AKT Answer Relating to Bleeding in Early Pregnancy: AKT Answer Relating to Hypertension in Pregnancy: AKT Answer Relating to Post-Partum Haemorrhage: AKT Answer Relating to Gastro-Intestinal Haemorrhage

Background: Hypertension of pregnancy [office blood pressure (BP) levels≥140/90 mmHg] is fairly common and can affect up to 10% of pregnant women worldwide. Hypertension of pregnancy is an important risk factor for the mother and carries increased morbidity and mortality for the fetus. Women with hypertension of pregnancy have a high-risk for future cardiovascular and renal events. Objectives: To summarize the literature related to several clinical aspects of hypertension in pregnancy and draw clinically meaningful conclusions. Method: We conducted an in-depth review of the literature to retrieve existing data on the definition, epidemiology, classification, and management of hypertension in pregnancy. Results: All pregnant women with hypertension should have a proper diagnostic workup and be treated appropriately. In women with mild hypertension, BP therapeutic target should be set to 110-140/80-85mmHg. In women with severe hypertension, BP should be reduced by at least 25% as soon as possible, and gradually thereafter to normal target levels of <140/105mmHg. In terms of preeclampsia, physicians need to consider potential complications and formulate prevention strategies. The choice of antihypertensive medication is crucial since certain classes can be detrimental to the fetus and should be avoided. Post-partum, the choice of antihypertensive therapy of the mother should take into consideration breastfeeding of the fetus. Given the life-long cardiovascular risk of women with pregnancy hypertension, a regular cardiovascular evaluation is in order. Conclusion: Albeit the antihypertensive treatment exerts significant benefits for both the mother and the baby, several clinical aspects remain un-tackled. More research is needed to further improve the treatment of such disorders.

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Insulinoma in pregnancy (a case presentation and systematic review of the literature)

Rare Tumors ◽

10.1177/2036361320986647 ◽

2021 ◽

Vol 13 ◽

pp. 203636132098664

Author(s):

Eva M Dobrindt ◽

Martina Mogl ◽

Peter E Goretzki ◽

Johann Pratschke ◽

Agata K Dukaczewska

Keyword(s):

Systematic Review ◽

Early Pregnancy ◽

Clinical Presentation ◽

Post Partum ◽

Clinical Signs ◽

Hyperinsulinemic Hypoglycemia ◽

Second Trimester ◽

Review Of The Literature ◽

Case Presentation ◽

In Pregnancy

Insulinomas are rare, benign and functional tumors that coincidentally may become overt during pregnancy or in the post-partum period. As the general symptoms of a pregnancy might cover the clinical presentation, diagnosing remains challenging. We present one additional case of a post-partum insulinoma, combined with a systematic review of the literature to sum up relevant details in diagnosis and treatment. A systematic request of Pubmed/Medline was conducted using the following terms: “insulinoma AND pregnancy” and “insulinoma” for a second request of ClinicalTrials.gov. All publications concerning pregnant or post-partum women with insulinoma were included. Thirty-six cases could be identified for analysis. Each publication was reviewed for demographic, diagnostic and therapeutic data. The most frequent clinical signs were unconsciousness and neurological symptoms. 64.9% were diagnosed during early pregnancy and 35.1% post-partum. 91.9% underwent surgery with a third resected during pregnancy without severe influence on fetal or maternal outcome. Three patients died of metastatic disease or misdiagnosing, two of them miscarried. Insulinoma in pregnancy is rare but should be considered in case of unclear hyperinsulinemic hypoglycemia. Surgery can be performed during the second trimester or post-partum with promising outcome.

