Accidentally discovered high INR in pregnancy unmasks an inherited factor VII (FVII) deficiency that is paradoxically associated with thrombotic tendency

2021 ◽  
Vol 14 (2) ◽  
pp. e237781
Author(s):  
Islam Tarek Elkhateb ◽  
Abdalla Mousa ◽  
Riham Mohye Eldeen ◽  
Yssra Soliman
Keyword(s):  
Obese Woman ◽  
Management Plan ◽  
Caesarian Section ◽  
Factor Vii ◽  
Risk Pregnancy ◽  
International Normalised Ratio ◽  
Birth Planning ◽  
Work Up ◽  
Thrombotic Tendency ◽  
In Pregnancy

A 32-year-old multiparous obese woman was referred to our center at 37 weeks of twin gestation. She was referred for birth planning following an accidentally discovered high international normalised ratio (INR) in routine preoperative labs. Her history was significant for recurrent pregnancy-associated deep venous thrombosis as well as two early pregnancy losses. Further work-up revealed transaminitis, mild splenomegaly and high lupus anticoagulant titre. A multidisciplinary team of physicians from the high-risk pregnancy, anaesthesiology, haematology, gastroenterology and hepatology departments put a management plan; it culminated into uncomplicated delivery of the patient by repeated caesarian section. The team was also able to figure out the cause of the patient’s high INR that is associated with thrombophilia rather than haemophilia.

Budd-Chiari syndrome diagnosed with pregnancy in a patient with inherited thrombophilia

2021 ◽  
Vol 14 (1) ◽  
pp. e237761
Author(s):  
Islam Tarek Elkhateb ◽  
Abdalla Mousa ◽  
Ahmed Hashem
Keyword(s):  
Factor V Leiden ◽  
Management Plan ◽  
Factor V ◽  
Budd Chiari Syndrome ◽  
Inherited Thrombophilia ◽  
Safe Delivery ◽  
Vein Thrombosis ◽  
Risk Pregnancy ◽  
Chiari Syndrome ◽  
Work Up

An 18-year-old primigravida was referred to our high risk pregnancy (HRP) department at 34 weeks of gestation for birth panning as she has Budd-Chiari syndrome (BCS). Her history was significant for familial thrombophilia. She had portal hypertension manifestations. Her work-up revealed factor V Leiden gene mutation, hepatic and portal vein thrombosis. A multidisciplinary team of physicians from the gastroenterology and hepatology, haematology and HRP departments puts a management plan; it culminated into safe delivery of the patient at 36 weeks of gestation. The patient was referred to a specialised BCS centre where she had successful liver transplantation done.

scholarly journals Recommendations of the AGG (Task Force for Obstetrics, Section Maternal Diseases) on the Management of Maternal Hepatitis B, C and D Infection in Pregnancy

2021 ◽  
Vol 81 (04) ◽  
pp. 390-397
Author(s):  
Maritta Kühnert ◽  
Sven Kehl ◽  
Ulrich Pecks ◽  
Ute Margaretha Schäfer-Graf ◽  
Tanja Groten ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis B ◽  
Task Force ◽  
Clinical Care ◽  
Diagnostic Procedures ◽  
Routine Clinical Care ◽  
Prenatal Counselling ◽  
Hepatitis Infection ◽  
Birth Planning ◽  
In Pregnancy

AbstractThese statements and recommendations should provide appropriate information about maternal and fetal routes of infection, screening, detection of risk factors, diagnostic procedures, treatment, birth planning and peripartum and postpartum management of maternal hepatitis infection and offer pointers for prenatal counselling and routine clinical care on delivery wards.

scholarly journals Huge symptomatic pedunculated uterine fibroid in pregnancy: Antepartum myomectomy and term delivery at a specialist hospital in Kano, Nigeria

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Iman Usman Haruna ◽  
Jamilu Tukur ◽  
Idris Usman Takai ◽  
Abdullahi Mustapha Miko Mohammed ◽  
Ali Abdurrahman Bunawa
Keyword(s):  
Caesarean Section ◽  
Acute Abdomen ◽  
Live Birth ◽  
Uterine Fibroid ◽  
Recent Literature ◽  
Caesarian Section ◽  
Term Delivery ◽  
In Pregnancy

Myomas are common in pregnancy and can go unnoticed. One in ten patients, however, develops complications that would necessitate their removal. Myomectomy performed at caesarian section had come to the lime light over the last decade and recent literature have shown its safety. There is still paucity of literature on myomectomy performed during pregnancy. Our case was a 25 years old primigravida at 21 weeks with features of acute abdomen secondary to uterine fibroid which was diagnosed during pregnancy. She subsequently had antepartum myomectomy and a live birth at term via caesarean section.

scholarly journals Aplikasi Web Cek Riska sebagai Upaya Meningkatkan Pengetahuan Ibu Mendeteksi Dini Risiko Tinggi Kehamilan

2020 ◽  
Vol 4 (1) ◽  
pp. 215-221
Author(s):  
Ni Luh Putu Martini ◽  
Irna Nursanti ◽  
Giri Widakdo
Keyword(s):  
High Risk ◽  
Experimental Design ◽  
Web Application ◽  
P Value ◽  
Group Design ◽  
Risk Pregnancy ◽  
Before And After ◽  
Quasi Experimental ◽  
The Mean ◽  
In Pregnancy

