scholarly journals PREGNANCY AND CHLOROFORM ANESTHESIA

1912 ◽  
Vol 15 (3) ◽  
pp. 246-258 ◽  
Author(s):  
G. H. Whipple
Keyword(s):  
Liver Injury ◽  
Pregnant Women ◽  
Border Zone ◽  
Premature Delivery ◽  
Human Beings ◽  
Liver Necrosis ◽  
Fetal Organ ◽  
Human Adults ◽  
Normal Human ◽  
Operative Measures

Pregnant dogs are susceptible to chloroform administered shortly before delivery or during labor, and show the same degree of liver injury as normal dogs, or even a somewhat greater one. Chloroform anesthesia may cause more or less hyaline necrosis in the border zone between the maternal and fetal parts of the placenta that may lead to hemorrhage, placental separation, and premature delivery. Chloroform anesthesia causes no injury to the liver of the fetus nor to any other fetal organ, in spite of the fact that it can be demonstrated to be present in these tissues. These experiments raise objections to the use of chloroform in pregnant women where an anesthetic must be continued for half an hour or longer. Chloroform anesthesia may be admissible for the few minutes at the end of the delivery, but when operative measures are necessary, before or after delivery, it is a dangerous anesthetic and surely capable of producing injury to the liver in the manner recognized in the case of normal persons. Objections may be raised to the application of conclusions derived from experiments on dogs to human cases; but the similarity of the effects of chloroform in man and dog surely affords a sound basis of comparison. Two fundamental facts would seem to be now established: (1) Normal human adults may be fatally poisoned (late chloroform poisoning) by chloroform anesthesia of one half to one hour's duration. (2) Normal and pregnant dogs are equally susceptible to late chloroform poisoning, and may be fatally poisoned by an anesthesia of two hours' duration. Hence one may conclude that probably normal and pregnant human beings are equally susceptible to chloroform poisoning, that chloroform anesthesia during any part of the pregnant period is capable of causing liver necrosis, and, consequently, that chloroform is a dangerous anesthetic.

Respect for Human Beings with Intellectual Disabilities

2018 ◽  
Author(s):  
Oliver Sensen
Keyword(s):  
Central Element ◽  
Respect For Persons ◽  
Human Beings ◽  
Intellectually Disabled ◽  
Second Person ◽  
Third Person ◽  
Human Adults ◽  
Normal Human ◽  
Objective Value ◽  
Person Account

Respect for persons is a central element of our ordinary moral views. However, there is a growing demand to include not just normal human adults, but also animals, the environment, and other traditions, etc., and to uphold a unified account of respect that seamlessly includes all of these beings. This chapter argues that this demand is best captured not by a third-person account that grounds the requirement to respect others in an objective value the other possesses, nor in a second-person account, but if one holds that there are internal, first-person reasons to adopt an attitude of respect. This chapter further argues that such reasons can be supported by every major normative outlook, such as Virtue Ethics, Consequentialism, and Deontology. The chapter considers which understanding of respect best fits our intuitions, and it then applies this view to the question of respect for intellectually disabled human beings.

scholarly journals Development of Severe Pathology in Immunized Pregnant Mice Challenged with Lethal Malaria Parasites

2013 ◽  
Vol 81 (10) ◽  
pp. 3865-3871 ◽  
Author(s):  
Shoichiro Mineo ◽  
Mamoru Niikura ◽  
Shin-Ichi Inoue ◽  
Masahiko Kuroda ◽  
Fumie Kobayashi
Keyword(s):  
Liver Injury ◽  
Pregnant Women ◽  
Fatty Infiltration ◽  
Premature Delivery ◽  
Pathological Features ◽  
Placental Pathology ◽  
Content Type ◽  
Enhanced Production ◽  
Increased Risk ◽  
Pregnant Mice

