P0133INCREASED INTRA-ABDOMINAL PRESSURE DURING LAPARASCOPIC PNEUMOPERITONEUM ENHANCES ALBUMINURIA VIA RENAL VENOUS CONGESTION, ILLUSTRATING PATHOPHYSIOLOGICAL ASPECTS OF HIGH OUTPUT PREECLAMPSIA

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Melanie Schoutteten ◽  
Dreesen Pauline ◽  
Nele Vande Velde ◽  
Line Heylen ◽  
Iris Kaminski ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Late Onset ◽  
Venous Congestion ◽  
Abdominal Pressure ◽  
Creatinine Ratio ◽  
Post Procedure ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Abdominal Hypertension ◽  
Laparoscopic Assisted ◽  
Relative Change

Abstract Background and Aims Intra-abdominal hypertension (IAH) causes severe organ dysfunction. Our aim is to evaluate the effect of increased intra-abdominal pressure (IAP) on renal function, hypothesizing that venous congestion may increase proteinuria and fluid retention without endothelial dysfunction. Method Three urine samples were collected from 32 non-pregnant women undergoing laparoscopic assisted vaginal hysterectomy (LAVH) and from 10 controls placed in Trendelenburg position for 60 minutes. Urine sampling was done before (PRE), during or immediately after (PER), and two hours after (POST) the procedure. Urinary albumin, protein and creatinine concentrations were measured in each sample, ratios were calculated and compared within and between groups. Results During LAVH, the albumin/creatinine ratio (ACR) increased and persisted POST-procedure, which was not observed in controls. A positive correlation existed between the LAVH duration and the relative change in both ACR and protein/creatinine ratio (PCR) PER- and POST-procedure. Conclusion Iatrogenic IAH increases urinary ACR and PCR in non-pregnant women via a process of venous congestion. This mechanism might explain the presentation of one specific subtype of late-onset preeclampsia, where no drop of maternal cardiac output is observed.

scholarly journals Increased Intra-Abdominal Pressure During Laparoscopic Pneumoperitoneum Enhances Albuminuria via Renal Venous Congestion, Illustrating Pathophysiological Aspects of High Output Preeclampsia

2020 ◽  
Vol 9 (2) ◽  
pp. 487 ◽  
Author(s):  
Pauline Dreesen ◽  
Melanie K. Schoutteten ◽  
Nele Vande Velde ◽  
Iris Kaminski ◽  
Line Heylen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Late Onset ◽  
Venous Congestion ◽  
Abdominal Pressure ◽  
Creatinine Ratio ◽  
Post Procedure ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Abdominal Hypertension ◽  
Laparoscopic Assisted ◽  
Relative Change

Intra-abdominal hypertension (IAH) causes severe organ dysfunction. Our aim is to evaluate the effect of increased intra-abdominal pressure (IAP) on renal function, hypothesizing that venous congestion may increase proteinuria and fluid retention without endothelial dysfunction. Three urine samples were collected from 32 non-pregnant women undergoing laparoscopic-assisted vaginal hysterectomy (LAVH) and from 10 controls placed in Trendelenburg position for 60 min. Urine sampling was done before (PRE), during or immediately after (PER), and two hours after (POST) the procedure. Urinary albumin, protein and creatinine concentrations were measured in each sample, and ratios were calculated and compared within and between groups. During LAVH, the albumin/creatinine ratio (ACR) increased and persisted POST-procedure, which was not observed in controls. A positive correlation existed between the LAVH duration and the relative change in both ACR and protein/creatinine ratio (PCR) PER- and POST-procedure. Iatrogenic IAH increases urinary ACR and PCR in non-pregnant women via a process of venous congestion. This mechanism might explain the presentation of one specific subtype of late-onset preeclampsia, where no drop of maternal cardiac output is observed.

scholarly journals Preeclampsia - abdominal hypertension syndrome in pregnancy. whether a hypothesis will become a theory?

2016 ◽  
Vol 97 (4) ◽  
pp. 638-644
Author(s):  
D V Marshalov ◽  
E M Shifman ◽  
I A Salov ◽  
A P Petrenko
Keyword(s):  
Pregnant Women ◽  
Normal Weight ◽  
Abdominal Pressure ◽  
Time Interval ◽  
Absolute Value ◽  
Abdominal Hypertension ◽  
Placental Blood ◽  
Placental Blood Flow ◽  
Large Representative ◽  
In Pregnancy