This study aimed to determine the effect of the risk checks web application on the knowledge of mothers to detect high risk early in pregnancy. The research design used in this study was a quasi-experimental design with one group design without control. The results showed that the mean difference before and after the intervention was 13.00, with a p-value of 0.000. In conclusion, the risk check web application can increase mothers' knowledge to detect high risk early in pregnancy.   Keywords: Web Application, High-Risk Pregnancy

Obesity in pregnancy

2020 ◽  
pp. 439-454
Author(s):  
Huda Al-Foudri ◽  
Stuart Davies ◽  
Abrie Theron
Keyword(s):  
Obese Woman ◽  
Epidemiological Studies ◽  
Morbidly Obese ◽  
Antenatal Screening ◽  
Screening Criteria ◽  
Obesity In Pregnancy ◽  
Labour Ward ◽  
Manual Handling ◽  
Body Mass Index Classification ◽  
In Pregnancy

Epidemiological studies show the incidence of obesity in pregnancy to be increasing, and the management of the morbidly obese woman on labour ward can be a challenge for anaesthetists. The chapter defines obesity, body mass index, classification, and prevalence, and reviews the physiological effects of obesity on the respiratory, cardiovascular, gastrointestinal, renal, endocrine, and haematological systems, as well as pharmacokinetic changes. Both fetal and maternal morbidities are listed followed by management proposals in the antenatal, peripartum, and postpartum periods. This includes antenatal screening, criteria for anaesthetic referral for assessment and what this should include to plan for delivery. Suggestions for management during labour and during an operative delivery are made. Attention is given to the ramped position and enhanced pre-oxygenation prior to induction of general anaesthesia with CPAP and THRIVE. Practical considerations and technical challenges are discussed and include manual handling, IV access, monitoring, regional techniques, and previous bariatric surgery.

Incisional Hernia in Pregnancy

2012 ◽  
Vol 2 (4) ◽  
pp. 60-62
Author(s):  
Sujoy Dasgupta
Keyword(s):  
Risk Factors ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Caesarian Section ◽  
Obstetric Complications ◽  
Optimal Management ◽  
Contributing Factors ◽  
Incisional Hernias ◽  
Pregnant State ◽  
In Pregnancy

Incisional hernias are not rare but obstetric complications due to an incisional hernia are rare. Literature suggests that the incisional hernia following a caesarian section may behave differently from an incisional hernia arising after a surgery in the non-pregnant state. The failure of hernia repair is more frequent in the former. The risk factors and the contributing factors to optimal management of these cases are discussed.

scholarly journals Dyspnoea at Term in an Obese Mother

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Vicky O'Dwyer ◽  
Yvonne O'Brien ◽  
Nadine Farah ◽  
Michael J. Turner
Keyword(s):  
Differential Diagnosis ◽  
Heart Disease ◽  
Obese Woman ◽  
Peripartum Cardiomyopathy ◽  
Morbidly Obese ◽  
Shortness Of Breath ◽  
Healthy Women ◽  
Obese Mother ◽  
Life Threatening ◽  
In Pregnancy

Peripartum cardiomyopathy is a serious, potentially life-threatening heart disease of uncertain aetiology in previously healthy women. We report a morbidly obese woman who presented with peripartum shortness of breath. We discuss the differential diagnosis of dyspnoea in pregnancy and highlight the complexity of care of the morbidly obese woman.

The coagulation factor VII in pregnancy

1984 ◽  
Vol 56 (2) ◽  
pp. 233-241 ◽  
Author(s):  
K. Dalaker and ◽  
H. Prydz
Keyword(s):  
Coagulation Factor ◽  
Factor Vii ◽  
Coagulation Factor Vii ◽  
In Pregnancy

scholarly journals Risk Perception in Pregnancy

2015 ◽  
Vol 20 (2) ◽  
pp. 120-127 ◽  
Author(s):  
Monique Robinson ◽  
Craig E. Pennell ◽  
Neil J. McLean ◽  
Jessica E. Tearne ◽  
Wendy H. Oddy ◽  
...  
Keyword(s):  
Risk Perception ◽  
Prenatal Testing ◽  
Obstetric Care ◽  
Fertility Treatment ◽  
Care Providers ◽  
Perception Of Risk ◽  
Emotional Context ◽  
Risk Pregnancy ◽  
Increased Risk ◽  
In Pregnancy

Despite huge advances in obstetric management and technology in recent decades, there has not been an accompanying decrease in patients’ perception of risk during pregnancy. The aim of this paper is to examine the context of risk perception in pregnancy and what practitioners can do to manage it. The modern pregnancy may induce a heightened perception of risk due to increased prenatal testing and surveillance, medico-legal complexity, fertility treatment, and the increasing use of the internet and social media as a source of information. The consequences of an inflated perception of risk during pregnancy include stress, anxiety, and depression, and these issues may have long-lasting implications for patients, their babies, and their families. There are numerous resilience and vulnerability factors that can help care providers identify those who may be predisposed to increased risk perception in pregnancy, and there is a role for both obstetric care providers and psychologists engaged in obstetric settings to manage and reduce risk perception in patients where possible. Ultimately, the medical management of risk during pregnancy can be complex but a thorough understanding of the social and emotional context can assist providers to support their patients through both high- and low-risk pregnancy and birth.

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