ABSTRACTPregnant women are highly susceptible to malaria infection because of their low immunity and are at increased risk of maternal illness or death, in addition to spontaneous abortion, stillbirth, premature delivery, and low birth weight. However, the detailed pathogenesis of maternal malaria remains unclear. In this study, we evaluated a mouse model that shows similar severe pathological features of pregnant women duringPlasmodium falciparuminfection and investigated the pathogenesis of maternal malaria. Pregnant mice immunized by infection with an attenuated parasite,Plasmodium bergheiXAT, were more susceptible to virulentP. bergheiNK65 challenge/infection than were nonpregnant mice and showed high levels of parasitemia and a poor pregnancy outcome associated with placental pathology, such as accumulation of parasitized red blood cells, in the late phase of pregnancy. Notably, the pregnant immune mice challenged/infected withP. bergheiNK65 developed liver injury associated with microvesicular fatty infiltration in late pregnancy. The pathological features were similar to acute fatty liver of pregnancy. Higher levels of gamma interferon and nitric oxide (NO) were found in plasma from pregnant immune mice infected withP. bergheiNK65 than in plasma from nonpregnant mice. These findings suggest that development of liver injury and placental pathology in pregnant immune mice challenged/infected withP. bergheiNK65 is accompanied by enhanced production of proinflammatory cytokines.

Optimisation of tactics of conducting pregnancy and labours at women after auxiliary reproductive technologies

2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  
Keyword(s):  
Pregnant Women ◽  
Resistance Index ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Premature Delivery ◽  
Control Group ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Placental Blood ◽  
Two Stages

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.

scholarly journals Energy determinants GAPDH and NDPK act as genetic modifiers for hepatocyte inclusion formation

2011 ◽  
Vol 195 (2) ◽  
pp. 217-229 ◽  
Author(s):  
Natasha T. Snider ◽  
Sujith V.W. Weerasinghe ◽  
Amika Singla ◽  
Jessica M. Leonard ◽  
Shinichiro Hanada ◽  
...  
Keyword(s):  
Liver Injury ◽  
Human Liver ◽  
Nuclear Translocation ◽  
Nucleoside Diphosphate Kinase ◽  
Isolated Hepatocytes ◽  
Dependent Manner ◽  
Genetic Modifiers ◽  
C3h Mice ◽  
Normal Human ◽  
Human Livers

Genetic factors impact liver injury susceptibility and disease progression. Prominent histological features of some chronic human liver diseases are hepatocyte ballooning and Mallory-Denk bodies. In mice, these features are induced by 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC) in a strain-dependent manner, with the C57BL and C3H strains showing high and low susceptibility, respectively. To identify modifiers of DDC-induced liver injury, we compared C57BL and C3H mice using proteomic, biochemical, and cell biological tools. DDC elevated reactive oxygen species (ROS) and oxidative stress enzymes preferentially in C57BL livers and isolated hepatocytes. C57BL livers and hepatocytes also manifested significant down-regulation, aggregation, and nuclear translocation of glyceraldehyde 3-phosphate dehydrogenase (GAPDH). GAPDH knockdown depleted bioenergetic and antioxidant enzymes and elevated hepatocyte ROS, whereas GAPDH overexpression decreased hepatocyte ROS. On the other hand, C3H livers had higher expression and activity of the energy-generating nucleoside-diphosphate kinase (NDPK), and knockdown of hepatocyte NDPK augmented DDC-induced ROS formation. Consistent with these findings, cirrhotic, but not normal, human livers contained GAPDH aggregates and NDPK complexes. We propose that GAPDH and NDPK are genetic modifiers of murine DDC-induced liver injury and potentially human liver disease.

Siderocyte Levels in 'Normal' Human Beings

Nature ◽  
1945 ◽  
Vol 155 (3931) ◽  
pp. 270-270 ◽  
Author(s):  
ROBERT A. M. CASE ◽  
VERA N. LADAN ◽  
MARJORIE E. NUTT
Keyword(s):  
Human Beings ◽  
Normal Human

scholarly journals A Novel Nomogram for Predicting the Risk of Premature Delivery Based on the Thyroid Function in Pregnant Women

2022 ◽  
Vol 12 ◽  
Author(s):  
Yu Meng ◽  
Jing Lin ◽  
Jianxia Fan
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Thyroid Function ◽  
Premature Delivery ◽  
Multivariable Logistic Regression Analysis ◽  
Decision Curve Analysis ◽  
Cutoff Values ◽  
Lemeshow Test ◽  
Maternal Thyroid

