficient to evaluate their hazard. A combined repeated dose and reproductive/developmental toxicity screening study for perfluorododecanoic acid (PFDoA; C12) was conducted in accordance with OECD guideline 422 to fill these toxicity data gaps...
November 2015: Environmental Toxicology
Chris Arthur, Kassam Mahomed
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is an uncommon obstetric condition characterised by intense maternal pruritis and biochemical abnormality. There is a degree of contention regarding the diagnosis and management of ICP, and currently, there are no nationally accepted guidelines. AIMS: To conduct a survey of Fellows and Members of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) regarding their diagnosis and management ICP...
June 2014: Australian & New Zealand Journal of Obstetrics & Gynaecology
Dinamene Santos, Camila Batoreu, Luisa Mateus, A P Marreilha Dos Santos, Michael Aschner
The iatrogenic risks associated with excessive Mn administration in parenteral nutrition (PN) patients are well documented. Hypermanganesemia and neurotoxicity are associated with the duration of Mn supplementation, Mn dosage, as well as pathological conditions, such as anemia or cholestasis. Recent PN guidelines recommend the biomonitoring of patients if they receive Mn in their PN longer than 30 days. The data in the literature are conflicting about the method for assessing Mn stores in humans as a definitive biomarker of Mn exposure or induced-neurotoxicity has yet to be identified...
July 2014: Neurotoxicology
Céline J Fischer, Myriam Bickle Graz, Vincent Muehlethaler, David Palmero, Jean-François Tolsa
AIMS: As growing concerns exist regarding phthalate exposure, which could be teratogenic, carcinogenic or induce reproductive toxicity, we aimed to review the evidence of the risks due to the use of medical devices containing di(2-ethylhexyl)phthalate in hospitalized neonates. METHODS: We reviewed the literature, searching through medical literature databases (Pubmed, MEDLINE, EBM reviews, Cochrane database, Embase and Google Scholar) using the following keywords: phthalate, di(2-ethylhexyl)phthalate, newborn and neonate...
September 2013: Journal of Paediatrics and Child Health
Bozena Leszczyńska-Gorzelak, Jan Oleszczuk, Beata Marciniak, Ryszard Poreba, Przemysław Oszukowski, Mirosław Wielgoś, Krzysztof Czajkowski
Intrahepatic Cholestasis of Pregnancy (ICP) constitutes the most common, reversible liver disease closely connected with pregnancy and spontaneously resolving in puerperium. ICP usually reoccurs in consecutive pregnancies (45-90%), often in a more intensified form. Many compounds (hormones, cytokines, medicines, endotoxins) can impair transport in the hepatocyte, disturb the intracellular transport and increase the permeability of the intercellular connections. As a result, the elements of bile may appear in the peripheral blood...
September 2012: Ginekologia Polska
Anni Mölsä, Kaisa Turunen, Kari J Mattila, Markku Sumanen
BACKGROUND: As conceptions have changed regarding the suitability of oral contraceptives for women with a history of intrahepatic cholestasis of pregnancy (ICP), we studied whether the contraindications formerly in force had affected family planning decisions and mode of contraception among women with such a history. STUDY DESIGN: ICP women and their controls who gave birth in 1969-1988 in Tampere University Hospital, Finland, were sent a questionnaire in 2010. The inquiry covered items concerning contraception, deliveries, menstruation and sex life...
December 2012: Contraception
Lucy C Chappell, Vinita Gurung, Paul T Seed, Jenny Chambers, Catherine Williamson, James G Thornton
OBJECTIVES: To test whether ursodeoxycholic acid reduces pruritus in women with intrahepatic cholestasis of pregnancy, whether early term delivery does not increase the incidence of caesarean section, and the feasibility of recruiting women with intrahepatic cholestasis of pregnancy to trials of these interventions. DESIGN: First phase of a semifactorial randomised controlled trial. SETTING: Nine consultant led maternity units, United Kingdom...
June 13, 2012: BMJ: British Medical Journal
C Arlicot, A Le Louarn, Y Bacq, J Potin, C Denis, F Perrotin
OBJECTIVE: Intrahepatic cholestasis of pregnancy (ICP) is the most commonly encountered pregnancy-specific liver disease. This condition, with no proven maternal morbidity, has been associated with an increased risk of prematurity and intrauterine fetal death. There is, to date, no scientific obstetrical guideline for clinical practice in France. The objective of our study was to precise, in this situation, how French obstetricians manage patients suffering from ICP. METHODS: We carried out, during 2010, a national descriptive practice survey of ICP management in France in association with the "Collège national des gynécologues-obstétriciens français"...
April 2012: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Albert J Czaja
Autoimmune hepatitis has diverse clinical phenotypes that challenge conventional diagnostic criteria and treatment strategies. The goals of this review are to characterize these special populations and provide guidelines for their management. Patients with acute or acute severe (fulminant) presentations may have centrilobular zone 3 hepatic necrosis, but they can respond to conventional corticosteroid therapy. Asymptomatic mild disease warrants corticosteroid treatment because spontaneous resolution is uncertain and 10-year survival is less than expected...
December 2011: Best Practice & Research. Clinical Gastroenterology
(no author information available yet)
No abstract text is available yet for this article.
August 2009: Journal of Hepatology
C Bartz, W Rath
The HELLP syndrome as part of the microangiopathic syndromes requires special attention in terms of a rapid and accurate diagnostic and differential diagnostic workup because of its possibly rapid clinical deterioration. It is defined by the classical triad of hemolysis,elevated liver enzymes and low platelet counts which may lead to prognostically relevant problems in differentiating it from thrombotic-thrombocytopenic purpura and hemolytic-uremic syndrome and other pregnancy-related and unrelated liver diseases, i...
2007: Gynäkologisch-geburtshilfliche Rundschau
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