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Screening for Hypertension in Pregnancy

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462300012927 ◽

1992 ◽

Vol 8 (S1) ◽

pp. 63-71

Author(s):

Robert L. Goldenberg

Keyword(s):

Blood Pressure ◽

Pregnancy Outcome ◽

Early Pregnancy ◽

Chronic Hypertension ◽

Hypertension In Pregnancy ◽

Decrease Blood Pressure ◽

Poor Pregnancy Outcome ◽

In Pregnancy

AbstractThe literature dealing with screening for hypertension in pregnancy was reviewed. No level of blood pressure or any other factor provides a guarantee of no risk for the development of preeclampsia. However, higher blood pressure in early pregnancy and a failure to decrease blood pressure in midpregnancy are both associated with the development of preeclampsia. The development of proteinuria, rather than the level of blood pressure, is the best predictor of poor pregnancy outcome. Multiparas, especially those with severe chronic hypertension who develop preeclampsia, are at greatest risk of poor pregnancy outcome.

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Critical care management of pulmonary arterial hypertension in pregnancy: the pre-, peri- and post-partum stages

Acute and Critical Care ◽

10.4266/acc.2021.00458 ◽

2021 ◽

Author(s):

Vorakamol Phoophiboon ◽

Monvasi Pachinburavan ◽

Nicha Ruamsap ◽

Natthawan Sanguanwong ◽

Nattapong Jaimchariyatam

Keyword(s):

Critical Care ◽

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Care Management ◽

Post Partum ◽

Hypertension In Pregnancy ◽

Critical Care Management ◽

Pulmonary Arterial ◽

In Pregnancy

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THE EFFECT OF DECREASED HEMOGLOBIN LEVELS AT FIRST TRIMESTER ON MATERNAL AND FETAL OUTCOME – A RETROSPECTIVE STUDY

10.36106/4500798 ◽

2021 ◽

pp. 16-18

Author(s):

Manasa D.R. ◽

Sadananjali Sadananjali ◽

Ramkrishna Yadgude

Keyword(s):

Health Care ◽

Retrospective Study ◽

Birth Weight ◽

Low Birth Weight ◽

Early Pregnancy ◽

Pregnancy Outcomes ◽

Negative Impact ◽

Post Partum ◽

Fetal Mortality ◽

Post Partum Haemorrhage

Background And Objective: Iron deciency anemia, especially during the rst trimester has a more negative impact on both maternal & fetal well being. Commonly associated conditions are post partum haemorrhage, birth asphyxia, preeclampsia, low birth weight, preterm, abortions, still born and many more. Thus the study was aimed to determine the levels of haemoglobin in early pregnancy and effect of pregnancy outcomes at Primary Health Care, Ankalagi, Belagavi. Methodology: A retrospective study was done from 2017 April to May 2020 April for a period of three years at PHC, Ankalagi, Belagavi. Over 718 pregnant women were enrolled. Regular ANC was done. Data was collected on Maternal Age, Body mass Index (BMI), Number of parity and Socio-economic determinants. Other Demographic characteristics included rst trimester haemoglobin levels, gestational age at delivery & mode, birth weight, and pregnancy outcomes were recorded. Hemoglobin levels were estimated by Sahil's hemoglobinometer method. Categorised into four groups a) Normal :more than11g/L b) Mild anemia :9-10.9g/dl c) Moderate anemia (7-8.9g/dl) and d) Severe anemia (<7.0g/dl) Results: Mean age was 18±39 yrs. Nearly 39.75% were anemic in early pregnancy. Mild anemic were 20.75%(149), moderate anemic were18.10%(130)and severe anemic were 0.4%(3)respectively. The pregnancy outcome of low level haemoglobins duing rst trimester showed miscarriage/abortions of about18.79%, LSCS mode of delivery of about 17.02%, low birth weight of about 9.21%, preterm baby of about 2.12%, neonatal admissions of about 2.12%, still born of about 1.06%, and post partum haemorrhage of 1.77% respectively. Conclusion: The above ndings suggests that anemia in rst trimester denitely has negative impact on both maternal &fetal health. Thus adequate iron intake in early trimester (prior to conception) is crucial for healthy pregnancy. It is one of the preventable causes which can decrease the maternal & fetal mortality. Should reinforce the health education from adolescent girls, with regular antenatal check up and active participation of ASHA workers. Mothers should receive appropriate nutritional advice and supplementation at their rst point of contact with health care professionals

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