scholarly journals Successful use of CPAP in a pregnant patient with COVID-19 pneumonia

2021 ◽  
Vol 14 (3) ◽  
pp. e238055
Author(s):  
Maxine Reindorf ◽  
Joseph Newman ◽  
Tejas Ingle
Keyword(s):  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Pregnant Patient ◽  
Shortness Of Breath ◽  
Short History ◽  
Trial Treatment ◽  
History Of ◽  
Robust Evidence ◽  
In Pregnancy

A 35-year-old nurse, who was 27 weeks pregnant at the time, was admitted to hospital with a short history of cough, fever and worsening shortness of breath. Oral and nasopharyngeal swabs were positive for SARS-CoV-2 on real-time viral PCR. During her admission, her breathing further deteriorated and she developed type 1 respiratory failure. A decision was made to trial treatment with continuous positive airway pressure (CPAP) as a means of avoiding intubation. The patient tolerated this well and made rapid improvements on this therapy. She was quickly weaned off and fully recovered before being discharged home. This case highlights the potential for CPAP to be used as a means of avoiding mechanical ventilation and iatrogenic preterm birth in COVID-19 pneumonia in pregnancy. Furthermore, it highlights the need for robust evidence to support this treatment.

scholarly journals When the Uterus Competes for Perfusion: Management of a Pregnant Patient with Bypass Graft Occlusion

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Sarah McGriff ◽  
Paige Percer ◽  
Iberia Sosa ◽  
Hector Mendez-Figueroa ◽  
Joseph L. Mills ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Bypass Graft ◽  
Pregnant Patient ◽  
Arterial Disease ◽  
Graft Occlusion ◽  
Left Lower Extremity ◽  
Ct Angiogram ◽  
History Of ◽  
Peripheral Arterial ◽  
In Pregnancy

Background. Peripheral arterial disease (PAD) in pregnancy has serious implications and requires multidisciplinary management. This becomes even more complicated in the setting of active disease and history of prior vascular grafts. Case. A woman presented with increasing left lower extremity pain at 18 weeks of gestation with a complex history of PAD and a previous bifurcated aorta-left femoral, -right iliac bypass. CT angiogram demonstrated known occluded bypass graft. A multidisciplinary team of providers developed guidelines for potential surgical intervention based upon clinical symptoms. Conclusion. Pelvic PAD can worsen in pregnancy in the setting of the enlarging uterus, which can potentially deplete perfusion of existing collateral vessels. Symptomatic approach to worsening disease provided an effective management strategy in this case.

Varicella zoster meningitis in a pregnant woman with uncontrolled type 1 diabetes mellitus

2021 ◽  
Vol 14 (2) ◽  
pp. e236644
Author(s):  
Laura Mroue ◽  
Harpreet Brar ◽  
Bernard Gonik
Keyword(s):  
Medical Literature ◽  
Pregnant Patient ◽  
Cerebrospinal Fluid Analysis ◽  
Neck Stiffness ◽  
Varicella Zoster ◽  
Fluid Analysis ◽  
First Case ◽  
The Us ◽  
History Of

We report the case of retrograde varicella zoster virus (VZV) reactivation presenting as aseptic meningitis without rash in a generally healthy pregnant patient. A 27-year-old nulliparous woman at 25 weeks of gestation presented to the emergency department with a 1-day history of severe headache associated with nausea, photophobia and neck stiffness. After ruling out a space-occupying lesion by brain imaging, lumbar puncture was performed. Cerebrospinal fluid analysis by PCR revealed the presence of VZV, making the diagnosis of acute varicella meningitis. The patient had immunoglobulin studies consistent with a history of primary VZV infection, thus confirming reactivation of VZV rather than primary infection. The patient was treated with acyclovir for 14 days and recovered fully. Her neonate was delivered full term without any evidence of vertical transmission. This is only the second reported case of VZV meningitis in a pregnant patient in the medical literature, and the first case in the US that was reported.

scholarly journals Unilateral Pulmonary Artery Aplasia in a Pregnant Patient

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Chitra Lal ◽  
Jim Barker ◽  
Charlie Strange
Keyword(s):  
Pulmonary Hypertension ◽  
Chest Pain ◽  
Pulmonary Artery ◽  
Case Reports ◽  
Pregnant Patient ◽  
Pregnant Female ◽  
Prospective Evaluation ◽  
Rare Anomaly ◽  
History Of ◽  
In Pregnancy

Unilateral pulmonary artery aplasia is a rare anomaly. Case reports of this condition in pregnant patients are even more uncommon and the best approach to management of such patients is still unclear. We report a patient who presented with a history of dyspnea, chest pain, and hemoptysis. Imaging established the diagnosis in a newly pregnant female. Management of the pulmonary artery aplasia patient in pregnancy requires prospective evaluation of pulmonary hypertension.

scholarly journals A Case of Babesiosis in a Pregnant Patient Treated with Red Blood Cell Exchange Transfusion

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Baruch Abittan ◽  
Aaron Nizam ◽  
Michael Oey ◽  
Felicia Callan ◽  
Lisa Simmonds ◽  
...  
Keyword(s):  
United States ◽  
Blood Cell ◽  
Gestational Age ◽  
Red Blood Cell ◽  
Exchange Transfusion ◽  
Pregnant Patient ◽  
Babesia Microti ◽  
History Of ◽  
Safe Treatment Option ◽  
In Pregnancy

Babesiosis, caused predominantly by Babesia microti, is an emerging health risk in the Northeastern and Midwestern United States. We present a case of a pregnant woman with history of splenectomy diagnosed with babesiosis at 23 5/7 weeks of gestational age refractory to antimicrobial therapy. She underwent the first reported red blood cell exchange transfusion for babesiosis in pregnancy, at 24 4/7 weeks of gestational age, which resulted in resolution of parasitemia. She had a full term, uncomplicated cesarean delivery. Exchange transfusion is potentially a safe treatment option for severe babesiosis infection in pregnancy and should be considered when other methods are poorly tolerated or ineffective.