Based on the analysis of literature and their own data the authors presented modern aspects of the etiology and pathogenesis of preeclampsia from the perspective of intra-abdominal hypertension syndrome. The data are collected from a large representative sample of 647 patients at various stages of gestation. It was shown that elevated levels of intra-abdominal pressure at 20-24 weeks of pregnancy in some cases preceded the development of preeclampsia. The level of intra-abdominal pressure, preceding the development of preeclampsia in pregnant women with obesity, was significantly higher than that of normal-weight patients (p <0.001). Along with the level of intra-abdominal pressure, the rate of its increase plays an important role in the preeclampsia development, with a greater degree than the absolute value of the intra-abdominal pressure. Pregnant women with a rapid and substantial increase in intra-abdominal pressure (more than 4 mm Hg for 2 weeks of gestation) are more likely to have complications of pregnancy than patients with an increase in intra-abdominal pressure less then 2 mm Hg in a given time interval (p <0.001), while the higher the increase in intra-abdominal pressure, at the earlier stages complication develops. The article also provides information about the dynamics of intra-abdominal pressure during pregnancy, relationships of intra-abdominal hypertension with parameters of utero-placental blood flow, renal hemodynamics, intestinal perfusion and permeability, level of endotoxemia in pregnant women. Based on the results of their own investigations, the authors suggest a model of preeclampsia development as a consequence of intra-abdominal hypertension syndrome.

scholarly journals Influence of vitamin D serum concentration, prenatal care and social determinants on birth weight: a northeastern Brazilian cohort study

2019 ◽  
Vol 122 (03) ◽  
pp. 284-292 ◽  
Author(s):  
Marcos Pereira-Santos ◽  
Gisele Queiroz Carvalho ◽  
Djanilson Barbosa dos Santos ◽  
Ana Marlucia Oliveira
Keyword(s):  
Vitamin D ◽  
Birth Weight ◽  
Prenatal Care ◽  
Serum Concentration ◽  
Pregnant Women ◽  
Social Determinants ◽  
Maternal Education ◽  
Late Onset ◽  
High Birth Weight ◽  
Maternal Vitamin

AbstractThe relationship among social determinants, vitamin D serum concentration and the health and nutrition conditions is an important issue in the healthcare of pregnant women and newborns. Thus, the present study analyses how vitamin D, prenatal monitoring and social determinants are associated with birth weight. The cohort comprised 329 pregnant women, up to 34 weeks gestational age at the time of admission, who were receiving care through the prenatal services of Family Health Units. Structural equation modelling was used in the statistical analysis. The mean birth weight was 3340 (sd 0·545) g. Each nmol increase in maternal vitamin D serum concentration was associated with an increase in birth weight of 3·06 g. Prenatal healthcare with fewer appointments (β −41·49 g, 95 % CI −79·27, −3·71) and late onset of care in the second trimester or third trimester (β −39·24 g, 95 % CI −73·31, −5·16) favoured decreased birth weight. In addition, low socio-economic class and the practice of Afro-Brazilian religions showed a direct association with high vitamin D serum concentrations and an indirect association with high birth weight, respectively. High gestational BMI (β 23·84, 95 % CI 4·37, 43·31), maternal education level (β 24·52 g, 95 % CI 1·82, 47·23) and length of gestation (β 79·71, 95 % CI 52·81; 106·6) resulted in high birth weight. In conclusion, maternal vitamin D serum concentration, social determinants and prenatal care, evaluated in the context of primary healthcare, directly determined birth weight.

scholarly journals Poor Adherence to the Screening-Based Strategy of Group B Streptococcus Despite Colonization of Pregnant Women in Greece

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 418
Author(s):  
Maria Maroudia Berikopoulou ◽  
Aikaterini Pana ◽  
Theodota Liakopoulou-Tsitsipi ◽  
Nikos F. Vlahos ◽  
Vasiliki Papaevangelou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Pregnant Women ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Culture Collection ◽  
Carrier Status ◽  
Cross Sectional ◽  
Screening Guidelines ◽  
Group B

Group B streptococcus (GBS) is a leading cause of serious neonatal infections. Maternal GBS colonization is associated with early- and late-onset neonatal disease (EOD/LOD). In Greece, a screening-based strategy is recommended, in which concurrent vaginal-rectal cultures should be obtained between 36 0/7 and 37 6/7 weeks’ gestation. We sought to examine the level of adherence to the GBS screening guidelines and estimate the prevalence of GBS colonization among pregnant women. Although in Greece the screening-based strategy is followed, we also examined known EOD risk factors and linked them to GBS colonization. A cross-sectional study of 604 women postpartum in three hospitals and maternity clinics was conducted. Following written informed consent, data were collected via a short self-completed questionnaire and review of patients’ records. In 34.6% of the enrolled pregnant women, no culture had been taken. Of the remaining, 12.8% had proper vaginal-rectal sample collections. The overall maternal colonization rate was 9.6%. At least one risk factor for EOD was identified in 12.6% of participants. The presence of risk factors was associated with positive cultures (p = 0.014). The rate of culture collection did not differ between women with or without an EOD risk factor. Adherence to a universal screening of pregnant women with vaginal-rectal cultures was poor. Despite probable underestimation of GBS carrier status, almost 1 in 10 participants were GBS positive during pregnancy. Screening of women with risk factors for EOD should, at least, be prioritized to achieve prevention and prompt intervention of EOD.

