Maternal depression and foetal responses to novel stimuli: insights from a socio-economically disadvantaged Indian cohort

2014 ◽  
Vol 5 (3) ◽  
pp. 178-182 ◽  
Author(s):  
M. Fernandes ◽  
A. Stein ◽  
K. Srinivasan ◽  
G. Menezes ◽  
M. Renton ◽  
...  

Maternal stress during pregnancy has pervasive effects on stress responsivity in children. This study is the first to test the hypothesis that maternal prenatal depression, as observed in South India, may be associated with how foetuses respond to a potentially stressful stimulus. We employed measures of foetal heart rate at baseline, during exposure to a vibroacoustic stimulus, and post-stimulation, to study patterns of response and recovery in 133 third trimester foetuses of depressed and non-depressed mothers. We show that the association between maternal depression and foetal stress responsivity is U-shaped with foetuses of mothers with high and low depression scores demonstrating elevated responses, and poorer recovery, than foetuses of mothers with moderate levels. The right amount of intra-uterine stimulation is important in conditioning foetuses towards optimal regulation of their stress response. Our results imply that, in certain environmental contexts, exposure to moderate amounts of intra-uterine stress may facilitate this process.

2021 ◽  
Vol 14 (1) ◽  
pp. e236106
Author(s):  
Carolina Smet ◽  
Tatiana Gigante Gomes ◽  
Lurdes Silva ◽  
Júlio Matias

Fibroepithelial polyps are benign lesions that may appear in the vulvovaginal region. They usually occur in women of reproductive age and tend to grow up to 5 cm, but there are some rare cases in which they grow up to 20 cm. We report a case of a 22-year-old woman in the third trimester of her first pregnancy with spontaneous bleeding from a pedunculated mass measuring 15 cm in the widest diameter on the right side of the vulva. Features of this case are discussed as well as its implications, especially regarding the decision of labour. Due to the big size of the mass and its propensity to bleed, we decided to perform an elective caesarean section as well as its excision.


2018 ◽  
Vol 39 ◽  
pp. 185-196 ◽  
Author(s):  
M. Romano ◽  
P. Bifulco ◽  
A.M. Ponsiglione ◽  
G.D. Gargiulo ◽  
F. Amato ◽  
...  

2021 ◽  
Vol 11 (9) ◽  
Author(s):  
Chandan Noel Vincent ◽  
S Elango ◽  
Dinakar Rai ◽  
Sujith Kumar ◽  
Ajay Sivakumar

Introduction:Pregnancy is a physiologically hypercoagulable state and a coronavirus disease 2019 (COVID-19) infection adds to this burden by accentuating the coagulopathy. We report two cases of severe peri-partum COVID infection leading to extremity gangrene secondary to a pro-thrombotic coagulopathy. Case Report:A 37-year-old lady, day-2 postpartum, was brought with severe COVID infection & and respiratory failure. She developed progressive gangrene of the foot. A computed tomography (CT) angiogram confirmed the presence of thrombosis of the left external iliac & and common femoral artery. She was managed with catheter- directed thrombolysis and fasciotomy. The dry gangrene of the foot was managed with a Boyd’s amputation. At 1-year follow-up, she is ambulant with a healthy stump. Case Two: A 34-year-old lady, 36 weeks of gestation, presented with fulminant COVID infection with respiratory failure and pulmonary embolus. The lady developed gangrene of the B/L toes. A CT angiogram revealed thrombosis below the popliteal trifurcation in both limbs along with segmental pulmonary thrombo-embolism involving the right lung and multiple splenic infarcts. She succumbed to the overwhelming infection and sepsis. Discussion:The pathogenesis of coagulopathy in pregnant COVID patients is attributed to the hypercoagulable effect, which leads to thrombo-embolisms and limb ischemia following a cytokine storm syndrome in severe infections. To date, this is the first experience detailing distal limb gangrene in fulminant COVID infection in peri-partum women. Although, cases have been reported on distal limb gangrene in severe COVID infection among non-pregnant individuals. Conclusion:A multidisciplinary team must manage COVID infections in the third trimester. A prompt recognition of any forms of lethal coagulopathy and vigilant treatment will prevent loss of life. Keywords:Coronavirus diseaseCOVID, foot gangrene, pregnancy, coagulopathy.


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