Successful management of subglottic stenosis in pregnancy

2021 ◽  
Vol 14 (3) ◽  
pp. e236466
Author(s):  
Shenghao Fang ◽  
Poonam Pai B H
Keyword(s):  
Multidisciplinary Approach ◽  
Postoperative Management ◽  
Subglottic Stenosis ◽  
Routine Practice ◽  
Shortness Of Breath ◽  
Successful Management ◽  
The Past ◽  
Surgical History ◽  
History Of ◽  
In Pregnancy

Evaluation and management of subglottic stenosis in pregnancy is challenging. It often is not only a multidisciplinary approach between obstetricians, otolaryngologists (ENT surgeons) and anesthesiologists, but also requires a thorough understanding of possible foreseen complications by the patient as well. Hence, whenever we are presented with a challenging case requiring multidisciplinary approach involving team of physicians from different specialties, it is routine practice to huddle regarding the preoperative, intraoperative and postoperative management and care. We present a case of a 37-year-old woman with a known history of idiopathic subglottic stenosis, 16 weeks’ pregnant, G4P1, with a surgical history significant for two previous subglottic dilations in the past and who now presented with an audible stridor and shortness of breath on activity. We highlighted the unique challenges encountered and the corresponding management adopted. This is a case of successful management of symptomatic worsening of subglottic stenosis managed during pregnancy.

Thromboembolic disorders in pregnancy

2016 ◽  
Author(s):  
Salma Ballal ◽  
Ian A. Greer
Keyword(s):  
Risk Factors ◽  
Low Molecular Weight Heparin ◽  
Pregnant Patient ◽  
Western World ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
History Of ◽  
Problem Awareness ◽  
Deep Vein ◽  
In Pregnancy

Thromboembolism in pregnancy remains a major cause of direct maternal mortality in the Western world. Thromboembolic events in pregnancy are spread across the three trimesters but the puerperium is the time of greatest risk with a relative risk of around 20-fold compared to the non-pregnant patient. When compared to the non-pregnant population where distal deep vein thrombosis is most common, most events in pregnancy are iliofemoral and left sided. Given the multi-hit nature of the problem, awareness of risk factors is important. The two most significant single risk factors in pregnancy for thromboembolism are history of previous venous thromboembolism and thrombophilia. The identification of risk factors will guide the use of thromboprophylaxis and assist diagnosis; however, objective diagnosis is required. Prophylaxis and treatment focuses on low-molecular-weight heparin, which is considered safe in pregnancy.

scholarly journals Anxiety, Prenatal Attachment, and Depressive Symptoms in Women with Diabetes in Pregnancy

2020 ◽  
Vol 17 (2) ◽  
pp. 425 ◽  
Author(s):  
Angela Napoli ◽  
Dorian A. Lamis ◽  
Isabella Berardelli ◽  
Valeria Canzonetta ◽  
Salvatore Sarubbi ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Psychiatric Symptoms ◽  
Depression Scale ◽  
Prenatal Attachment ◽  
Diabetes In Pregnancy ◽  
Interaction Factor ◽  
History Of ◽  
In Pregnancy

The purpose of this study was to evaluate the relationship between anxiety, prenatal attachment, and depressive symptoms among women with diabetes in pregnancy. Participants were 131 consecutive pregnant women between the ages of 20 and 45 with a diagnosis of gestational or pregestational type 1 or type 2 diabetes. Data on previous psychiatric symptoms were obtained from the Anamnestic and Social Questionnaire and the Mini-International Neuropsychiatric Interview (MINI). Information on prenatal attachment was collected using The Prenatal Attachment Inventory (PAI), and The Edinburgh Postnatal Depression Scale (EPDS) assessed depressive symptoms in the third trimester of pregnancy (at a mean of 25 weeks). Results demonstrated that in women affected by diabetes in pregnancy, two facets of prenatal attachment (anticipation, interaction) were negatively correlated with depressive symptoms, and a history of anxiety, assessed with the MINI, moderated the relation between the prenatal attachment interaction factor and depressive symptoms during pregnancy.

scholarly journals Development of bullous lung disease in a patient with severe COVID-19 pneumonitis

2020 ◽  
Vol 13 (10) ◽  
pp. e237455
Author(s):  
Samuel Berhane ◽  
Adam Tabor ◽  
Ajay Sahu ◽  
Anand Singh
Keyword(s):  
Chest Pain ◽  
Continuous Positive Airway Pressure ◽  
Lung Disease ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sudden Onset ◽  
Shortness Of Breath ◽  
The Right ◽  
Safety Netting

A 60-year-old man presented with sudden onset right-sided chest pain and gradually worsening shortness of breath on exertion. Eleven days earlier, he had an admission with COVID-19 pneumonitis requiring 8 days of continuous positive airway pressure. He was tachypnoeic with a respiratory rate of 24 breaths/min, oxygen saturations on room air of 91%. Examination revealed reduced air entry and a resonant percussion note over the right hemithorax. Chest radiograph suggested a complex right pneumothorax; however, a CT chest was notable for widespread right-sided bullous lung disease. After a day of observation on a COVID-19 ward (and a repeat radiograph with a stable appearance), he was discharged with a 2-week follow-up with the respiratory team, safety netting advice and ambulatory oxygen. This case suggests that bullous lung disease may be a complication of severe COVID-19 pneumonitis.

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