BackgroundMaternal thyroid dysfunction and autoantibodies were associated with preterm delivery. However, recommendations for cutoff values of thyroperoxidase antibody (TPOAb) positivity and thyroid-stimulating homone (TSH) associated with premature delivery are lacking.ObjectiveTo identify the pregnancy-specific cutoff values for TPOAb positivity and TSH associated with preterm delivery. To develop a nomogram for the risk prediction of premature delivery based on maternal thyroid function in singleton pregnant women without pre-pregnancy complications.MethodsThis study included data from the International Peace Maternity and Child Care Health Hospital (IPMCH) in Shanghai, China, between January 2013 and December 2016. Added data between September 2019 and November 2019 as the test cohort. Youden’s index calculated the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration. Univariate and multivariable logistic regression analysis were used to screen the risk factors of premature delivery. The nomogram was developed according to the regression coefficient of relevant variables. Discrimination and calibration of the model were assessed using the C-index, Hosmer-Lemeshow test, calibration curve and decision curve analysis.Results45,467 pregnant women were divided into the training and validation cohorts according to the ratio of 7: 3. The testing cohort included 727 participants. The pregnancy-specific cutoff values associated with the risk of premature delivery during the first trimester were 5.14 IU/mL for TPOAb positivity and 1.33 mU/L for TSH concentration. Multivariable logistic regression analysis showed that maternal age, history of premature delivery, elevated TSH concentration and TPOAb positivity in the early pregnancy, preeclampsia and gestational diabetes mellitus were risk factors of premature delivery. The C-index was 0.62 of the nomogram. Hosmer-Lemeshow test showed that the Chi-square value was 2.64 (P = 0.955 > 0.05). Decision curve analysis showed a positive net benefit. The calibration curves of three cohorts were shown to be in good agreement.ConclusionsWe identified the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration associated with preterm delivery in singleton pregnant women without pre-pregnancy complications. We developed a nomogram to predict the occurrence of premature delivery based on thyroid function and other risk factors as a clinical decision-making tool.

scholarly journals FOLATE METABOLISM IMPAIRMENT IN SMOKING PREGNANT WOMEN

2013 ◽  
Vol 62 (2) ◽  
pp. 34-42
Author(s):  
Tatyana Valeryevna Semenova ◽  
Yuliya Pavlovna Milyutina ◽  
Aleksandr Vartanovich Arutyunyan ◽  
Olga Nikolayevna Arzhanova
Keyword(s):  
Plasma Level ◽  
Pregnant Women ◽  
Homocysteine Level ◽  
Late Pregnancy ◽  
Folate Metabolism ◽  
Premature Delivery ◽  
Essential Condition ◽  
Delivery Outcome ◽  
Pregnancy And Delivery ◽  
High Smoking Rate

Tobacco smoking is one of the pressing issues of public health. Russia ranks among the countries with a very high smoking rate. Smoking frequency among pregnant women in St. Petersburg is about 26.4%, among which 18.9% of the women smoke every day, and the rest 7.5% of them on the occasion. Complications from pregnancy (threatening miscarriage, premature delivery, anaemia) and from labour and delivery (labour abnormalities) in the smoking women occurs at almost twice the rate in those non-smoking, threatening miscarriage and anaemia notably having a more severe clinical picture and being more reluctant to the therapy. Smoking is one of the risk factors of hyperhomocysteinemia, which is in turn a marker of the folate metabolism impairment in the organism. It has been shown that homocysteine plasma level increases in the smoking pregnant women. Besides, a significant decrease in folate plasma level has been found in the same women. It is a folate deficiency that most of all raises homocysteine level in blood plasma. It has been proved that elevated homocysteine level has a direct toxic effect on the endothelium. Microthrombosis and microcirculation loss result in a series of obstetric complications. In late pregnancy, hyperhomocysteinemia causes chronic fetoplacental insufficiency and chronic intrauterine hypoxia. Therefore, many complications from pregnancy, such as gestosis and fetoplacental insufficiency, are associated with hyperhomocysteinemia, which is most probably caused by the smoking derived folate metabolism impairment. Supplementary folate and vitamin B complex therapy may possibly improve the pregnancy and delivery outcome in the pregnant women with high homocysteine plasma level. This, however, requires supportive clinical trials. Smoking cessation at birth spacing and prevention of hyperhomocysteinemia must be an essential condition for favourable prognosis for pregnancy.

scholarly journals Frequency and Fetomaternal Outcome in COVID 19 Positive Pregnant Women

2021 ◽  
pp. 200-205
Author(s):  
Mehwish Younus ◽  
Urooj Naz ◽  
Aruna Kumari Hira ◽  
Sana Shahmir ◽  
Uroosa Naz ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Maternal Outcome ◽  
Premature Delivery ◽  
Care Hospital ◽  
Observational Cohort ◽  
The Mean ◽  
Adverse Pregnancy ◽  
Antenatal Visits ◽  
High Chance