Vaginal herniation after secondary laparoscopic assisted vaginal hysterectomy following primary radiochemotherapy for stage IIIA cervical cancer

2008 ◽  
Vol 88 (2) ◽  
pp. 285-286
Author(s):  
Markus Vogt ◽  
Christhardt Köhler ◽  
Simone Marnitz ◽  
Chie Hee Cho ◽  
Malgorzata Lanowska ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Vaginal Hysterectomy ◽  
Stage Iiia ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Laparoscopic Assisted

scholarly journals Pelviscopic Compared to Laparotomic and Vaginal Intrafascial Hysterectomy

1997 ◽  
Vol 3 (4) ◽  
pp. 231-239
Author(s):  
L. Mettler ◽  
N. Lutzewitsch
Keyword(s):  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Surgical Techniques ◽  
Abdominal Hysterectomy ◽  
Supracervical Hysterectomy ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Indications For Operation ◽  
Laparoscopic Assisted ◽  
Benign Disorders ◽  
The University

Between 1993 and 1994, 368 women underwent hysterectomies for benign disorders at the University of Kiel. Of these, 58.7% were performed either by pelviscopic or by laparotomy Classic Intrafascial Supracervical Hysterectomy (CISH). Of the remaining, 14.8% were performed by abdominal hysterectomy, 13.6% by Intrafascial Vaginal Hysterectomy (IVH), 12.2% by Vaginal Hysterectomy (VH), and only 0.05% by Laparoscopic Assisted Vaginal Hysterectomy (LAVH). Comparative data of these six surgical techniques concerning patients characteristics, indications for operation, histological features, blood loss, operating time, hospital stay, uterine weights and postoperatively used analgesics are described.

scholarly journals Genomic and phenotypic characterisation of invasive neonatal and colonising group B Streptococcus isolates from Slovenia, 2001–2018

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tina Perme ◽  
Daniel Golparian ◽  
Maja Bombek Ihan ◽  
Andrej Rojnik ◽  
Miha Lučovnik ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Virulence Factors ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Genomic Diversity ◽  
Neonatal Disease ◽  
Phenotypic Characterisation ◽  
High Prevalence ◽  
Group B ◽  
The Impact

Abstract Background Group B Streptococcus (GBS) is the leading cause of invasive neonatal disease in the industrialized world. We aimed to genomically and phenotypically characterise invasive GBS isolates in Slovenia from 2001 to 2018 and contemporary colonising GBS isolates from screening cultures in 2018. Methods GBS isolates from 101 patients (invasive isolates) and 70 pregnant women (colonising isolates) were analysed. Basic clinical characteristics of the patients were collected from medical records. Antimicrobial susceptibility and phenotypic capsular serotype were determined. Whole-genome sequencing was performed to assign multilocus sequence types (STs), clonal complexes (CCs), pathogenicity/virulence factors, including capsular genotypes, and genome-based phylogeny. Results Among invasive neonatal disease patients, 42.6% (n = 43) were females, 41.5% (n = 39/94) were from preterm deliveries (< 37 weeks gestation), and 41.6% (n = 42) had early-onset disease (EOD). All isolates were susceptible to benzylpenicillin with low minimum inhibitory concentrations (MICs; ≤0.125 mg/L). Overall, 7 serotypes were identified (Ia, Ib, II-V and VIII); serotype III being the most prevalent (59.6%). Twenty-eight MLST STs were detected that clustered into 6 CCs. CC-17 was the most common CC overall (53.2%), as well as among invasive (67.3%) and non-invasive (32.9%) isolates (p < 0.001). CC-17 was more common among patients with late-onset disease (LOD) (81.4%) compared to EOD (47.6%) (p < 0.001). The prevalence of other CCs was 12.9% (CC-23), 11.1% (CC-12), 10.5% (CC-1), 8.2% (CC-19), and 1.8% (CC-498). Of all isolates, 2.3% were singletons. Conclusions A high prevalence of hypervirulent CC-17 isolates, with low genomic diversity and characteristic profile of pathogenicity/virulence factors, was detected among invasive neonatal and colonising GBS isolates from pregnant women in Slovenia. This is the first genomic characterisation of GBS isolates in Slovenia and provides valuable microbiological and genomic baseline data regarding the invasive and colonising GBS population nationally. Continuous genomic surveillance of GBS infections is crucial to analyse the impact of IND prevention strategies on the population structure of GBS locally, nationally, and internationally.

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