Objective: To determine the frequency and outcome in pregnant women with COVID-19 infection. Study Design: This is a observational cohort study. Setting: Study carried out at Department of Obstetrics & Gynecology, Civil Hospital, Dow University of health sciences Karachi, from July 2020 to November 2021. Materials & Methods:  The study was conducted in a tertiary care hospital in Karachi. Women having COVID-19 positive status during any stage of their pregnancy having antenatal visits in our hospital were included in our study. Maternal demographics, race, maternal outcome, and neonatal complications were noted on a self-made Performa. Statistical analysis was done by SPSS version 21 and descriptive statistics with frequencies were mainly calculated. Results: During the defined time of 14 months, we had 143 women visiting antenatal outpatient department and were tested positive for COVID-19. Majority of the women were tested for COVID-19 due to symptoms like fever, flu, cough and diarrhea. The mean age of women in our study was found to be 30 ± 6.7 years. The most frequent maternal outcome with SARSCOV-2 was preterm delivery. Out of 143, 27 cases had emergency lower segment C-section.PCR testing of neonates was carried out and 8.39% (n=12) neonates tested positive for SARSCOV-2.  Conclusion: Infection with Covid-19 during pregnancy is associated with adverse pregnancy outcomes. Covid-19  infection can be transmitted to the fetus during pregnancy or childbirth. Neonatal has a high chance of being admitted to the ICU, and women also faces other complications of Covid 19, such as the risk of miscarriage and premature delivery.

scholarly journals Effect of Sulfadoxine-Pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania

2020 ◽  
Author(s):  
Wigilya Padili Mikomangwa ◽  
Omary Minzi ◽  
Ritah Mutagonda ◽  
Vito Baraka ◽  
Eulambius M. Mlugu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Malaria Transmission ◽  
Geometric Mean ◽  
Placental Malaria ◽  
Intermittent Preventive Treatment ◽  
Premature Delivery ◽  
Maternal Anaemia ◽  
Malaria During Pregnancy ◽  
Placental Blood ◽  
Low Malaria Transmission

Abstract Background Malaria in pregnancy increases the risk of deleterious maternal and birth outcomes. The use of ≥3 doses of sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria (IPTp-SP) is recommended for preventing the consequences of malaria during pregnancy. This study assessed the effect of IPTp-SP for prevention of malaria during pregnancy in low transmission settings. Methods A cross-sectional study that involved consecutively selected 1,161 pregnant women was conducted at Mwananyamala regional referral hospital in Dar es Salaam. Assessment of the uptake of IPTp-SP was done by extracting information from antenatal clinic cards. Maternal venous blood, cord blood, placental blood and placental biopsy were collected for assessment of anaemia and malaria. High performance liquid chromatography with ultraviolet detection (HPLC-UV) was used to detect and quantify sulfadoxine (SDX). Dried blood spots (DBS) of placental blood were collected for determination of sub-microscopic malaria using polymerase chain reaction (PCR). Results In total, 397 (34.2%) pregnant women reported to have used sub-optimal doses (≤2) while 764(65.8%) used optimal doses (≥3) of IPTp-SP at the time of delivery. The prevalence of placental malaria as determined by histology was 3.6%. Submicroscopic placental malaria was detected in 1.4% of the study participants. Women with peripheral malaria had six times risk of maternal anaemia than those who were malaria negative (aOR, 5.83; 95% CI, 1.10-30.92; p = 0.04). The geometric mean plasma SDX concentration was 10.76± 2.51μg/mL. Sub-optimal IPTp-SP dose was not associated with placental malaria, premature delivery and fetal anaemia. The use of ≤2 doses of IPTp-SP increased the risk of maternal anaemia by 1.36 fold compared to ≥3 doses (aOR, 1.36; 95%CI, 1.04-1.79; p = 0.02). Conclusion The use of <2 doses of IPTp-SP increased the risk of maternal anaemia. However, sub-optimal doses (≤2 doses) were not associated with increased the risk of malaria parasitaemia, fetal anaemia and preterm delivery among pregnant women in low malaria transmission setting. The use of optimal doses (≥3doses) of IPTp-SP and complementary interventions should continue even in areas with low malaria transmission.

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